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Milani GP, Ronchi A, Agostoni C, Marchisio P, Chidini G, Pesenti N, Bellotti A, Cugliari M, Crimi R, Fabiano V, Pietrasanta C, Pugni L, Mosca F. Long-lasting effects of COVID-19 pandemic on hospitalizations and severity of bronchiolitis. Eur J Pediatr 2024; 183:1751-1758. [PMID: 38236404 PMCID: PMC11001736 DOI: 10.1007/s00431-023-05395-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/14/2023] [Accepted: 12/17/2023] [Indexed: 01/19/2024]
Abstract
Bronchiolitis is a common cause of hospitalization in infants. The long-lasting impact of hygiene and social behavior changes during the pandemic on this disease is debated. We investigated the prevalence of hospitalized cases, clinical severity, and underlying risk factors before and during pandemic. The study was conducted in 27 hospitals in Italy and included infants hospitalized for bronchiolitis during the following four periods: July 2018-March 2019, July 2020-March 2021, July 2021-March 2022, and July 2022-March 2023. Data on demographics, neonatal gestational age, breastfeeding history, underlying chronic diseases, presence of older siblings, etiologic agents, clinical course and outcome were collected. A total of 5330 patients were included in the study. Compared to 2018-19 (n = 1618), the number of hospitalizations decreased in 2020-21 (n = 121). A gradual increase was observed in 2021-22 (n = 1577) and 2022-23 (n = 2014). A higher disease severity (need and length of O2-supplementation, need for non-invasive ventilation, hospital stay) occurred in the 2021-22 and, especially, the 2022-23 periods compared to 2018-19. This tendency persisted after adjusting for risk factors associated with bronchiolitis severity. Conclusions: Compared to adults, COVID-19 in infants is often asymptomatic or mildly symptomatic and rarely results in hospitalization. This study indicates that the pandemic has indirectly induced an increased burden of bronchiolitis among hospitalized infants. This shift, which is not explained by the recognized risk factors, suggests the existence of higher infant vulnerability during the last two seasons. What is known: • The pandemic led to a change in epidemiology of respiratory diseases • Large data on severity of bronchiolitis and underlying risk factors before and during COVID-19 pandemic are scarce What is new: • Compared to pre-pandemic period, hospitalizations for bronchiolitis decreased in 2020-21 and gradually increased in 2021-22 and 2022-23 • Compared to pre-pandemic period, higher disease burden occurred in 2021-22 and, especially, in 2022-23. This tendency persisted after adjusting for risk factors associated with bronchiolitis severity • The interplay among viruses, preventive measures, and the infant health deserves to be further investigated.
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Affiliation(s)
- Gregorio Paolo Milani
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Via Della Commenda 9, 20122, Milan, Italy
| | - Andrea Ronchi
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Agostoni
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Via Della Commenda 9, 20122, Milan, Italy
| | - Paola Marchisio
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Giovanna Chidini
- Department of Anaesthesia, Intensive Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nicola Pesenti
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anita Bellotti
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Via Della Commenda 9, 20122, Milan, Italy
| | - Marco Cugliari
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Via Della Commenda 9, 20122, Milan, Italy
| | - Riccardo Crimi
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Via Della Commenda 9, 20122, Milan, Italy
| | - Valentina Fabiano
- Pediatric Department, "Vittore Buzzi" Children's Hospital, Milan, Italy
- Department of Biomedical and Clinical Science, University of Milan, Milan, Italy
| | - Carlo Pietrasanta
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Via Della Commenda 9, 20122, Milan, Italy
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lorenza Pugni
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Mosca
- Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Via Della Commenda 9, 20122, Milan, Italy
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Hu S, Wang X, Ma Y, Cheng H. Global Research Trends in Pediatric COVID-19: A Bibliometric Analysis. Front Public Health 2022; 10:798005. [PMID: 35252087 PMCID: PMC8888448 DOI: 10.3389/fpubh.2022.798005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 01/07/2022] [Indexed: 01/27/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) emerged in 2019 and has since caused a global pandemic. Since its emergence, COVID-19 has hugely impacted healthcare, including pediatrics. This study aimed to explore the current status and hotspots of pediatric COVID-19 research using bibliometric analysis. Methods The Institute for Scientific Information Web of Science core collection database was searched for articles on pediatric COVID-19 to identify original articles that met the criteria. The retrieval period ranged from the creation of the database to September 20, 2021. A total of 3,561 original articles written in English were selected to obtain data, such as author names, titles, source publications, number of citations, author affiliations, and countries where the studies were conducted. Microsoft Excel (Microsoft, Redmond, WA) was used to create charts related to countries, authors, and institutions. VOSviewer (Center for Science and Technology Studies, Leiden, The Netherlands) was used to create visual network diagrams of keyword, author, and country co-occurrence. Results We screened 3,561 publications with a total citation frequency of 30,528. The United States had the most published articles (1188 articles) and contributed the most with author co-occurrences. The author with the most published articles was Villani from the University of Padua, Italy. He also contributed the most co-authored articles. The most productive institution was Huazhong University of Science and Technology in China. The institution with the most frequently cited published articles was Shanghai Jiao Tong University in China. The United States cooperated most with other countries. Research hotspots were divided into two clusters: social research and clinical research. Besides COVID-19 and children, the most frequent keywords were pandemic (251 times), mental health (187 times), health (172 times), impact (148 times), and multisystem inflammatory syndrome in children (MIS-C) (144 times). Conclusion Pediatric COVID-19 has attracted considerable attention worldwide, leading to a considerable number of articles published over the past 2 years. The United States, China, and Italy have leading roles in pediatric COVID-19 research. The new research hotspot is gradually shifting from COVID-19 and its related clinical studies to studies of its psychological and social impacts on children.
