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Multicenter Study
. 2023 Sep;108(9):e15.
doi: 10.1136/archdischild-2023-325448. Epub 2023 May 2.

SARS-CoV-2-related bronchiolitis: a multicentre international study

Giorgio Cozzi  1 , Aleksandar Sovtic  2   3 , Davide Garelli  4 , Uros Krivec  5   6 , Davide Silvagni  7 , Ilaria Corsini  8 , Marco Colombo  9 , Manuela Giangreco  10 , Antonietta Giannattasio  11 , Gregorio Paolo Milani  12   13 , Marta Minute  14 , Federico Marchetti  15 , Antonio Gatto  16 , Carla Debbia  17 , Anna Jolanda Gortan  18 , Marta Massaro  19 , Elpis Hatziagorou  20 , Domenico Ravidà  21 , Raz Diamand  22 , Elizabeth Jones  23 , Jelena Visekruna  2 , Alessandro Zago  24 , Egidio Barbi  25   24 , Alessandro Amaddeo  25 , Luisa Cortellazzo Wiel  23 ; SARS-CoV-2 bronchiolitis study group
Collaborators, Affiliations
Multicenter Study

SARS-CoV-2-related bronchiolitis: a multicentre international study

Giorgio Cozzi et al. Arch Dis Child. 2023 Sep.

Abstract

Background: Bronchiolitis is the main acute lower respiratory tract infection in infants. Data regarding SARS-CoV-2-related bronchiolitis are limited.

Objective: To describe the main clinical characteristics of infants with SARS-CoV-2-related bronchiolitis in comparison with infants with bronchiolitis associated with other viruses.

Setting, patients, interventions: A multicentre retrospective study was conducted in 22 paediatric emergency departments (PED) in Europe and Israel. Infants diagnosed with bronchiolitis, who had a test for SARS-CoV-2 and were kept in clinical observation in the PED or admitted to hospital from 1 May 2021 to 28 February 2022 were considered eligible for participation. Demographic and clinical data, diagnostic tests, treatments and outcomes were collected.

Main outcome measures: The main outcome was the need for respiratory support in infants testing positive for SARS-CoV-2 compared with infants testing negative.

Results: 2004 infants with bronchiolitis were enrolled. Of these, 95 (4.7%) tested positive for SARS-CoV-2. Median age, gender, weight, history of prematurity and presence of comorbidities did not differ between the SARS-CoV-2-positive and SARS-CoV-2-negative infants. Human metapneumovirus and respiratory syncytial virus were the viruses most frequently detected in the group of infants negative for SARS-CoV-2.Infants testing positive for SARS-CoV-2 received oxygen supplementation less frequently compared with SARS-CoV-2-negative patients, 37 (39%) vs 1076 (56.4%), p=0.001, OR 0.49 (95% CI 0.32 to 0.75). They received less ventilatory support: 12 (12.6%) high flow nasal cannulae vs 468 (24.5%), p=0.01; 1 (1.0%) continuous positive airway pressure vs 125 (6.6%), p=0.03, OR 0.48 (95% CI 0.27 to 0.85).

Conclusions: SARS-CoV-2 rarely causes bronchiolitis in infants. SARS-CoV-2-related bronchiolitis mostly has a mild clinical course.

Keywords: Covid-19; emergency care; infant welfare; paediatric emergency medicine.

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Conflict of interest statement

Competing interests: None declared.

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