Pediatric Bronchiolitis Admissions to ICU Fall During COVID-19

By Lisa Rapaport

March 29, 2021

(Reuters Health) - Pediatric intensive care unit (PICU) admissions for bronchiolitis plunged in Paris during the COVID-19 pandemic, a French study suggests.

Researchers examined data on bronchiolitis PICU admissions at five hospitals in Paris for all children under 2 years of age during the autumn-winter bronchiolitis season of 2020, as well as for the same period over the five previous years.

Over the five pre-COVID seasons, there were a total of 3,099 bronchiolitis admissions to the PICU, with 2,190 (70.7%) happening from September to December. Based on this trend, researchers predicted that there should have been 444 bronchiolitis admissions to the PICU for the same four-month period of 2020. The actual number of admissions was 65, however, 85.3% lower than expected.

"I firmly believe that the most likely explanation is a reduced contamination from bronchiolitis viruses - mainly respiratory syncytial virus (RSV) - as a consequence of decreased human contacts elicited by all the public health measures that were mandated for COVID-19 including social distancing, mask-wearing, hand hygiene, curfews, and lockdowns," said study co-author Dr. Ricardo Carbajal, chief of the pediatric emergency department at University Hospital Armand Trousseau, in Paris, and a professor at the Sorbonne University Faculty of Medicine.

It's unlikely that the reduction in bronchiolitis PICU admissions was due to parents not bringing babies to the hospital or infants not getting admitted, Dr. Cabajal said by email.

"The monitoring of visits for bronchiolitis in the community, outside hospitals, also showed a marked decrease in visits for bronchiolitis," Dr. Cabajal said. "Furthermore, since children have been spared by COVID-19, PICU beds were available for any child that needed intensive care."

There were also no pediatric bronchiolitis deaths from September to December 2020, compared with a total of 19 deaths over the five precious seasons, the researchers report in Pediatrics.

The study results suggest that some hygiene measures used during the pandemic might also be deployed to help minimize the spread of respiratory viral infections and bronchiolitis among infants, the research team concludes.

While results from Paris, with about 20% of the population of France, are likely representative of what happened nationwide, the authors note, though it's still possible that these results might not be representative of what occurred in other countries.

Even so, the results underscore that infection control practices implemented during the pandemic might be beneficial in the future to prevent RSV among children, said Dr. Lara Shekerdemian, chief of critical care at Texas Children's Hospital and professor and vice chair of pediatrics at Baylor College of Medicine in Houston.

"Infections with viruses like RSV in particular that are typically transmitted through direct contact between small children - have fallen dramatically during the pandemic," Dr. Shekerdemian, who wasn't involved in the study, said by email.

Less contact leads to lower risk of transmitting or acquiring these infections, and the study results suggest that sanitizing, masking, and distancing are also effective for minimizing transmission, Dr. Shekerdemian added.

"After the pandemic, I hope that certain practices remain: these include of course hand hygiene, and in hospital or healthcare environments, masking becoming more routine," Dr. Shekerdemian said.

SOURCE: https://bit.ly/2P9GZij Pediatrics, online March 17, 2021.

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