Impact of Iron Deficiency Anemia on the Severity of Bronchiolitis in Pediatric Patients

Iron Deficiency Anemia on the Severity of Bronchiolitis in Pediatric Patients

Abstract

Bronchiolitis is an acute inflammatory respiratory illness involving the lower respiratory tract occurring in the first 2 years of life. Objectives: To determine the impact and outcomes of the severity of iron deficiency anemia (IDA) in patients with acute bronchiolitis (AB). Methods: This analytical, cross-sectional study was conducted in the Department of Pediatric Medicine, Ziauddin University Hospital, Karachi, Pakistan, from April 2025 to September 2025. A total of 126 children aged 2–23 months with AB were enrolled through non-probability consecutive sampling. Bronchiolitis severity was classified by the Wang score. Data were analyzed using SPSS version 26.0, with p<0.05 considered significant. Results: In 126 children, 73 (57.9%) were males, and the median age was 10.0 months (IQR 6.0–14.0). Mild IDA was present in 38 (31.2%), moderate in 64 (50.8%), and severe in 24 (19.0%) cases. With increasing anaemia severity, weight decreased (8.7 vs 7.6 kg; p=0.038), SpO₂ declined (92.4% vs 88.7%; p=0.016), respiratory rate rose (p=0.009), and Wang score increased (5.3 vs 9.4; p=0.004). Severe IDA showed longer tachypnoea resolution (5.1 vs 3.2 days; p<0.001), retraction recovery (6.2 vs 3.9 days; p=0.002), greater oxygen requirement (18 [75.0%] vs 13 [34.2%]; p=0.002), and prolonged hospital stay (7.2 vs 5.1 days; p<0.001). Severe IDA was significantly associated with severe bronchiolitis (p=0.004). Conclusions: The severity of IDA was strongly associated with worse clinical presentation and delayed recovery in children with acute bronchiolitis. Lower haemoglobin and microcytic indices correlated with higher Wang respiratory scores, greater oxygen support requirements, and longer hospital stays.