How Was Pediatric Flexible Bronchoscopy Implementation Affected During COVID-19 Era?: A Retrospective Study

Abstract

Rationale: As application of flexible bronchoscopy (FB) has a high risk for infection transmission, it is recommended to postpone elective FB procedures during COVID-19 pandemic. We aimed to determine how COVID-19 pandemic affected pediatric FB implementation. Methods: Medical records of patients who underwent FB from March 11, 2015 to September 11, 2020 were examined retrospectively. Records of post-COVID-19 period (March 11, 2020 to September 11, 2020) were compared with records of pre-COVID-19 (consists of each six-month time window from March 11 to September 11 of each year from 2015 to 2019) period in terms of hospitalization status of the patients, with numbers and indications of FB. Some additional measures were taken during FB procedure in post-COVID-19 period. Number of health workers infected during FB procedures in post-COVID-19 period was reviewed. Results: Of total 182 procedures, the least FB was performed in post-COVID-19 period (34, 30, 36, 36, 25 and 21 procedures respectively from 2015 to 2020). Ninetythree (51.1%) patients were male. The median age of the patients was 48 months (range, 1-204 months). Eighty-two (45.0%) patients had chronic diseases. While 62 (34.2%) patients were hospitalized for another reason before FB, 120 (65.9%) patients were outpatient who applied for FB. Three most common indications for FB were atelectasis (n=39, 21.4%), chronic cough (n=32, 17.5%) and stridor (n=27, 14.8 %). While microbiological sampling with bronchoalveolar lavage was the most common indication in post-COVID-19 period, atelectasis was leading in pre-COVID-19 period (p<0.001). In post-COVID-19 period most of the patients were inpatients while outpatient predominance was determined in pre-COVID-19 period (p<0.001) (Table 1). None of the health workers was infected during FB procedure. Conclusion: Postponing elective FB procedures decreased the numbers and affected the indications of procedures in our center during COVID-19 era. Taking additional measures are of great importance and effective to prevent transmission of infection during FB.