Pediatric RSV-Associated Hospitalizations Before and During the COVID-19 Pandemic
Importance: Respiratory syncytial virus (RSV) is a leading cause of pediatric hospitalizations.
Objective: To describe the epidemiology and burden of RSV-associated hospitalizations among children and adolescents in Canadian tertiary pediatric hospitals from 2017 to 2022, including changes during the COVID-19 pandemic.
Design, Setting, and Participants: This cross-sectional study was conducted during 5 RSV seasons (2017-2018 to 2021-2022) at 13 pediatric tertiary care centers from the Canadian Immunization Monitoring Program Active (IMPACT) program. Hospitalized children and adolescents aged 0 to 16 years with laboratory-confirmed RSV infection were included.
Main Outcomes and Measures: The proportion of all-cause admissions associated with RSV and counts and proportions of RSV hospitalizations with intensive care unit (ICU) admission, prolonged stay (≥7 days), and in-hospital mortality were calculated overall and by season, age group, and region. Seasonality was described using epidemic curves. RSV hospitalizations for 2021-2022 were compared with those in the prepandemic period of 2017-2018 through 2019-2020. Bonferroni corrections were applied to P values to adjust for multiple statistical comparisons.
Results: Among 11 014 RSV-associated hospitalizations in children and adolescents (6035 hospitalizations among male patients [54.8%]; 5488 hospitalizations among patients aged <6 months [49.8%]), 2594 hospitalizations (23.6%) had admission to the ICU, of which 1576 hospitalizations (60.8%) were among children aged less than 6 months. The median (IQR) hospital stay was 4 (2-6) days. The mean (SD) number of RSV-associated hospitalizations during prepandemic seasons was 2522 (88.8) hospitalizations. There were 58 hospitalizations reported in 2020-2021, followed by 3170 hospitalizations in 2021-2022. The proportion of all-cause hospitalizations associated with RSV increased from a mean of 3.2% (95% CI, 3.1%-3.3%) before the pandemic to 4.5% (95% CI, 4.3%-4.6%) in 2021-2022 (difference, 1.3 percentage points; 95% CI, 1.1-1.5 percentage points; corrected P < .001). A significant increase in RSV-associated hospitalizations was found in 2021-2022 for 3 provinces (difference range, 2.5 percentage points; 95% CI, 1.4-3.6 percentage points for Quebec to 2.9 percentage points; 95% CI, 1.4-3.5 percentage points for Alberta; all corrected P < .001). Age, sex, ICU admission, prolonged length of stay, and case fatality rate did not change in 2021-2022 compared with the prepandemic period. Interregional differences in RSV seasonality were accentuated in 2021-2022, with peaks for 1 province in October, 4 provinces in December, and 3 provinces in April, or May.
Conclusions and Relevance: This study found that the burden of RSV-associated hospitalizations in Canadian pediatric hospitals was substantial, particularly among infants aged less than 6 months, and RSV hospitalizations increased in 2021-2022 compared with the prepandemic period, while severity of illness remained similar. These findings suggest that RSV preventive strategies for infants aged less than 6 months would be associated with decreased RSV disease burden in children.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:6 |
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| Enthalten in: |
JAMA network open - 6(2023), 10 vom: 02. Okt., Seite e2336863 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bourdeau, Malou [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Completed 05.10.2023 Date Revised 06.03.2024 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1001/jamanetworkopen.2023.36863 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM362861315 |
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| 245 | 1 | 0 | |a Pediatric RSV-Associated Hospitalizations Before and During the COVID-19 Pandemic |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 05.10.2023 | ||
| 500 | |a Date Revised 06.03.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Importance: Respiratory syncytial virus (RSV) is a leading cause of pediatric hospitalizations | ||
| 520 | |a Objective: To describe the epidemiology and burden of RSV-associated hospitalizations among children and adolescents in Canadian tertiary pediatric hospitals from 2017 to 2022, including changes during the COVID-19 pandemic | ||
| 520 | |a Design, Setting, and Participants: This cross-sectional study was conducted during 5 RSV seasons (2017-2018 to 2021-2022) at 13 pediatric tertiary care centers from the Canadian Immunization Monitoring Program Active (IMPACT) program. Hospitalized children and adolescents aged 0 to 16 years with laboratory-confirmed RSV infection were included | ||
