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Trends in SARS-CoV-2-related pediatric hospitalizations reported to the Canadian Nosocomial Infection Surveillance
Diane Lee1, Erin McGill1, Linda Pelude1
1Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON, Canada.
Objective:
This study describes trends in COVID-19 hospitalizations and healthcare-associated (HA) COVID-19 in Canada among pediatric (age <18 years) patients during pre-Omicron and Omicron-dominant periods.
Design:
Prospective surveillance for COVID-19 infection.
Setting:
The Canadian Nosocomial Infection Surveillance Program is a sentinel surveillance system with 45 hospitals providing COVID-19 data on pediatric patients, including all 13 pediatric tertiary care facilities in Canada.
Patients:
Pediatric patients hospitalized with laboratory-confirmed COVID-19 at a participating hospital between March 1, 2020, and December 31, 2022.
Methods:
Analyzed case-level data on pediatric patients with COVID-19, including demographics, acquisition source, and outcomes.
Results:
Among 5,143 pediatric cases, the majority (81%) were reported during the Omicron-dominant period (beginning December 26, 2021). However, a lower proportion required intensive care during the Omicron wave (11% vs 14%, P < 0.05); no difference in mortality was observed. Of those patients admitted to hospital due to COVID-19 (n = 2,700), 45% had at least one pre-existing comorbidity. The majority (90%) of patients with HA-COVID-19 were reported during the Omicron period. There was no difference in mortality between patients with HA and community-associated (CA) infection, although a greater proportion of CA infections led to intensive care unit admission (6% vs 13%, P < 0.01).
Conclusions:
Surveillance findings indicate that both HA- and CA-COVID-19 hospitalizations in Canada increased among pediatric patients following the emergence of the Omicron variant, although disease severity decreased. Pre-existing health conditions were common among pediatric patients hospitalized with COVID-19, highlighting the importance of preventing severe illness in this sub-population.
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