Mortality Associated With Viral Bronchiolitis in a Pediatric Department: A Retrospective Analysis.

INTRODUCTION

In Morocco, acute viral bronchiolitis remains a major public health problem, and its incidence continues to rise. Acute viral bronchiolitis can be severe and even fatal, especially in vulnerable populations. The objectives of this study were to analyze the causes of death due to viral bronchiolitis and to highlight the importance of prophylaxis in high-risk groups.

METHODS

This was a retrospective, descriptive study spanning 11 years and 11 months, from January 1, 2013, to December 10, 2024. We included all cases of acute bronchiolitis complicated by infant death. The study focused on infants aged one to 24 months who presented with acute bronchitis.

RESULTS

During the study period, 32 cases of viral bronchiolitis resulted in death during hospitalization. The average age of patients was five months and 15 days, with a male predominance. The average duration between the onset of symptoms and death was seven days, ranging from 24 hours to 30 days. The risk factors included male sex (n=20, 62.5%), passive smoking (n=17, 53.1%), young age (n=16, 50%), and preterm infancy (n=4, 12.5%). Comorbidities were found in 25 (78%) cases, including 19 (59.4%) of congenital heart disease, one (3.12%) of bronchopulmonary dysplasia, one (3.12%) of spinal muscular atrophy, one (3.12%) of hypopituitarism, one (3.12%) of ichthyosis, and one (3.12%) of polymalformative syndrome. The primary causes of death were congenital heart diseases, including ventricular septal defect (n=5, 15.62%), dilated cardiomyopathy (n=3, 9.37%), complex congenital heart disease (n=1, 3.12%), double outlet right ventricle (n=1, 3.12%), and tetralogy of Fallot (n=1, 3.12%). The average duration of hospitalization was five days, ranging from one hour to 15 days. All patients required intensive care, but they could not be transferred due to the lack of available beds, leading to mortality.  Conclusion: Infants born prematurely with chronic lung disease or with decompensated congenital heart disease are at increased risk of severe acute bronchiolitis, particularly due to respiratory syncytial virus (RSV). This risk underscores the importance of prophylaxis with anti-RSV monoclonal antibodies.