J Pediatr Infect Dis 2023; 18(05): 245-249
DOI: 10.1055/s-0043-1768441
Original Article

Acute Bronchiolitis in Term Newborns Following Relaxation in COVID-19 Appropriate Behavior

Umar Amin Qureshi
1   Department of Pediatrics, Government Medical College, Srinagar, Jammu and Kashmir, India
1   Department of Pediatrics, Government Medical College, Srinagar, Jammu and Kashmir, India
Mohd Suhail Lone
2   Department of Pediatric Microbiology, Government Medical College, Srinagar, Jammu and Kashmir, India
Muzafar Jan
1   Department of Pediatrics, Government Medical College, Srinagar, Jammu and Kashmir, India
Nisar Ahmad Wani
3   Department of Pediatric Radiology, Government Medical College, Srinagar, Jammu and Kashmir, India
Mubashir Hassan Shah
1   Department of Pediatrics, Government Medical College, Srinagar, Jammu and Kashmir, India
› Author Affiliations


Objective Neonatal bronchiolitis is not well characterized. We studied the profile of acute bronchiolitis in term newborns during a respiratory syncytial virus (RSV) surge following relaxation in coronavirus disease 2019 (COVID-19) appropriate behavior.

Methods This was a retrospective descriptive study performed in the neonatology division of a tertiary care pediatric hospital at Srinagar, Jammu and Kashmir, India. Term neonates (born at ≥37 completed gestational weeks) from 7 up to 28 days of life admitted with bronchiolitis over a 1-month period (November 2021) were included.

Results Out of total 480 neonatal admissions over a month, 35 (7%) had acute bronchiolitis. Eight neonates were excluded. Out of 27 included neonates, 13 were males. Mean age at presentation was 20 days. All neonates were born at term (≥37 completed gestational weeks). Cough (26), rapid breathing (20), and lower chest indrawing (20) were the predominant presenting features. Median SPO2 was 87% (interquartile range 85–92%). Fourteen (52%) neonates needed admission to neonatal intensive care unit. Respiratory support was needed in the form of oxygen through nasal prongs in 24 (89%) newborns. Heated humidified high-flow nasal cannula (HHHFNC) and bubble continuous positive airway pressure were used in five neonates each. Two neonates were mechanically ventilated. The mean duration of the hospital stay was 6.2 days. All neonates survived.

Conclusion A series of 27 term neonates with bronchiolitis during an RSV surge is reported in the aftermath of lifting of COVID-19 restrictions. Many of these neonates were sick enough to require significant respiratory support. The outcome was good in all neonates.

Publication History

Received: 29 November 2022

Accepted: 27 March 2023

Article published online:
26 April 2023

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  • References

  • 1 Ralston SL, Lieberthal AS, Meissner HC. et al; American Academy of Pediatrics. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics 2014; 134 (05) e1474-e1502
  • 2 Papoff P, Moretti C, Cangiano G. et al. Incidence and predisposing factors for severe disease in previously healthy term infants experiencing their first episode of bronchiolitis. Acta Paediatr 2011; 100 (07) e17-e23
  • 3 Singhi S, Singhi PD. Clinical signs in neonatal pneumonia. Lancet 1990; 336 (8722): 1072-1073
  • 4 Curatola A, Lazzareschi I, Bersani G, Covino M, Gatto A, Chiaretti A. Impact of COVID-19 outbreak in acute bronchiolitis: Lesson from a tertiary Italian Emergency Department. Pediatr Pulmonol 2021; 56 (08) 2484-2488
  • 5 Agha R, Avner JR. Delayed seasonal RSV surge observed during the COVID-19 pandemic. Pediatrics 2021; 148 (03) e2021052089
  • 6 Delestrain C, Danis K, Hau I. et al. Impact of COVID-19 social distancing on viral infection in France: A delayed outbreak of RSV. Pediatr Pulmonol 2021; 56 (12) 3669-3673
  • 7 Alan S, Erdeve O, Cakir U. et al; TurkNICU-RSV Trial Group. Outcome of the Respiratory Syncytial Virus related acute lower respiratory tract infection among hospitalized newborns: a prospective multicenter study. J Matern Fetal Neonatal Med 2016; 29 (13) 2186-2193
  • 8 Baker RE, Park SW, Yang W, Vecchi GA, Metcalf CJE, Grenfell BT. The impact of COVID-19 nonpharmaceutical interventions on the future dynamics of endemic infections. Proc Natl Acad Sci U S A 2020; 117 (48) 30547-30553
  • 9 Cohen R, Ashman M, Taha M-K. et al. Pediatric Infectious Disease Group (GPIP) position paper on the immune debt of the COVID-19 pandemic in childhood, how can we fill the immunity gap?. Infect Dis Now 2021; 51 (05) 418-423
  • 10 Curatola A, Graglia B, Ferretti S. et al. The acute bronchiolitis rebound in children after COVID-19 restrictions: a retrospective, observational analysis. Acta Biomed 2023; 94 (01) e2023031
  • 11 Perk Y, Özdil M. Respiratory syncytial virüs infections in neonates and infants. Turk Pediatri Ars 2018; 53 (02) 63-70
  • 12 Yong JH, Schuh S, Rashidi R. et al. A cost effectiveness analysis of omitting radiography in diagnosis of acute bronchiolitis. Pediatr Pulmonol 2009; 44 (02) 122-127
  • 13 Shaw KN, Bell LM, Sherman NH. Outpatient assessment of infants with bronchiolitis. Am J Dis Child 1991; 145 (02) 151-155