ArticleEuropean journal of pediatrics2022
Increased use of high-flow nasal cannulas after the pandemic in bronchiolitis: a more severe disease or a changed physician's attitude?
Article in European journal of pediatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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10 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- High-flow nasal cannula for lower respiratory infections in children under 2 years: a systematic review of indications.Archives of disease in childhood · 2026Pooled it
- Impact of COVID-19 Pandemic on Bronchiolitis Epidemiology in Greece.Medicina (Kaunas, Lithuania) · 2025Article
- Hospitalizations for bronchiolitis among infants before and after the SARS-CoV-2 pandemic: an area-based study of the Emilia-Romagna Region, Italy.Italian journal of pediatrics · 2025Article
- Severe bronchiolitis before and after the COVID-19 pandemic: a retrospective database analysis by the Italian Network of PICU study group (TIPNet).Journal of anesthesia, analgesia and critical care · 2024Article
- Severe respiratory syncytial virus disease.Journal of intensive medicine · 2024Review
- Epidemiology of respiratory syncytial virus in hospitalized children before, during, and after the COVID-19 lockdown restriction measures in Greece.Epidemiology and infection · 2024Article
- Increased bronchiolitis burden and severity after the pandemic: a national multicentric study.Italian journal of pediatrics · 2024Article
- Management of Acute Bronchiolitis in Spoke Hospitals in Northern Italy: Analysis and Outcome.Diseases (Basel, Switzerland) · 2024Article
- Urgent Hospitalizations Related to Viral Respiratory Disease in Children during Autumn and Winter Seasons 2022/2023.Viruses · 2023Article
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14 authors at 7 institutions in 1 country.
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Abstract
After the SARS-CoV-2 pandemic, we noticed a marked increase in high-flow nasal cannula use for bronchiolitis. This study aims to report the percentage of children treated with high-flow nasal cannula (HFNC) in various seasons. The secondary outcomes were admissions for bronchiolitis, virological results, hospital burden, and NICU/PICU need. We conducted a retrospective study in four Italian hospitals, examining the medical records of all infants (< 12 months) hospitalized for bronchiolitis in the last four winter seasons (1 September-31 March 2018-2022). In the 2021-2022 winter season, 66% of admitted children received HFNC versus 23%, 38%, and 35% in the previous 3 years. A total of 876 patients were hospitalized in the study periods. In 2021-2022, 300 infants were hospitalized for bronchiolitis, 22 in 2020-2021, 259 in 2019-2020, and 295 in 2018-2019. The percentage of patients needing intensive care varied from 28.7% to 18%, 22%, and 15% in each of the four considered periods (p < 0.05). Seventy-seven percent of children received oxygen in the 2021-2022 winter; vs 50%, 63%, and 55% (p < 0.01) in the previous 3 years. NIV/CPAP was used in 23%, 9%, 16%, and 12%, respectively. In 2021-2020, 2% of patients were intubated; 0 in 2020-2021, 3% in 2019-2020, and 1% in 2018-2019.
conclusionThis study shows a marked increase in respiratory support and intensive care admissions this last winter. While these severity indexes were all driven by medical choices, more reliable indexes such as intubation rate and length of stay did not change. Therefore, we suggest that there is a more aggressive treatment attitude rather than a more severe disease. WHAT IS KNOWN: • COVID-19 pandemic deeply impacted bronchiolitis epidemiology, reducing hospitalizations to onetenth. In the 2021-2022 winter, bronchiolitis resurged to pre-pandemic numbers in Europe. WHAT IS NEW: • Bronchiolitis hospitalization rose much faster in the 2021-2022 winter period, peaking at a higher level. Respiratory supports and high-flow nasal cannula increased significantly compared to the pre-pandemic era.
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