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To the Editor: During the coronavirus disease 2019 (COVID-19) pandemic, there are restrictions on social gatherings and events; closure of schools, day-care centers, crèches, playgrounds, cinema halls, and gymnasium; and restricted travel and transport [1]. Several preventive strategies are in place based on the transmission dynamics, including social distancing, universal use of masks, and hand hygiene. Confinement of infants and children to homes lead to decreased exposure to outside environment or other children. The travel restrictions and nonavailability of public transport possibly led to poor accessibility to the healthcare system. These are the major factor that changed the epidemiology of infectious respiratory diseases in children including acute viral bronchiolitis (AVB). AVB is a common cause of hospitalization among infants leading to significant morbidity and occasional mortality [2].
We retrospectively analyzed admissions due to AVB in our Pediatric Emergency during the months of November 2019 to February 2020 (prepandemic) and November 2020 to February 2021 (during pandemic). During the pre-pandemic period, the total number of admissions to the Pediatric Emergency were 3770 and out of them 173 (4.6%) were due to AVB. During the pandemic, the total number of admissions were 1589, and 8 (0.5%) had AVB. There was significant decrease in admissions due to AVB (p = 0.001). During prepandemic period, 36.6% (n = 63) infants with AVB needed PICU admission, 14.5% (n = 25) required mechanical ventilation, and 8.1% (n = 14) died. Whereas during the pandemic, none of the infants with AVB required PICU admission or mechanical ventilation and there was no mortality.
The infection prevention and control measures (use of face mask, hand hygiene, social distancing, and social isolation), closure of day-care centers and schools leading to limited exposure to other infants and children, restricted transport, and limited accessibility to healthcare settings during the pandemic are the possible reasons for the reduction in the incidence, hospitalization, and severity of pediatric infectious respiratory diseases including AVB [3, 4].
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Angurana SK, Williams V, Takia L. Acute Viral Bronchiolitis: A Narrative Review. J Pediatr Intensive Care. 2020. https://doi.org/10.1055/s-0040-1715852.
Friedrich F, Ongaratto R, Scotta MC, et al. Early impact of social distancing in response to COVID-19 on hospitalizations for acute bronchiolitis in infants in Brazil. Clin Infect Dis. 2021;72:2071–5.
Van Brusselen D, De Troeyer K, Ter Haar E, Vander Auwera A, Poschet K, Van Nuijs S, et al. Bronchiolitis in COVID-19 times: a nearly absent disease? Eur J Pediatr. 2021;180:1969–73.
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Takia, L., Awasthi, P. & Angurana, S.K. Impact of COVID-19 on Acute Viral Bronchiolitis Hospitalization Among Infants in North India. Indian J Pediatr 88, 1154 (2021). https://doi.org/10.1007/s12098-021-03905-3
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DOI: https://doi.org/10.1007/s12098-021-03905-3