Perfil epidemiológico das internações por bronquiolite aguda e bronquite aguda em crianças no estado de São Paulo (2020-2025)

• DOI: https://doi.org/10.22533/at.ed.8208222612015

• Palavras-chave: Bronquite aguda, Bronquiolite aguda, Internação, Criança, Epidemiologia, Vírus Sincicial Respiratório (VSR), Sistema Único de Saúde, Hospitalização, Estudos Epidemiológicos, Crianças

• Keywords: Acute bronchitis, Acute bronchiolitis, Hospitalization, Children, Epidemiology, Respiratory Syncytial Virus (RSV), Unified Health System (SUS), Hospitalization, Epidemiologic studies, children

• Abstract: Introduction: Lower respiratory tract diseases in children represent a significant public health problem due to their high morbidity and mortality and their impact on healthcare demand. Among these conditions, acute bronchiolitis—most commonly caused by the Respiratory Syncytial Virus (RSV)—and acute bronchitis are prominent. Acute bronchiolitis is characterized by inflammation of the bronchioles and occurs more frequently in infants, often progressing from mild cold symptoms to severe cough, wheezing, and respiratory distress, which may lead to respiratory failure. Acute bronchitis usually results from viral infections of the upper airways and presents with persistent cough, initially dry and later productive, accompanied by mild fever and wheezing. Risk factors such as prematurity, absence of breastfeeding, passive smoking, and socioeconomic vulnerability may worsen clinical outcomes. Recently, the World Health Organization has recommended immunization strategies against RSV, and Brazil has adopted these measures by introducing vaccination for pregnant women and monoclonal antibody prophylaxis for newborns and children up to two years of age within the Unified Health System. Objective: To identify the epidemiological profile of hospitalizations due to acute bronchiolitis and acute bronchitis in children in the state of São Paulo, Brazil, from 2020 to 2025, according to temporal distribution, sex, race/color, and age group. Methods: This quantitative, descriptive epidemiological study was conducted using secondary data from the Hospital Information System of the Brazilian Unified Health System (SIH/SUS). Hospitalizations coded as acute bronchitis (ICD-10 J20) and acute bronchiolitis (ICD-10 J21) among children aged 1 to 14 years between 2020 and 2025 were included. Absolute and relative frequencies were calculated considering time, place, and person variables, and the results were contextualized in light of control measures adopted during and after the COVID-19 pandemic. Although childhood is defined as individuals under 12 years of age, the age group categorization available in the database did not allow this exact cutoff. This limitation did not significantly affect the results, as hospitalization incidence decreased with increasing age due to immune system maturation and improved mucociliary clearance. Results: A total of 32,908 hospitalizations were recorded in the state, with 11,919 occurring in the municipality of São Paulo. The highest number of hospitalizations was observed in 2023 (7,330), followed by 2024 (6,704), while 2020 showed a marked reduction (2,502), likely associated with social distancing and mask use. Hospitalizations were more frequent among males (53%). The most commonly reported race/color was White (48%), followed by Brown (39%). Children aged 1 to 4 years accounted for approximately 79% of hospitalizations, indicating greater immunological vulnerability. Conclusion: Acute bronchiolitis and acute bronchitis remain important causes of pediatric hospitalizations in the state of São Paulo, particularly among young male children and those identified as White or Brown. The gradual increase in hospitalizations after 2021 reflects the resumption of viral circulation following the relaxation of pandemic-related control measures. These findings highlight the importance of continuous epidemiological surveillance, preventive strategies, and the expansion of immunization policies to reduce the incidence and severity of these diseases.