Hospital Admissions for Respiratory Tract Infections in Children Aged 0–5 Years for 2017/2023

Abstract

<b>Aim:</b> To compare hospital admissions across common respiratory tract infections (RTI) in 2017-21, and project possible hospital admissions for the RTIs among children aged 0-12 months and 1-5 years in 2022 and 2023. <b>Methods:</b> In 644 885 children aged 0-12 months and 1-5 years, we plotted the observed monthly number of RTI admissions [upper- and lower RTI, influenza, respiratory syncytial virus (RSV), and COVID-19] from January 1st, 2017 until October 31st, 2021. We also plotted the number of RTI admissions with a need for respiratory support. We used the observed data to project four different scenarios of RTI admissions for the rest of 2021 until 2023, with different impacts on hospital wards: (1) "Business as usual," (2) "Continuous lockdown," (3) "Children's immunity debt," and (4) "Maternal and child immunity debt." <b>Results:</b> By October 31st, 2021, the number of simultaneous RTI admissions had exceeded the numbers usually observed at the typical season peak in January, i.e., ~900. Based on our observed data and assuming that children and their mothers (who transfer antibodies to the very youngest) have not been exposed to RTI over the last one and a half years, our scenarios suggest that hospitals should be prepared to handle two <i>to three times</i> as many RTI admissions, and two <i>to three times</i> as many RTI admissions requiring respiratory support among 0-5-year-olds as normal, from November 2021 to April 2022. <b>Conclusion:</b> Scenarios with immunity debt suggest that pediatric hospital wards and policy makers should plan for extended capacity.