Written by Kimiko Dunbar
Spoon Feed
Infants admitted with bronchiolitis after the COVID-19 pandemic (but before nirsevimab) required longer hospital stays and higher rates of oxygen therapy.
Got bronchiolitis? Plan to stay awhile
This article resonates with what the majority of us have been feeling in the pediatric wards: atypically busy respiratory seasons compared to the pre-COVID era. This retrospective, single-center study examined bronchiolitis severity and epidemiology before, during, and after the COVID-19 pandemic in hospitalized infants under 12 months in Paris, France. Hospitalizations (n=702) showed longer durations (5.6 vs. 3.9 days, p<0.001) and higher oxygen therapy rates (70.9% vs. 65.4%, p=0.04) post-pandemic, correlating with increased RSV prevalence (83.5% vs. 72%, p=0.01). Patients with RSV had significantly longer hospital stays (5.7 vs 3.7 days, p<0.001), higher rates of oxygen therapy (77.4% vs 44.4%, p<0.001), and more ICU admissions for non-invasive ventilation (18.5% vs. 6.1%, p 0.002) compared to RSV-negative patients over all years. That said, there were no significant differences in the total number of bronchiolitis admissions, ICU admissions, or patients in need of non-invasive or mechanical ventilation. Further, the increase in RSV prevalence could also be attributed to the significant increase in viral testing in the post-pandemic era (95% v.s. 51%, p<0.001). Regardless, the study highlights the need for preventive strategies, like nirsevimab (Beyfortus), to mitigate RSV’s impact on vulnerable populations.
How does this change my practice?
This provides further evidence of the need for RSV vaccination for pregnant women and infants, although it’s hard to know if numbers have truly increased given the increase in respiratory testing post-pandemic. This article won’t change my practice much, but it may be helpful to guide admission expectations, anticipatory guidance, and encouragement of vaccination and general infection prevention during respiratory season.
Source
Bronchiolitis: Increased severity in the post-COVID-19 era. Pediatr Pulmonol. 2024 Dec;59(12):3197-3203. doi: 10.1002/ppul.27172. Epub 2024 Jul 11. PMID: 38990099
