Paediatric health system impact of an early respiratory viral season in Eastern Ontario, Canada: A descriptive analysis

Objectives: We examined trends in patient volumes and care intensity among children admitted with laboratory-confirmed respiratory viral infections over 5 years in Ottawa, following the most recent and intense respiratory viral season experienced throughout the Ontario paediatric health system.Methods: This was a retrospective cohort study of patients at the Children's Hospital of Eastern Ontario (CHEO) in Ottawa, who were diagnosed with a laboratory-confirmed respiratory viral infection in the first 72 h of admission between October 22, 2017 and March 25, 2023. Their admissions were stratified by age groups and level of care intensity, based on unit of admission and/or additional ventilatory needs, with Level 3 patients requiring intensive care unit admission, and evaluated for trends over six surveillance periods that began in Week 35 (early September) and ended in Week 34 (end-August) of the following year.Results: During the surveillance period from August 28, 2022 to March 25, 2023, there was an early, steep and twofold increase in admissions due to respiratory viral infections compared to previous periods, driven largely by Respiratory Syncytial Virus and Influenza A. Despite similar age distributions, there was a larger volume of Level 2 and 3 admissions, and higher proportion of patients requiring Level 2 care intensity in inpatient medicine units (23.4% versus 10.4% in pre-pandemic years; P < 0.001).Conclusions: The most recent viral season was 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 paediatric health systems through these predictable surge periods.