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Affiliation(s)
- Siyu Hu
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Xi Wang
- Department of Clinical Laboratory, The First Hospital of Jilin University, Changchun, China
| | - Yucong Ma
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, China
| | - Hang Cheng
- Department of Pediatrics, The First Hospital of Jilin University, Changchun, China
- *Correspondence: Hang Cheng
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Nicolì S, Benevento M, Ferorelli D, Mandarelli G, Solarino B. Little patients, large risks: An overview on patient safety management in pediatrics settings. Front Pediatr 2022; 10:919710. [PMID: 36186651 PMCID: PMC9523149 DOI: 10.3389/fped.2022.919710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/29/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Simona Nicolì
- Section of Legal Medicine, Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Marcello Benevento
- Section of Legal Medicine, Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Davide Ferorelli
- Section of Legal Medicine, Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Gabriele Mandarelli
- Section of Forensic Psychiatry, Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Biagio Solarino
- Section of Legal Medicine, Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
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Bottari G, Stellacci G, Ferorelli D, Dell’Erba A, Aricò M, Benevento M, Palladino G, Solarino B. Imaging Appropriateness in Pediatric Radiology during COVID-19 Pandemic: A Retrospective Comparison with No COVID-19 Period. CHILDREN-BASEL 2021; 8:children8060463. [PMID: 34205841 PMCID: PMC8227712 DOI: 10.3390/children8060463] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/28/2021] [Accepted: 05/30/2021] [Indexed: 12/15/2022]
Abstract
During the COVID-19 pandemic, the number of accesses to the Pediatric Emergency Department (pED) in Italy sharply decreased by 30%. The purpose of this study is to evaluate how this novel setting impacted on management of children with trauma, and the use and appropriateness of imaging studies in such patients at the pED. All imaging studies performed in patients with trauma at the pED of a tertiary children's Hospital during the first wave of the COVID-19 pandemic (between March and May 2020) were reviewed, in comparison with a control time interval (March to May 2019). In the pre-COVID control era, 669 imaging studies documented bone fractures in 145/568 children (25.5%). In the COVID-era, 79/177 (44.6%) pediatric patients showed bone fractures on 193 imaging studies. Comparative analysis shows a 71% decrease in imaging studies, and the proportion of negative imaging studies (with no evidence of bone fractures) dropped in 2020 by 19% compared to the 2019 control era (p < 0.001). The sharp decrease of negative studies suggests that the rate of appropriateness was higher during COVID-era, suggesting some attitude toward defensive medicine in the previous control year, as a result of some degree of imaging inappropriateness. The impact of a pandemic on emergency medicine may offer a unique opportunity to revisit diagnostic and therapeutic protocols in pediatrics.
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Affiliation(s)
- Giampiero Bottari
- Department of Interdisciplinary Medicine (DIM), Institute of Legal Medicine, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy; (D.F.); (A.D.); (M.B.); (B.S.)
- Correspondence:
| | - Giandomenico Stellacci
- Department of Pediatric Radiology, Giovanni XXIII Pediatric Hospital, Via G. Amendola 207, 70126 Bari, Italy; (G.S.); (G.P.)
| | - Davide Ferorelli
- Department of Interdisciplinary Medicine (DIM), Institute of Legal Medicine, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy; (D.F.); (A.D.); (M.B.); (B.S.)
| | - Alessandro Dell’Erba
- Department of Interdisciplinary Medicine (DIM), Institute of Legal Medicine, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy; (D.F.); (A.D.); (M.B.); (B.S.)
| | - Maurizio Aricò
- COVID-19 Management Crisis Unit, Giovanni XXIII Pediatric Hospital, Via G. Amendola 207, 70126 Bari, Italy;
| | - Marcello Benevento
- Department of Interdisciplinary Medicine (DIM), Institute of Legal Medicine, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy; (D.F.); (A.D.); (M.B.); (B.S.)
| | - Giuseppe Palladino
- Department of Pediatric Radiology, Giovanni XXIII Pediatric Hospital, Via G. Amendola 207, 70126 Bari, Italy; (G.S.); (G.P.)
| | - Biagio Solarino
- Department of Interdisciplinary Medicine (DIM), Institute of Legal Medicine, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy; (D.F.); (A.D.); (M.B.); (B.S.)
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