Pediatric anesthesia & critical care
Pediatric Respiratory Syncytial Virus Hospitalizations and Respiratory Support After the COVID-19 Pandemic
Authors' conclusion
This cross-sectional study identified a postpandemic pediatric RSV surge that resulted in markedly increased hospital volumes and advanced respiratory support needs in older children with fewer comorbidities than prepandemic seasons.
Study context
- Population
- Children 5 years or younger with respiratory syncytial virus (RSV) at 48 freestanding US children's hospitals, 2017–202348 US children's hospitals
- Participants
- 288,816 participants
- Exposure
- Postpandemic RSV season vs prepandemic seasonal averages
- Outcome
- ED presentations, hospital or ICU admission and LOS, demographics, respiratory support use, mortality and CPR
Methodological detailsmulticentre, Pediatric Health Information System (PHIS) database
- Multicentre
- PHIS database
Main finding
As reported in the abstract
RSV hospital presentations, prepandemic vs postpandemic
39 698 vs 94 347
P < .001
Hospitalizations, postpandemic vs prepandemic (86.7% more)
50 619 vs 27 114
P < .001
Observational data: associations, not effects.
Further findings
Age at presentation, 2022 to 2023 vs prepandemic
- Median (IQR) age, 2022 to 2023 vs prepandemic
- 11.3 [4.1-26.6] months vs 6.8 [2.6-16.8] months (P < .001)
Comorbidities in hospitalized patients, 2022 to 2023 vs prepandemic
- Comorbidities, 2022 to 2023 vs prepandemic
- 17.6% vs 21.8% (P < .001)
Advanced respiratory support use, 2022 to 2023 vs prepandemic
- Advanced respiratory support use increased 70.1%
- 9094 vs 5340 (P < .001)
Age of children requiring high-flow nasal cannula (HFNC), postpandemic vs prepandemic
- Median (IQR) age for HFNC
- 6.9 [2.7-16.0] months vs 4.6 [2.0-11.7] months
Age of children requiring noninvasive ventilation (NIV), postpandemic vs prepandemic
- Median (IQR) age for NIV
- 6.0 [2.1-16.5] months vs 4.3 [1.9-11.9] months
Comorbid conditions by respiratory support modality, after vs before the pandemic
- HFNC
- 14.9% vs 19.1%
- NIV
- 22.0% vs 28.5%
- Invasive mechanical ventilation
- 30.5% vs 38.0%
- P < .001
Original publication
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