Pediatric health system impact of an early respiratory viral season in Eastern Ontario, Canada: A descriptive analysis

Background: The current respiratory viral season in Ontario started early with an intensity experienced throughout the pediatric health system. We sought to examine trends in patient volumes and level of care intensity among children admitted with laboratory-confirmed respiratory viral infection over the last five years in Ottawa. Methods: This was a retrospective cohort study of patients at CHEO, a pediatric health centre in Ottawa, who were diagnosed with a laboratory-confirmed respiratory viral infection in the first 72 hours of admission between October 22, 2017 and December 10, 2022. Their admissions were stratified by age groups and levels of care intensity and evaluated for trends over six surveillance periods that begin in Week 35 and end in Week 34 of the following calendar year. Results: During this current surveillance period, there was an early, rapid, two-fold increase in admissions due to respiratory viral infections compared to previous periods, driven largely by RSV and influenza. While there were similar age distributions, there was a larger volume of Level 2 and 3 admissions, and higher proportion of patients requiring Level 2 intensity of care (20.8% versus 2.2% to 12.0% in pre-pandemic years; p<0.001). Lengths of stay were comparable to pre-pandemic surveillance years. Interpretation: The current viral season has been associated with elevated volumes and higher inpatient acuity compared to previous years and underscores the need for additional operational and human health resources to support pediatric health systems.