Rates of Acute Wheezing in Children During the COVID-19 Pandemic in Rayong Province, Thailand
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Abstract
OBJECTIVES: This study investigates the rates of acute wheezing and identifies the associated risk factors among children under five during the COVID-19 pandemic in Rayong Province, Thailand.
MATERIALS AND METHODS: A retrospective study was performed on pediatric patients aged from one day to five years who were diagnosed with respiratory diseases (ICD-10 codes J00-J99) at Sri Rayong Hospital between 2019 and 2022. The study included 6,733 patients with a total of 25,830 visits. Data were retrieved from the hospital’s information system.
RESULTS: From the study the majority of patients were male (51.77%). The highest acute wheezing rate appeared post-COVID-19 pandemic (25.16%) and the lowest acute wheezing rate appeared during COVID-19 pandemic (17.57%). The numbers of acute wheezing in all three phases were relevant to respiratory syncytial virus (RSV) infection. Tripledemic was not found, but only two viruses, COVID-19 and RSV were detected. In addition, no association of acute wheezing with infections of influenza A/B and COVID-19 was found, possibly because these infections rarely caused acute wheezing in children under five years old. Multiple logistic regression presented significant risk factors associated with acute wheezing, namely RSV infection (adjusted Odds ratio; 95% confidence interval (4.29; 2.34-7.86), human metapneumovirus (hMPV) infection (3.40; 1.32 - 8.74) and eosinophilia (2.51; 1.33-4.76).
CONCLUSION: Acute wheezing was highest in the post-COVID-19 pandemic (25.16%) and lowest in the period that had implemented COVID-19 preventive measures (17.57%). The infections of RSV and hMPV as well as eosinophilia were the risk factors associated with acute wheezing. The dramatic increase in RSV outbreaks after the easing of lockdown and restriction measures might be due to the immunity debt or immunity gap. COVID-19 prevention measures could only temporarily reduce RSV infection along with acute wheezing symptoms. RSV can be prevented by active immunity (monoclonal antibodies and vaccine). Infection and acute wheezing should be better prevented by RSV vaccine.
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