Sarah A Buchan1,2, Hannah Chung3, Timothy Karnauchow4,5, J Dayre McNally4, Michael A Campitelli3, Jonathan B Gubbay2,6,7, Kevin Katz6,8, Allison J McGeer1,6,9, David C Richardson10, Susan E Richardson6,7, Andrew Simor6,11, Marek Smieja12, George Zahariadis13,14, Dat Tran7,15, Natasha S Crowcroft1,2,6, Laura C Rosella1,2,3, Jeffrey C Kwong1,2,3,16,17. 1. From the Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. 2. Public Health Ontario, Toronto, ON, Canada. 3. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. 4. Children's Hospital of Eastern Ontario, Ottawa, ON, Canada. 5. Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON, Canada. 6. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada. 7. The Hospital for Sick Children, Toronto, ON, Canada. 8. North York General Hospital, Toronto, ON, Canada. 9. Sinai Health System, Toronto, ON, Canada. 10. William Osler Health System, Brampton, ON, Canada. 11. Sunnybrook Health Sciences Centre, Toronto, ON, Canada. 12. McMaster University, Hamilton, ON, Canada. 13. London Health Sciences Centre, London, ON, Canada. 14. Newfoundland & Labrador Public Health Laboratory, St. John's, NF&L, Canada. 15. Department of Paediatrics. 16. Department of Family & Community Medicine, University of Toronto, Toronto, ON, Canada. 17. University Health Network, Toronto, ON, Canada.
Abstract
BACKGROUND: Respiratory illnesses are a major contributor to pediatric hospitalizations, with influenza and respiratory syncytial virus (RSV) causing substantial morbidity and cost each season. We compared the characteristics and outcomes of children 0-59 months of age who were hospitalized with laboratory-confirmed influenza or RSV between 2009 and 2014 in Ontario, Canada. METHODS: We included hospitalized children who were tested for influenza A, influenza B and RSV and were positive for a single virus. We characterized individuals by their demographics and healthcare utilization patterns and compared their hospital outcomes, in-hospital cost and postdischarge healthcare use by virus type and by presence of underlying comorbidities. RESULTS: We identified and analyzed 7659 hospitalizations during which a specimen tested positive for influenza or RSV. Children with RSV were the youngest whereas children with influenza B were the oldest [median ages 6 months (interquartile range: 2-17 months) and 25 months (interquartile range: 10-45 months), respectively]. Complex chronic conditions were more prevalent among children with all influenza (sub)types than RSV (31%-34% versus 20%). In-hospital outcomes were similar by virus type, but in children with comorbidities, postdischarge outcomes varied. We observed no differences in in-hospital cost between viruses or by presence of comorbidities [overall median cost: $4150 Canadian dollars (interquartile range: $3710-$4948)]. CONCLUSIONS: Influenza and RSV account for large numbers of pediatric hospitalizations. RSV and influenza were similar in terms of severity and cost in hospitalized children. Influenza vaccination should be promoted in pregnant women and young children, and a vaccine against RSV would mitigate the high burden of RSV.
BACKGROUND:Respiratory illnesses are a major contributor to pediatric hospitalizations, with influenza and respiratory syncytial virus (RSV) causing substantial morbidity and cost each season. We compared the characteristics and outcomes of children 0-59 months of age who were hospitalized with laboratory-confirmed influenza or RSV between 2009 and 2014 in Ontario, Canada. METHODS: We included hospitalized children who were tested for influenza A, influenza B and RSV and were positive for a single virus. We characterized individuals by their demographics and healthcare utilization patterns and compared their hospital outcomes, in-hospital cost and postdischarge healthcare use by virus type and by presence of underlying comorbidities. RESULTS: We identified and analyzed 7659 hospitalizations during which a specimen tested positive for influenza or RSV. Children with RSV were the youngest whereas children with influenza B were the oldest [median ages 6 months (interquartile range: 2-17 months) and 25 months (interquartile range: 10-45 months), respectively]. Complex chronic conditions were more prevalent among children with all influenza (sub)types than RSV (31%-34% versus 20%). In-hospital outcomes were similar by virus type, but in children with comorbidities, postdischarge outcomes varied. We observed no differences in in-hospital cost between viruses or by presence of comorbidities [overall median cost: $4150 Canadian dollars (interquartile range: $3710-$4948)]. CONCLUSIONS: Influenza and RSV account for large numbers of pediatric hospitalizations. RSV and influenza were similar in terms of severity and cost in hospitalized children. Influenza vaccination should be promoted in pregnant women and young children, and a vaccine against RSV would mitigate the high burden of RSV.
Authors: Sonya C Tang Girdwood; Tomoyuki Mizuno; Kelli A Krallman; Laura A Benken; Erin M Stoneman; Toni M Yunger; Hector R Wong; Alexander A Vinks; Jennifer M Kaplan Journal: Pediatr Infect Dis J Date: 2019-12 Impact factor: 2.129