Presti Santiago, Manti Sara, Gammeri Carmela, Parisi Giuseppe F, Papale Maria, Leonardi Salvatore
Pediatric Respiratory Unit, AOUP "G. Rodolico-San Marco", University of Catania, Catania, Italy.
Pediatric Unit, Department of Human Pathology in Adult and Developmental Age, "Gaetano Barresi", University of Messina, Messina, Italy.
Pediatr Pulmonol. 2024 May;59(5):1298-1304. doi: 10.1002/ppul.26904. Epub 2024 Feb 14.
Bronchiolitis is a common lower respiratory tract infection (LRTI) affecting infants and young children. Respiratory syncytial virus (RSV) has historically been the primary causative agent, but other viruses also contribute to the LRTI epidemiology. Recent changes in epidemiology and clinical patterns due to the coronavirus disease 2019 (COVID-19) pandemic have raised concerns. This study aims to analyze the impact of the pandemic on bronchiolitis epidemiology and severity.
Two consecutive bronchiolitis seasons (October 2021 to March 2022 and October 2022 to March 2023) were compared. Data on viral agents, hospitalization duration, clinical severity, and respiratory support requirements were collected from pediatric patients at San Marco Hospital, University of Catania.
In the 2021-2022 season, RSV was the predominant virus (40%), followed by other viruses, with mild clinical outcomes. In the 2022-2023 season, RSV remained prevalent (58.7%), but other viruses, including rhinovirus (RV) and influenza, showed a significant increase (p < .05) in bronchiolitis cases and severity. Notably, RSV-related bronchiolitis did not exhibit greater severity compared to non-RSV cases in the 2022-2023 season, contrary to the previous year.
The COVID-19 pandemic appears to have shifted the epidemiological landscape of bronchiolitis, with a peak incidence in November instead of January/February. Non-RSV viruses (RV, influenza A and B, as well as metapneumovirus) have gained prominence, possibly due to viral competition and reduced pandemic-related restrictions. Traditionally, RSV has been the primary pathogen responsible for most bronchiolitis cases. Nonetheless, the findings of this study indicate a shifting landscape in bronchiolitis etiology, with RSV gradually diminishing in its role. Contrary to the previous year, RSV-related bronchiolitis did not exhibit greater severity compared to non-RSV cases in the 2022-2023 season.
细支气管炎是一种影响婴幼儿的常见下呼吸道感染（LRTI）。呼吸道合胞病毒（RSV）一直是主要病原体，但其他病毒也在LRTI的流行病学中起作用。2019年冠状病毒病（COVID-19）大流行导致的流行病学和临床模式的近期变化引发了关注。本研究旨在分析大流行对细支气管炎流行病学和严重程度的影响。
比较了两个连续的细支气管炎季节（2021年10月至2022年3月和2022年10月至2023年3月）。从卡塔尼亚大学圣马尔科医院的儿科患者中收集了有关病毒病原体、住院时间、临床严重程度和呼吸支持需求的数据。
在2021 - 2022季节，RSV是主要病毒（40%），其次是其他病毒，临床结局较轻。在2022 - 2023季节，RSV仍然流行（58.7%），但其他病毒，包括鼻病毒（RV）和流感病毒，在细支气管炎病例和严重程度方面显著增加（p < 0.05）。值得注意的是，与2021 - 2022年相反，2022 - 2023季节与RSV相关的细支气管炎与非RSV病例相比，严重程度并未更高。
COVID-19大流行似乎改变了细支气管炎的流行病学格局，发病高峰出现在11月而非1月/2月。非RSV病毒（RV、甲型和乙型流感病毒以及偏肺病毒）变得更加突出，这可能是由于病毒竞争和与大流行相关的限制减少所致。传统上，RSV一直是大多数细支气管炎病例的主要病原体。尽管如此，本研究结果表明细支气管炎病因格局正在发生变化，RSV的作用逐渐减弱。与前一年相反，2022 - 2023季节与RSV相关的细支气管炎与非RSV病例相比，严重程度并未更高。
