Pediatric Bronchiolitis Admissions Surged During the COVID-19 Pandemic

The number of pediatric bronchiolitis hospital admissions temporarily decreased and then substantially increased during the COVID-19 pandemic. Children hospitalized with bronchiolitis during the pandemic were older and more likely to require intensive care unit (ICU) admission. These findings were published in Jama Network Open.

Researchers conducted a retrospective cross-sectional study to evaluate patterns of bronchiolitis admissions during (2020-2021 and 2022-2023) vs before (2010-2011 and 2019-2020) the COVID-19 pandemic. Data were sourced from 41 children’s hospitals in the United States. Eligible patients included children younger than 2 years. The primary outcome was the number of bronchiolitis hospitalizations by season and month during the COVID-19 pandemic.

The final analysis included 400,801 admissions for bronchiolitis, representing a total of 349,609 patients. Overall, the median patient age was 6 (IQR, 2-12) months, 58.7% were boys, and 43.7% were White.

The median number of annual admissions for bronchiolitis was 29,308 (IQR, 26,196-34,157) during the prepandemic era. However, pediatric bronchiolitis admissions decreased by 69.2% (n=9030) from 2020 to 2021 and then increased by 75.3% (n=51,397) from 2022 to 2023.

Patients hospitalized with bronchiolitis during vs before the pandemic were older (median age, 7 [IQR, 3-14] vs 6 [IQR, 2-12] months; P <.001), more likely to require ICU admission (65.2% in 2022 vs 59.1% in 2019; P <0.001), and less likely to require invasive mechanical ventilation.

Increases in bronchiolitis admissions occurred among all age groups during the pandemic. The most significant increase was observed from 2022 to 2023 among children aged 12 to 23 months, with admissions 2.2-times higher than those of the prepandemic era.

Further analysis showed atypical seasonality of bronchiolitis during the COVID-19 pandemic. Winter-predominant seasonality was noted in prepandemic bronchiolitis seasons, with the highest rate of admissions observed from December through February.

Limitations of this study include the lack of a comprehensive database of pediatric admissions in the US, the inability to determine whether changes in pediatric admissions and ventilation rates occurred due to changes in patient acuity or clinician practices, and the potential underestimation of the true number of bronchiolitis admissions.

According to the researchers, “[T]hese data suggest that the 2023-2024 bronchiolitis season may regress to typical prepandemic levels as population immunity returns to historical norms.”

Disclosures: Multiple study authors declared affiliations with pharmaceutical, biotech, and/or device companies. Please see the original reference for a full list of disclosures.

This article originally appeared on Infectious Disease Advisor