We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Pediatric Respiratory Syncytial Virus Hospitalizations, 2017-2023.
- Authors
Fitzpatrick, Tiffany; Buchan, Sarah A.; Mahant, Sanjay; Fu, Longdi; Kwong, Jeffrey C.; Stukel, Therese A.; Guttmann, Astrid
- Abstract
Key Points: Question: Were there changes in the epidemiologic characteristics of pediatric respiratory syncytial virus (RSV) in Ontario, Canada, following the COVID-19 pandemic? Findings: In this cohort study of 700 000 children younger than 5 years per study year, the 2021-2022 RSV season peaked slightly earlier than expected, but overall admission rates were comparable with prepandemic seasons; in contrast, the 2022-2023 season peaked earlier and resulted in more than twice as many hospitalizations. There were notable differences in sociodemographic and clinical characteristics of children admitted after vs before the pandemic. Meaning: These findings suggest the need for ongoing surveillance to assess the persistence of atypical RSV epidemics and studies examining any implications this may have for capacity planning and immunization programs. Importance: Respiratory syncytial virus (RSV) transmission was disrupted worldwide following the COVID-19 pandemic, and further study is required to better understand these changes. Objective: To compare observed and expected RSV hospital and intensive care unit (ICU) admission rates and characteristics of admitted children during the 2021-2022 and 2022-2023 seasons. Design, Setting, and Participants: A population-based cohort study of all children aged younger than 5 years in Ontario, Canada, July 1, 2017, through March 31, 2023, was conducted. Exposures: Individual and neighborhood-level sociodemographic and clinical characteristics were identified from administrative data, including age, palivizumab eligibility, complex medical conditions, rurality, and living in a marginalized neighborhood. Main Outcomes and Measures: The main outcome was RSV-associated hospitalization. Secondary outcomes included ICU admissions, mechanical ventilation, extracorporeal membrane oxygenation, and in-hospital death. Poisson generalized estimating equations were used to model weekly age- and sex-specific hospitalization rates and estimate expected rates in the postpandemic era; adjusted rate ratios (RRs) and 95% CIs are reported. Results: This cohort study included approximately 700 000 children per study year. Compared with prepandemic years (2017-2018, 2018-2019, and 2019-2020), the 2021-2022 RSV season peaked slightly earlier, but overall admission rates were comparable (289.1 vs 281.4-334.6 per 100 000, or approximately 2000 admissions). The 2022-2023 season peaked a month earlier and resulted in more than twice as many hospitalizations (770.0 per 100 000; n = 4977 admissions). The proportion of children admitted to an ICU in 2022-2023 (13.9%) was slightly higher than prepandemic (9.6%-11.4%); however, the population-based rate was triple the prepandemic levels (106.9 vs 27.6-36.6 per 100 000 children in Ontario). With the exception of palivizumab-eligible children, all sociodemographic and health status characteristics were associated with lower-than-expected RSV hospitalization rates in 2021-2022. In contrast, older age of patients was associated with higher-than-expected rates in 2022-2023 (ie, 24-59 months: RR, 1.90; 95% CI, 1.35-2.66). Conclusions and Relevance: There were notable differences in RSV epidemiologic characteristics in Ontario following the COVID-19 pandemic. It is not yet clear whether and how long atypical RSV epidemics may persist. Clinicians and program planners should consider the potential for ongoing impacts to health care capacity and RSV immunization programs. This cohort study examines the hospitalization rates associated with respiratory syncytial virus infection during the 2021-2022 and 2022-2023 seasons compared with the pre-COVID-19 2017-2020 seasons in Ontario, Canada.
- Subjects
ONTARIO; POISSON distribution; EXTRACORPOREAL membrane oxygenation; RESEARCH funding; HOSPITAL care; SEX distribution; RESPIRATORY syncytial virus infections; HOSPITAL mortality; DESCRIPTIVE statistics; AGE distribution; POPULATION geography; HOSPITAL care of newborn infants; LONGITUDINAL method; INTENSIVE care units; ARTIFICIAL respiration; SOCIODEMOGRAPHIC factors; CONFIDENCE intervals; DATA analysis software; COVID-19 pandemic; HOSPITAL care of children; CHILDREN
- Publication
JAMA Network Open, 2024, Vol 7, Issue 6, pe2416077
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2024.16077