Pediatric Acute Respiratory Virus Hospitalizations: A Population-Based Cohort Study, 2017–2024
Bibliographic record
Abstract
BACKGROUND: Coronavirus disease 2019 (COVID-19) mitigation measures resulted in widespread disruptions to respiratory viruses. The objective of this study was to compare observed and expected pediatric viral acute respiratory infection (ARI)-related hospitalizations, and the characteristics of admitted children, postpandemic. METHODS: Total and virus-specific ARI-related hospitalization rates were determined using a population-based cohort of youth <18 years in Ontario, Canada between July 2017 and June 2024. Sociodemographic and clinical characteristics were identified from linked administrative data. Expected weekly postpandemic age- and sex-specific admission rates were estimated using Poisson regression; adjusted rate ratios (RRs) and 95% confidence intervals (CIs) were reported. RESULTS: This cohort included approximately 2.7 million youth per year. There was a sharp reduction in ARIs in 2020/2021, followed by a moderate return in 2021/2022; influenza remained mostly absent (n = 168). An out of season persistence and overwhelming ARI burden occurred in 2022/2023, particularly for RSV (n = 4701 admissions vs 1969-2357 prepandemic) and human metapneumovirus (n = 377 vs 93-127). Overall, more older children (mean age, 38.9-42.8 vs 37.2-37.9 months prepandemic) and fewer males were admitted postpandemic; males were the only group with lower than expected 2022/2023 admissions (RR, 0.63; 95% CI, .57-.70 for all ARIs). COVID-19-related admissions contributed minimally to ARI-related hospitalizations overall, particularly among <5 year olds. Prepandemic seasonality appears to nearly have resumed in 2023/2024. CONCLUSIONS: Postpandemic disruptions in multiple ARIs substantially influenced the intensity, timing, and characteristics of children seeking health care. Although 2023/2024 was more typical, it is not yet clear when-or if-prepandemic ARI seasonality will resume. LAY SUMMARY: Substantial, unprecedented changes in several common childhood respiratory viruses occurred in each season following the COVID-19 pandemic, drastically impacting the timing and magnitude of demands placed upon the pediatric health care system, as well as the characteristics of children seeking care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".