Impact of reduced COVID-19 restrictions on pediatric recurrent respiratory infections in Southern Italy: a cross-sectional analysis

Abstract

Aim: This study investigated changes in pediatric respiratory health resulting from the easing of COVID-19-related social restrictions, following a noted decrease in respiratory infections during the lockdown. The COVID-19 restrictions have inadvertently influenced the epidemiology of other viruses and contributed to changes in patterns of recurrent respiratory infections (RRIs) in children. Methods: This cross-sectional study analyzed the records of children who underwent at “Respiratory Diseases of Pediatric Interest Unit” at the University Hospital “Luigi Vanvitelli” in Naples, Italy, between October 2022 and June 2023. The study aimed to assess associations with RRIs, the occurrence of febrile episodes, and antibiotic usage. Results: Out of 262 patients (38.2% females, median age 6 years), 81.7% experienced at least one respiratory infection over six months, and 23.7% suffered from RRIs [RRIs in the last six months (RRIS)]. Notably, being underweight was significantly associated with RRIs in the last six months (P-value 0.043), resulting in a 47% increased incidence of respiratory infections (P-value 0.012). No significant associations were observed with sex or age. With increasing age, there was a decreasing incidence rate of 3% for the number of RRIs (P-value 0.019), 4% for febrile episodes (P-value 0.031), and 7% for the number of antibiotic courses (P-value < 0.001). Conclusions: The study emphasizes age and weight’s role in children’s post-COVID-19 RRI prevalence. It signifies the need for proactive preparedness, targeting younger underweight populations and tailored interventions for recurrent cases.