College of Medicine, University of Central Florida, Orlando, FL, USA.
Department of Cardiac Surgery, Nemours Children's Hospital, Orlando, FL, USA.
Clin Pediatr (Phila). 2024 Jan;63(1):73-79. doi: 10.1177/00099228231208941. Epub 2023 Oct 23.
A retrospective, cross-sectional study of children with bronchiolitis aged 1 to 24 months during an ED visit between 2019 and 2021 was performed. Chi-square or Kruskal-Wallis was used to compare groups. The gamma coefficient was used to measure the association of variables through time. Bronchiolitis cases decreased by 75% from 2019 to 2020 and rose back to prepandemic levels by 2021. Radiographs (gamma -0.443), steroids (gamma -0.298), and bronchodilators (gamma -0.414) decreased during the study period ( < .001). Laboratory studies (gamma 0.032), viral testing (gamma 0.097), antibiotic use (gamma -0.069), and respiratory support (gamma 0.166) were unchanged. The decrease in steroids and bronchodilators was related to a clinical pathway that discouraged their use. Respiratory support remained unchanged. The COVID-19 pandemic (2019-2021) seems to have had little effect on the severity or resource utilization associated with bronchiolitis but may have unraveled a potential bronchiolitis phenotype that may have been more prominent during the pandemic.
一项回顾性、横断面研究，纳入了 2019 年至 2021 年期间因毛细支气管炎在急诊科就诊的 1 至 24 月龄儿童。采用卡方检验或 Kruskal-Wallis 检验比较组间差异。采用伽马系数衡量变量随时间的关联。2019 年至 2020 年毛细支气管炎病例减少了 75%，到 2021 年又恢复到疫情前水平。在研究期间，胸片（伽马系数-0.443）、类固醇（伽马系数-0.298）和支气管扩张剂（伽马系数-0.414）减少（<0.001）。实验室研究（伽马系数 0.032）、病毒检测（伽马系数 0.097）、抗生素使用（伽马系数-0.069）和呼吸支持（伽马系数 0.166）未改变。类固醇和支气管扩张剂的减少与不鼓励使用的临床路径有关。呼吸支持未改变。COVID-19 大流行（2019-2021 年）似乎对毛细支气管炎的严重程度或与资源利用相关影响不大，但可能揭示了一种潜在的毛细支气管炎表型，这种表型在大流行期间可能更为突出。
