Changes in hospital admissions associated with pediatric respiratory syncytial virus after the COVID-19 pandemic in Canada: an active surveillance study.
The COVID-19 pandemic affected the epidemiology of respiratory syncytial virus (RSV). We sought to describe tertiary care hospital admissions associated with pediatric RSV in 2022/23 in Canada and to assess pandemic-related changes.
We conducted active surveillance of hospital-admitted infants and children aged 0 to 16 years at 13 Immunization Monitoring Program, Active (IMPACT) centres. We compared RSV-associated hospital admissions in 2022/23 with those in the prepandemic period (2017/18 through 2019/20). We calculated province-specific and age-stratified proportions of all-cause hospital admissions with RSV detection and age-stratified proportions of RSV-associated intensive care unit (ICU) admissions. We performed seasonal autoregressive integrated moving average (SARIMA) time-series analyses.
In 2022/23, 5362 RSV-associated hospital admissions occurred, including 1260 (23.5%) ICU admissions, both more than double the prepandemic yearly averages. Overall, the median age increased from 6 (interquartile range [IQR] 1 to 20) months to 9 (IQR 2 to 27) months (p < 0.001). The proportion of RSV-associated hospital admissions among all-cause admissions increased by 3.5 percentage points (95% confidence interval [CI] 3.3 to 3.7 percentage points), to 6.8% (95% CI 6.6% to 7.0%). Whereas 41.5% of RSV-associated hospital admissions were among infants younger than 6 months, this age group accounted for 62.1% of ICU admissions. Overall, the ICU proportion remained constant; however, the odds of ICU admission among infants younger than 6 months increased (adjusted odds ratio 1.35, 95% CI 1.2 to 1.52) compared with the prepandemic period. National weekly incidence in 2022/23 peaked earlier and higher, and persisted longer than expected by SARIMA.
In 2022/23, the number of RSV-associated hospital admissions and ICU admissions increased dramatically in Canadian pediatric hospitals. The greatest burden remained in infants younger than 6 months. Strategies for RSV immunization for young infants may have a substantial public health impact.
We conducted active surveillance of hospital-admitted infants and children aged 0 to 16 years at 13 Immunization Monitoring Program, Active (IMPACT) centres. We compared RSV-associated hospital admissions in 2022/23 with those in the prepandemic period (2017/18 through 2019/20). We calculated province-specific and age-stratified proportions of all-cause hospital admissions with RSV detection and age-stratified proportions of RSV-associated intensive care unit (ICU) admissions. We performed seasonal autoregressive integrated moving average (SARIMA) time-series analyses.
In 2022/23, 5362 RSV-associated hospital admissions occurred, including 1260 (23.5%) ICU admissions, both more than double the prepandemic yearly averages. Overall, the median age increased from 6 (interquartile range [IQR] 1 to 20) months to 9 (IQR 2 to 27) months (p < 0.001). The proportion of RSV-associated hospital admissions among all-cause admissions increased by 3.5 percentage points (95% confidence interval [CI] 3.3 to 3.7 percentage points), to 6.8% (95% CI 6.6% to 7.0%). Whereas 41.5% of RSV-associated hospital admissions were among infants younger than 6 months, this age group accounted for 62.1% of ICU admissions. Overall, the ICU proportion remained constant; however, the odds of ICU admission among infants younger than 6 months increased (adjusted odds ratio 1.35, 95% CI 1.2 to 1.52) compared with the prepandemic period. National weekly incidence in 2022/23 peaked earlier and higher, and persisted longer than expected by SARIMA.
In 2022/23, the number of RSV-associated hospital admissions and ICU admissions increased dramatically in Canadian pediatric hospitals. The greatest burden remained in infants younger than 6 months. Strategies for RSV immunization for young infants may have a substantial public health impact.
Authors
Lopes Lopes, Embree Embree, Jadavji Jadavji, Kazmi Kazmi, Langley Langley, Lebel Lebel, Le Saux Le Saux, Moore Moore, Morris Morris, Pernica Pernica, Robinson Robinson, Sadarangani Sadarangani, Shulha Shulha, Bettinger Bettinger, Papenburg Papenburg,
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