Title Prevalence of SARS-CoV-2 positivity in infants with bronchiolitis: a multicentre international study.
Author Cozzi, Giorgio; Cortellazzo Wiel, Luisa; Amaddeo, Alessandro; Gatto, Antonio; Giangreco, Manuela; Klein-Kremer, Adi; Bosis, Samantha; Silvagni, Davide; Debbia, Carla; Nanni, Laura; Chiappa, Sara; Minute, Marta; Corsini, Ilaria; Morabito, Giuliana; Gortan, Anna Jolanda; Colombo, Marco; Marchetti, Federico; Garelli, Davide; Piffer, Arianna; Cardinale, Fabio; Levy, Nitai; Curatola, Antonietta; Gojsina, Bojana; Basu, Suvradeep; Barbi, Egidio; Sovtic, Aleksandar
Journal Arch Dis Child Publication Year/Month 2022-Jun
PMID 35705371 PMCID PMC9240451
Affiliation + expend 1.IRCCS Materno Infantile Burlo Garofolo, Trieste, Italy.

BACKGROUND: Bronchiolitis is the leading acute respiratory tract infection in infants during the winter season. Since the beginning of the SARS-CoV-2 pandemic, a reduction in the number of bronchiolitis diagnoses has been registered. OBJECTIVE: The present study aimed to describe the incidence and clinical features of bronchiolitis during the 2020-2021 winter season in a large cohort of children in Europe and Israel, and to clarify the role of SARS-CoV-2. SETTING, PATIENTS, INTERVENTIONS: We conducted a multicentre observational cross-sectional study in 23 paediatric emergency departments in Europe and Israel. Clinical and demographic data about all the cases of infants diagnosed with bronchiolitis from 1 October 2020 to 30 April 2021 were collected. For each enrolled patient, diagnostic tests, treatments and outcomes were reported. MAIN OUTCOME MEASURES: The main outcome was the prevalence of SARS-CoV-2-positive bronchiolitis. RESULTS: Three hundred and fourteen infants received a diagnosis of bronchiolitis during the study period. Among 535 infants who tested positive for SARS-CoV-2, 16 (3%) had bronchiolitis. Median age, male sex predominance, weight, history of prematurity and presence of comorbidities did not differ between the SARS-CoV-2-positive and SARS-CoV-2-negative groups. Rhinovirus was the most common involved pathogen, while respiratory syncytial virus (RSV) was detected in one case. SARS-CoV-2 bronchiolitis had a mild clinical course, with one patient receiving oxygen supplementation and none requiring paediatric or neonatal intensive care unit admission. CONCLUSIONS: During the SARS-CoV-2 pandemic, a marked decrease in the number of bronchiolitis diagnoses and the disappearance of the RSV winter epidemic were observed. SARS-CoV-2-related bronchiolitis was rare and mostly displayed a mild clinical course.

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