Jonas Jennifer A, Acker Karen P, Thomas Charlene, Yen Steven, Levine Deborah A
Department of Pediatrics, Weill Cornell Medicine, New York Presbyterian Hospital-Weill Cornell.
Department of Pediatrics, Division of Pediatric Infectious Diseases, Weill Cornell Medicine, New York Presbyterian Hospital.
Pediatr Emerg Care. 2025 Sep 1;41(9):679-686. doi: 10.1097/PEC.0000000000003402. Epub 2025 Apr 29.
While children represented a small percentage of those hospitalized during the COVID-19 pandemic, there was a surge of pediatric viral-related admissions in the immediate postpandemic viral season. Our study compares the epidemiology and health care utilization of children with acute respiratory infections during the 2022-2023 season to prepandemic and subsequent postpandemic seasons to see if trends persisted.
We examined administrative data for children who presented to 2 urban pediatric emergency departments (ED) during 3 periods: 2017-2020 (prepandemic), 2022-2023 (immediate postpandemic), and 2023-2024 (subsequent postpandemic). Outcomes included hospitalization rate for viral-related indications, stepdown/intensive care unit (ICU) admission, and use of advanced respiratory support. Multivariable regression controlled for demographics and specific viruses.
During the study period, there were 65,313 all-cause ED encounters. Compared with prepandemic seasons, viral-related admissions doubled in 2022-2023. In addition to an increase in ED visits, the odds of viral-related admission increased by 98% [adjusted odds ratio (aOR): 1.98; 99.8% CI: 1.75-2.24], odds of stepdown/ICU admission increased by 131% (aOR: 1.31; 99.8% CI: 1.67-3.21) and odds of advanced respiratory support increased by 70% (aOR: 1.70; 99.8% CI: 1.21-2.40). In 2023-2024, the stepdown/ICU admission rate remained the same compared with 2022-2023, and the odds of advanced respiratory support increased (aOR: 1.79, 99.8% CI: 1.22-2.63). Infection with respiratory syncytial virus increased adjusted odds of more advanced care.
Pediatric ED visits and hospitalization rate decreased in 2023-2024 compared with the postpandemic surge, but the admission rate remained high compared with prepandemic seasons, percent admitted to stepdown/ICU persisted, and the use of advanced respiratory support continued to increase.
在新冠疫情期间，儿童住院人数占比虽小，但在疫情刚结束后的病毒流行季，儿科病毒相关住院人数激增。我们的研究比较了2022 - 2023年季节与疫情前及后续疫情后季节中患急性呼吸道感染儿童的流行病学特征和医疗保健利用情况，以观察趋势是否持续。
我们检查了3个时间段内前往2家城市儿科急诊科就诊的儿童的管理数据，这3个时间段分别为：2017 - 2020年（疫情前）、2022 - 2023年（疫情刚结束后）和2023 - 2024年（后续疫情后）。观察指标包括病毒相关指征的住院率、降级/重症监护病房（ICU）入院情况以及高级呼吸支持的使用情况。多变量回归对人口统计学特征和特定病毒进行了控制。
在研究期间，共有65313次因各种原因的急诊科就诊。与疫情前季节相比，2022 - 2023年病毒相关住院人数翻倍。除了急诊就诊次数增加外，病毒相关入院的几率增加了98%[调整优势比（aOR）：1.98；99.8%置信区间（CI）：1.75 - 2.24]，降级/ICU入院几率增加了131%（aOR：1.31；99.8% CI：1.67 - 3.21），高级呼吸支持的几率增加了70%（aOR：1.70；99.8% CI：1.21 - 2.40）。在2023 - 2024年，与2022 - 2023年相比，降级/ICU入院率保持不变，高级呼吸支持的几率增加（aOR：1.79，99.8% CI：1.22 - 2.63）。呼吸道合胞病毒感染增加了接受更高级护理的调整后几率。
与疫情后激增期相比，2023 - 2024年儿科急诊就诊和住院率有所下降，但与疫情前季节相比，住院率仍然较高，降级/ICU入院百分比持续存在，并且高级呼吸支持的使用继续增加。
