Journal Article Epublish 4 citations
PubMed: 40807039 DOI: 10.3390/jcm14155420
The Path of Bronchiolitis Towards Intensive Care: Risk Factor Analysis in a Large Italian Cohort.
J Clin Med 14(15)
Authors: Marco Maglione, Luca Pierri, Fabio Savoia, Camilla Calì, Roberta Ragucci, Marco Sarno, Giulia Ranucci, Emma Coppola, Francesco Nunziata, Antonino Di Toro, Vincenzo Tipo, Antonietta Giannattasio, The Brand Study
Affiliations
- Pediatric Emergency Unit, Santobono-Pausilipon Children's Hospital, 80129 Naples, Italy.
- Neonatal Intensive Care Unit, Santobono-Pausilipon Children's Hospital, 80129 Naples, Italy.
- Epidemiology, Biostatistics and Childhood Cancer Registry Unit, Santobono-Pausilipon Children's Hospital, 80129 Naples, Italy.
- Chronic and Multifactorial Diseases Unit, Santobono-Pausilipon Children's Hospital, 80129 Naples, Italy.
- Department of Pediatrics, AORN Sant'Anna E San Sebastiano, 81100 Caserta, Italy.
- Department of Pediatrics, San Leonardo Hospital, 80053 Castellammare di Stabia, Italy.
- Pediatric Immunoreumatology Unit, Santobono-Pausilipon Children's Hospital, 80129 Naples, Italy.
Abstract
Background/Objectives: Bronchiolitis is the leading cause of hospitalization in infants under 12 months. While often self-limiting, a subset of cases evolves into severe disease requiring intensive care. This study aimed to identify risk factors for severe bronchiolitis in two consecutive respiratory syncytial virus (RSV) seasons (before and after the introduction of nirsevimab) in Southern Italy. Methods: A retrospective, multicenter cohort study was conducted on all infants ≤12 months hospitalized with bronchiolitis from October 2023 to March 2025. Patients were categorized by disease severity: those requiring Sub-Intensive or Intensive Care (IC group) and others (n-IC group). Demographic and clinical data, virological testing, and therapeutic interventions were analyzed. Multivariable logistic regression was used to identify independent risk factors for severe disease. Results: Among 1056 hospitalized infants, 10.5% required intensive care. RSV was detected in 73.5% of tested patients and was significantly associated with severe outcomes. Independent risk factors for IC admission included younger age (<3 months), comorbidities, and RSV infection. A 33% reduction in bronchiolitis admissions was observed in the second season (post-nirsevimab), although the rate of severe cases remained stable (about 10% in both seasons). Conclusions: Younger age, comorbidities, and RSV infection are significant predictors of severe bronchiolitis. Although overall admissions decreased post-nirsevimab, severe cases persisted. These findings underscore the need for targeted preventive strategies and highlight the potential role of intermediate care approaches in managing bronchiolitis severity.
MeSH
Comorbidity, Respiratory Syncytial Viruses, Risk Factors, Bronchiolitis, Infections, Infant, Respiratory Syncytial Virus Infections