1 Bronchiolitis has resurged since COVID-19-related physical distancing measures have been relaxed
Bronchiolitis is a viral lower respiratory tract infection, leading to small airway inflammation and edema, and is usually caused by respiratory syncytial virus. (1) Before the COVID-19 pandemic, in Ontario, 2.6/100 children younger than 1 year had a visit to an emergency department for bronchiolitis. (2) Incidence decreased during 2020 owing to masking, school closures and physical distancing measures. However, when those were relaxed, many countries experienced off-seasonal resurgence and more presentations of children older than 1 year. (3)
2 Infants typically present with symptoms of viral respiratory infection; neonates may present with apneas or cyanosis only
Most children present with low-grade fever, tachypnea, chest wall retractions and reduced oral intake, with crackles and wheeze bilaterally. (1,4) Risk factors for severe bronchiolitis include cardiorespiratory, neuromuscular or immunodeficiency comorbidities; age 3 months or younger; and prematurity. (1,4) Bacterial pneumonia should be considered if fever is 39[degrees]C or higher or there are unilateral chest signs on auscultation. (4)
3 Investigations are not recommended routinely
Nasopharyngeal swabs do not alter management but may be used to cohort children in hospital. (1) Chest radiographs and...