Waiting for the next winter. Outpatient pediatric visits for respiratory infections before, during, and after the COVID-19 pandemic in the city of Buenos Aires

Introduction: During the COVID-19 pandemic, pediatric visits due to acute lower respiratory infections (ALRIs) decreased, but most reports are from hospitalized patients. There is little information on this phenomenon in outpatients, who are the majority in ALRI. We evaluated the impact of the COVID-19 pandemic on ALRI-related outpatient visits in the City of Buenos Aires.Methods: Observational study including all outpatient visits of children under 2 years of age to the public health system of the City of Buenos Aires, between 1 January 2018 and 31 December 2022. We analyzed the total number of visits and the ALRI-related visits, and their distribution throughout the study period.Results: A total of 704,426 visits were registered, 7.38% of them due to ALRI. ALRI-related visits decreased from the implementation of a national lockdown (2020) and increased again as the restriction measures decreased, particularly the return to full school attendance (2021). In general, the proportion of ALRI-related visits was significantly higher in the cold months than in the warm ones (9.8% vs. 5.5%; odds ratio: 1.76, 95% confidence interval: 1.73-1.79; p < .001). This difference was observed before (2018 and 2019) and after the pandemic (2022), but not in 2020-2021. The peak of ALRI-related visits occurred in the cold months in pre-pandemic years (2018-2019), did not appear in 2020, reappeared delayed in 2021, and recovered seasonality in 2022.Conclusion: Outpatient ALRI-related visits decreased significantly in the city of Buenos Aires during the COVID-19 pandemic and currently seem to have recovered their magnitude and seasonality.