How did seasonal respiratory infections in hospitalized children change during the COVID-19 pandemic?

Details

The study aimed to describe the incidence of seasonal respiratory viral infections (s-RVIs) before and during the COVID-19 pandemic and to compare virus-specific outcomes in pediatric patients. It was a retrospective cross-sectional study of patient admissions to Children’s National Hospital between October 1, 2015, and December 31, 2020.

In cohort 1, there were 12,451 patient admissions between March 15 and December 31, 2020. Of these, 8,162 (66%) were tested for SARS-CoV-2, and 249 (2.0% of admissions) were positive.

In cohort 2, there were 10,986 patient admissions between April 1 and December 31, 2020. Of these, 844 (8%) were tested for seasonal respiratory viruses upon admission, and 160 were positive. Laboratory-confirmed s-RVIs were therefore associated with 1.5% of admissions.

In cohort 3, there were 49,901 patient admissions during viral seasons between October 1, 2015, and March 31, 2020. Of these, 7,539 (15%) were tested for seasonal respiratory viruses upon admission, and 4,531 were positive; laboratory-confirmed s-RVIs were associated with 9.0% of admissions. hHRV/rENT was the most frequently detected virus, but its detection rate decreased substantially during the COVID-19 pandemic, from 31% to 18% (P < .001).

After April 21, 2020, no patients had RSV, influenza, hMPV, hPIV, or hCoV detected upon admission.

The three cohorts showed no statistically significant differences in ICU admission percentages—10.8%, 15.0%, and 14.2%, respectively (P > .05)—or death at discharge—0.8%, 0.6%, and 0.5%, respectively (P > .05).

The authors concluded that, compared with COVID-19, s-RVI cases were associated with a higher proportion of inpatient admissions, but ICU admission and death rates were similar in hospitalized pediatric patients. They also concluded that public health interventions to prevent COVID-19 were highly effective in preventing pediatric s-RVIs.