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. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Review Ethics Board of CHEO Research Institute waived ethical approval for this work I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present work are contained in the manuscript