Changes in Bronchiolitis Characteristics During the COVID-19 Pandemic: A Description of Pediatric Emergency Department Visits in a Community Hospital, 2019-2021

Clin Pediatr (Phila). 2024 Jan;63(1):73-79. doi: 10.1177/00099228231208941. Epub 2023 Oct 23.


A retrospective, cross-sectional study of children with bronchiolitis aged 1 to 24 months during an ED visit between 2019 and 2021 was performed. Chi-square or Kruskal-Wallis was used to compare groups. The gamma coefficient was used to measure the association of variables through time. Bronchiolitis cases decreased by 75% from 2019 to 2020 and rose back to prepandemic levels by 2021. Radiographs (gamma -0.443), steroids (gamma -0.298), and bronchodilators (gamma -0.414) decreased during the study period (P < .001). Laboratory studies (gamma 0.032), viral testing (gamma 0.097), antibiotic use (gamma -0.069), and respiratory support (gamma 0.166) were unchanged. The decrease in steroids and bronchodilators was related to a clinical pathway that discouraged their use. Respiratory support remained unchanged. The COVID-19 pandemic (2019-2021) seems to have had little effect on the severity or resource utilization associated with bronchiolitis but may have unraveled a potential bronchiolitis phenotype that may have been more prominent during the pandemic.

Keywords: COVID-19; bronchiolitis; pandemic; pediatric emergency department.

MeSH terms

  • Bronchiolitis* / drug therapy
  • Bronchodilator Agents / therapeutic use
  • COVID-19*
  • Child
  • Cross-Sectional Studies
  • Emergency Service, Hospital
  • Hospitals, Community
  • Humans
  • Pandemics
  • Retrospective Studies
  • Steroids / therapeutic use


  • Bronchodilator Agents
  • Steroids