EP271 - IMPACT OF REDUCED EXPOSURE TO RESPIRATORY VIRUSES IN THE PREVIOUS YEAR ON THE EPIDEMIOLGY OF BRONCHIOLITIS IN A TERTIARY PAEDIATRIC INTENSIVE CARE UNIT (PICU). (ID 640)
Abstract
Backgrounds:
Many young children had reduced exposure to respiratory viruses for part of their life due to non-pharmaceutical interventions (NPI) associated with the COVID-19 pandemic starting March 2020.
The aim is to describe the potential impact of COVID-19 infections, NPIs and subsequent relaxing of these on bronchiolitis admissions to a tertiary referral PICU in London.
Methods
Retrospective chart review. Data from 01/03/2019-29/02/2020 (“baseline”) compared to 01/03/2020-28/02/2021 (“NPI”) containing significant periods of NPIs, and 01/03/2021-31/10/2021 (“opening”) when most NPIs were gradually lifted.
Results:
The “NPI” period confirms previously described absence of Respiratory Syncytial Virus (RSV) bronchiolitis, but ongoing Rhino/Enterovirus infections. Other indicators were highly flawed by changed PICU logistics and closures. Comparing “baseline” to “opening” period (see Table 1) we found an early peak and increase in admissions/month, an increase in median age, and increase in the proportion of children >365 days of age. However, median length of stay, proportion of children mechanically ventilated and median ventilation days decreased. No cases of severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2) bronchiolitis, but an increase in the proportion of single infection with Rhino/Enterovirus and RSV were seen.
Conclusions/Learning Points:
The increase in PICU admissions after the “NPI” period suggests increased susceptibility and/or circulation of respiratory viruses. The increased frequency of children over one-year points towards unusually severe disease in children above the at-risk age. However, overall, there are no indicators of more severe disease among those admitted to PICU. Sars-CoV-2 does not play a role in severe bronchiolitis, but Rhino/Enterovirus single infection is disproportionately present when other pathogens are absent. Awareness of these changes is highly relevant for clinicians and PICU leads to rapidly adapt and provide high-level care in such exceptional but potentially recurring circumstances.
