Disease severity in RSV and non-RSV bronchiolitis: Usefulness in clinical decision-making

Background: Bronchiolitis morbidity remains a major health problem and identifying risk factors for disease progression can help in clinical decision-making Aims: To assess differences in disease severity between RSV (respiratory syncytial virus) and non-RSV bronchiolitis during two consecutive RSV seasons (2010-2012). Methods: Medical records of all patients Results: We analyzed 479 patients (317M:162F) and 582 episodes of bronchiolitis. In the two models the number of children who required supplemental oxygen, the LOS and length of oxygen therapy were significantly higher for the RSV episodes. In model1 the number of children who required ICU (odds ratio[OR]=6.9; 95% confidence interval[CI]:2.4-20.0), non invasive ventilation (OR=10.6; 95%CI: 3.0-38.5) and a NGT (OR=17.7; 95%CI: 10.0-31.3) was significantly higher in the RSV group. In model2 the length of NGT was longer for children in the RSV group (5.4±4.7 vs. 3.3±2.4; P=0.01). However, the need for intubation did not differ between groups in both models. No death was documented. Conclusions: RSV episodes were more severe compared to non-RSV. Our findings show that viral diagnosis is useful not only for cohorting babies but also to determine the prognosis and to assist in clinical decision-making.