Trends in Pediatric Hospital Admissions Caused or Contributed by SARS-CoV-2 Infection in England

Area of Science:

• Pediatric infectious diseases
• Epidemiology of viral infections
• Public health surveillance

Background:

• SARS-CoV-2 has significantly impacted global health, with evolving characteristics in pediatric populations.
• Understanding temporal trends in pediatric hospital admissions related to SARS-CoV-2 is crucial for public health preparedness.

Purpose of the Study:

• To analyze changes in the characteristics of pediatric hospital admissions associated with SARS-CoV-2 over time.
• To compare admission types, severity, and outcomes between different periods of the pandemic.

Main Methods:

• A national, observational cohort study utilizing English electronic health records from July 2020 to August 2023.
• Inclusion criteria: children (<18 years) hospitalized with SARS-CoV-2 as a cause or contributor, excluding incidental infections.
• Outcomes assessed: hospitalization types, critical care, pediatric inflammatory multisystem syndrome-temporally associated with SARS-CoV-2 (PIMS-TS), and mortality.

Main Results:

• Significant decrease in PIMS-TS cases (11.2% to 0.8%) and critical care use (8.4% to 4.4%) from pre-Omicron to Omicron eras.
• Reduced mortality rate among hospitalized children (521 to 249 per 100,000).
• Median age of hospitalized children decreased from 4.7 to 1.1 years, with infants comprising a larger proportion of admissions (30.1% to 48.8%).

Conclusions:

• Infants have become the most affected pediatric age group by SARS-CoV-2.
• This shift is likely due to lower immunity in infants, increasing their vulnerability to respiratory illnesses.
• Findings underscore the need for targeted public health strategies for infants during viral respiratory seasons.