HIPAK Annual Meeting 2022

The Impact of the COVID-19 Pandemic on Respiratory Morbidity during Infancy: A Birth-Cohort Study

Nataly Rosenfeld 1,4 Avigdor Mandelberg 2,4 Ilan Dalal 1,4 Diana Tasher 3,4 Alma Kamar 1,4 Michael Schnapper 1,4 Keren Armoni Domany 2,4
1Pediatric Department, The Edith Wolfson Medical Center, Holon, Israel, ישראל
2Pediatric Pulmonology Unit, The Edith Wolfson Medical Center, Holon, Israel, ישראל
3Infectious Diseases Unit, The Edith Wolfson Medical Center, Holon, Israel
4Sackler Faculty of Medicine, Tel- Aviv University, Tel- Aviv Israel, ישראל

Objective: To evaluate the incidence of wheezing and overall respiratory morbidity in healthy infants born during the first peak of the coronavirus (COVID-19) pandemic, compared to infants born during the preceding year.

Methods: This was a single center retrospective birth cohort study to compare a cohort of children born between February-March 2020 (COVID-19 group) to a control group of children born between February-March 2019 (pre-COVID-19 group). At one year of age, we collected respiratory data using validated, parental, telephone questionnaires. Primary outcome: wheezing incidence and/or bronchodilator use. Secondary outcomes: recurrent wheezing, emergency-room visits, hospital admissions, pneumonia diagnosis, and admissions due to lower-respiratory-tract-infections (LRTI). We included the following covariate risk factors in the logistic regression models; atopy, daycare attendance, breastmilk feeding, parental smoking and gestational age.

Results: We enrolled 588 infants, 294 in each group (48% males). Demographic, perinatal, and atopic characteristics were similar between the groups. Compared to the pre-COVID-19 group, infants born during the COVID-19 period were significantly less likely to report wheezing and/or bronchodilator use (adjusted-OR, 0.4; 95% CI-0.27-0.58), recurrent wheezing episodes (adjusted-OR, 0.54; 95% CI-0.29-0.99), systemic steroid use, (adjusted-OR, 0.35; 95% CI-0.23-0.83), emergency-room visits (adjusted-OR, 0.33; 95% CI-0.16-0.66), LRTI admissions (adjusted-OR,0.18; 95% CI-0.05-0.66), or pneumonia diagnosis (adjusted-OR, 0.2; 95% CI-0.08-0.47).

Conclusions: This is the first study investigating wheezing and respiratory morbidity in healthy infants during the first COVID-19 pandemic year. Our study demonstrated a significant decrease in all aspects of respiratory morbidity. A longitudinal follow-up study to explore the subsequent impact of these findings, is warranted.