• Christina Belza, Christina Diong, Eleanor Pullenayegum, Katherine E Nelson, Kazuyoshi Aoyama, Longdi Fu, Francine Buchanan, Sanober Diaz, Ori Goldberg, Astrid Guttmann, Charlotte Moore Hepburn, Sanjay Mahant, Rachel Martens, Natasha R Saunders, and Eyal Cohen.
• The Hospital for Sick Children, Toronto, Ontario, Canada.
• J Hosp Med. 2024 Oct 22.

AbstractDecreased severe respiratory illness was observed during the first 2 years of the COVID-19 pandemic, with a relatively smaller decrease among children with medical complexity (CMC) compared to non-CMC. We extended this analysis to the third pandemic year (April 1, 2022, to March 31, 2023) when pandemic public health measures were loosened. A population-based repeated cross-sectional study evaluated respiratory hospitalizations among CMC and non-CMC (<18 years) in Ontario, Canada. Among the 67,517 CMC and 3,006,504 non-CMC in Ontario, there were more CMC respiratory hospitalizations compared with the expected prepandemic levels (n = 3145 hospitalizations, corresponding to rate ratio [RR], 1.20; 95% confidence interval [CI], 1.16-1.25) with an even larger relative increase among non-CMC (n = 6653, RR, 1.36; 95% CI, 1.34-1.38). Increased intensive care unit admissions for respiratory illness were also observed (CMC: RR, 1.44; 95% CI, 1.31-1.59; non-CMC: RR, 2.02; 95% CI, 1.89-2.16). Understanding respiratory surge drivers may provide insights to protect at-risk children from respiratory morbidity.© 2024 Society of Hospital Medicine.

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