ABSTRACT
Respiratory syncytial virus (RSV) infection is the leading cause of
bronchiolitis among infants <12 months old. It is widely known
that coinfections between RSV and other viruses can worsen the clinical
picture of affected patients.
To evaluate the severity of clinical pictures of bronchiolitis in the
2019-2020 winter season, we performed a retrospective study of our
third-level Pediatric Emergency Department (ED) admission charts.
From February 2 to March 9, 2020 (start date of the Italian lockdown),
we observed a peak of patients with a clinical picture of bronchiolitis
requiring oxygen therapy of 55.1%, compared with 18% and 14.5% during
the same period in 2017-2018 and 2018-2019, respectively
(p<0.0001), without other clinically significant differences
between the groups.
Several authors hypothesized that SARS-CoV2 was present in northern
Italy some weeks before the first confirmed case.
We suggest that one of the causes of this unexpected severe
bronchiolitis peak may be a SARS-CoV2 - RSV coinfection in a period when
SARS-CoV2 was already circulating in northern Italy. Given the lack of
real-time polymerase chain reaction (RT-PCR) tests for SARS-CoV2 at that
time, our suggestion remains a hypothesis.