| 520 | |a Main Outcomes and Measures: The proportion of all-cause admissions associated with RSV and counts and proportions of RSV hospitalizations with intensive care unit (ICU) admission, prolonged stay (≥7 days), and in-hospital mortality were calculated overall and by season, age group, and region. Seasonality was described using epidemic curves. RSV hospitalizations for 2021-2022 were compared with those in the prepandemic period of 2017-2018 through 2019-2020. Bonferroni corrections were applied to P values to adjust for multiple statistical comparisons | ||
| 520 | |a Results: Among 11 014 RSV-associated hospitalizations in children and adolescents (6035 hospitalizations among male patients [54.8%]; 5488 hospitalizations among patients aged <6 months [49.8%]), 2594 hospitalizations (23.6%) had admission to the ICU, of which 1576 hospitalizations (60.8%) were among children aged less than 6 months. The median (IQR) hospital stay was 4 (2-6) days. The mean (SD) number of RSV-associated hospitalizations during prepandemic seasons was 2522 (88.8) hospitalizations. There were 58 hospitalizations reported in 2020-2021, followed by 3170 hospitalizations in 2021-2022. The proportion of all-cause hospitalizations associated with RSV increased from a mean of 3.2% (95% CI, 3.1%-3.3%) before the pandemic to 4.5% (95% CI, 4.3%-4.6%) in 2021-2022 (difference, 1.3 percentage points; 95% CI, 1.1-1.5 percentage points; corrected P < .001). A significant increase in RSV-associated hospitalizations was found in 2021-2022 for 3 provinces (difference range, 2.5 percentage points; 95% CI, 1.4-3.6 percentage points for Quebec to 2.9 percentage points; 95% CI, 1.4-3.5 percentage points for Alberta; all corrected P < .001). Age, sex, ICU admission, prolonged length of stay, and case fatality rate did not change in 2021-2022 compared with the prepandemic period. Interregional differences in RSV seasonality were accentuated in 2021-2022, with peaks for 1 province in October, 4 provinces in December, and 3 provinces in April, or May | ||
| 520 | |a Conclusions and Relevance: This study found that the burden of RSV-associated hospitalizations in Canadian pediatric hospitals was substantial, particularly among infants aged less than 6 months, and RSV hospitalizations increased in 2021-2022 compared with the prepandemic period, while severity of illness remained similar. These findings suggest that RSV preventive strategies for infants aged less than 6 months would be associated with decreased RSV disease burden in children | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 700 | 1 | |a Vadlamudi, Nirma Khatri |e verfasserin |4 aut | |
| 700 | 1 | |a Bastien, Nathalie |e verfasserin |4 aut | |
| 700 | 1 | |a Embree, Joanne |e verfasserin |4 aut | |
| 700 | 1 | |a Halperin, Scott A |e verfasserin |4 aut | |
| 700 | 1 | |a Jadavji, Taj |e verfasserin |4 aut | |
| 700 | 1 | |a Kazmi, Kescha |e verfasserin |4 aut | |
| 700 | 1 | |a Langley, Joanne M |e verfasserin |4 aut | |
| 700 | 1 | |a Lebel, Marc H |e verfasserin |4 aut | |
| 700 | 1 | |a Le Saux, Nicole |e verfasserin |4 aut | |
| 700 | 1 | |a Moore, Dorothy |e verfasserin |4 aut | |
| 700 | 1 | |a Morris, Shaun K |e verfasserin |4 aut | |
| 700 | 1 | |a Pernica, Jeffrey M |e verfasserin |4 aut | |
| 700 | 1 | |a Robinson, Joan |e verfasserin |4 aut | |
| 700 | 1 | |a Sadarangani, Manish |e verfasserin |4 aut | |
| 700 | 1 | |a Bettinger, Julie A |e verfasserin |4 aut | |
| 700 | 1 | |a Papenburg, Jesse |e verfasserin |4 aut | |
| 700 | 0 | |a Canadian Immunization Monitoring Program Active (IMPACT) Investigators |e verfasserin |4 aut | |
| 700 | 1 | |a Foo, Cheryl |e investigator |4 oth | |
| 700 | 1 | |a Bridger, Natalie |e investigator |4 oth | |
| 700 | 1 | |a Halperin, Scott A |e investigator |4 oth | |
| 700 | 1 | |a Top, Karina A |e investigator |4 oth | |
| 700 | 1 | |a Thibeault, Roseline |e investigator |4 oth | |
| 700 | 1 | |a Moore, Dorothy |e investigator |4 oth | |
| 700 | 1 | |a Papenburg, Jesse |e investigator |4 oth | |
| 700 | 1 | |a Lebel, Marc H |e investigator |4 oth | |
| 700 | 1 | |a Le Saux, Nicole |e investigator |4 oth | |
| 700 | 1 | |a Morris, Shaun K |e investigator |4 oth | |
| 700 | 1 | |a Kamzi, Kescha |e investigator |4 oth | |
| 700 | 1 | |a Purewal, Rupeena |e investigator |4 oth | |
| 700 | 1 | |a Chawla, Rupesh |e investigator |4 oth | |
| 700 | 1 | |a Jadavji, Taj |e investigator |4 oth | |
| 700 | 1 | |a Burton, Catherine |e investigator |4 oth | |
| 700 | 1 | |a Bettinger, Julie A |e investigator |4 oth | |
| 700 | 1 | |a Sadarangani, Manish |e investigator |4 oth | |
| 700 | 1 | |a Sauvé, Laura |e investigator |4 oth | |
| 700 | 1 | |a Bullard, Jared |e investigator |4 oth | |
| 700 | 1 | |a Embree, Joanne |e investigator |4 oth | |
| 700 | 1 | |a Pernica, Jeffrey |e investigator |4 oth | |
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