Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
Institute for Health Protection of Mother and Child of Serbia 'Dr Vukan Cupic', Beograd, Serbia.
Arch Dis Child. 2023 Sep;108(9):e15. doi: 10.1136/archdischild-2023-325448. Epub 2023 May 2.
Bronchiolitis is the main acute lower respiratory tract infection in infants. Data regarding SARS-CoV-2-related bronchiolitis are limited.
To describe the main clinical characteristics of infants with SARS-CoV-2-related bronchiolitis in comparison with infants with bronchiolitis associated with other viruses.
SETTING, PATIENTS, INTERVENTIONS: A multicentre retrospective study was conducted in 22 paediatric emergency departments (PED) in Europe and Israel. Infants diagnosed with bronchiolitis, who had a test for SARS-CoV-2 and were kept in clinical observation in the PED or admitted to hospital from 1 May 2021 to 28 February 2022 were considered eligible for participation. Demographic and clinical data, diagnostic tests, treatments and outcomes were collected.
The main outcome was the need for respiratory support in infants testing positive for SARS-CoV-2 compared with infants testing negative.
2004 infants with bronchiolitis were enrolled. Of these, 95 (4.7%) tested positive for SARS-CoV-2. Median age, gender, weight, history of prematurity and presence of comorbidities did not differ between the SARS-CoV-2-positive and SARS-CoV-2-negative infants. Human metapneumovirus and respiratory syncytial virus were the viruses most frequently detected in the group of infants negative for SARS-CoV-2.Infants testing positive for SARS-CoV-2 received oxygen supplementation less frequently compared with SARS-CoV-2-negative patients, 37 (39%) vs 1076 (56.4%), p=0.001, OR 0.49 (95% CI 0.32 to 0.75). They received less ventilatory support: 12 (12.6%) high flow nasal cannulae vs 468 (24.5%), p=0.01; 1 (1.0%) continuous positive airway pressure vs 125 (6.6%), p=0.03, OR 0.48 (95% CI 0.27 to 0.85).
SARS-CoV-2 rarely causes bronchiolitis in infants. SARS-CoV-2-related bronchiolitis mostly has a mild clinical course.
毛细支气管炎是婴儿急性下呼吸道感染的主要类型。关于 SARS-CoV-2 相关毛细支气管炎的数据有限。
描述与其他病毒相关的毛细支气管炎患儿相比，SARS-CoV-2 相关毛细支气管炎患儿的主要临床特征。
设置、患者、干预措施：本研究为多中心回顾性研究，在欧洲和以色列的 22 个儿科急诊室进行。2021 年 5 月 1 日至 2022 年 2 月 28 日期间，在儿科急诊室接受 SARS-CoV-2 检测并接受临床观察或住院治疗的诊断为毛细支气管炎且检测结果为 SARS-CoV-2 阳性的婴儿被认为符合参与条件。收集了人口统计学和临床数据、诊断检测、治疗和结局。
SARS-CoV-2 阳性患儿与 SARS-CoV-2 阴性患儿相比，需要呼吸支持的主要结局。
共纳入 2004 例毛细支气管炎患儿，其中 95 例（4.7%）SARS-CoV-2 检测阳性。SARS-CoV-2 阳性与 SARS-CoV-2 阴性患儿的中位年龄、性别、体重、早产史和合并症无差异。在 SARS-CoV-2 阴性患儿中，最常检测到的病毒是人偏肺病毒和呼吸道合胞病毒。与 SARS-CoV-2 阴性患儿相比，SARS-CoV-2 阳性患儿接受氧疗的比例较低，分别为 37 例（39%）和 1076 例（56.4%），p=0.001，OR 0.49（95%CI 0.32 至 0.75）。他们接受的通气支持较少：12 例（12.6%）高流量鼻导管与 468 例（24.5%），p=0.01；1 例（1.0%）持续气道正压通气与 125 例（6.6%），p=0.03，OR 0.48（95%CI 0.27 至 0.85）。
SARS-CoV-2 很少引起婴儿毛细支气管炎。SARS-CoV-2 相关毛细支气管炎大多具有较轻的临床病程。
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