Pediatric hospital admissions, case severity, and length of hospital stay during the first 18 months of the COVID-19 pandemic in a tertiary children’s hospital in Switzerland

Abstract

Background SARS-CoV-2 directly contributes to the burden of respiratory disease in children, but indirect effects of protective measures also need to be considered to assess the overall impact of the pandemic on children's health. Methods We retrospectively compared pre-pandemic and pandemic data of main admission diagnoses, sorted by ICD-10 diagnosis groups, in a tertiary children's hospital in Switzerland from 2017 until August 2021. Hospital admission rates, severity, and length of stay (LOS) of the individual ICD-10 groups during the pandemic were compared with three previous years accounting for seasonal differences. Results Among 20,168 hospital admissions (n = 13′950 in pre-pandemic years; n = 3′120 in 2020 and n = 3′098 in 2021), there were significant decreases in numbers of admissions for respiratory diseases during the early pandemic with a rebound in summer 2021. During the pandemic, admissions for non-respiratory infections, neoplasms, and skin diseases decreased but increased for trauma. Particularly, a drop in admissions for different respiratory infections [e.g. respiratory syncytial virus (RSV) and bronchiolitis] was pronounced after introduction of strict measures, but admissions increased again after restrictions were loosened. While disease severity was lower for respiratory and neurologic diseases and bronchiolitis throughout the pandemic, gastrointestinal disease admissions had longer LOS and in the first pandemic year greater severity. For RSV and pneumonia, disease severity and LOS were higher in the first pandemic year and lower in the second pandemic year. Conclusion The pandemic and associated protective measures had a significant effect on respiratory and non-respiratory admissions, particularly with decreases in hospital admissions for respiratory infections followed by a rebound after loosening of measures.

Comparing SARS-CoV-2 variants among children and adolescents in Germany: relative risk of COVID-19-related hospitalization, ICU admission and mortality

“…Increased concern about the new condition, might prompt more hospital admissions in the early phase of the COVID-19 pandemic. Literature, however, suggests that an increased fear of possible infection with SARS-CoV-2, resulted in a reduction of medical consultation and hospital admission for respiratory infections [38][39][40].…”

Trend in the admissions of patients with non-COVID-19 respiratory symptoms during COVID-19 pandemic and its impact on hospital finances in Surabaya, Indonesia

“…Previous literature has also discussed the impact of the COVID-19 pandemic. Still, the literature does not have estimates of the magnitude of the COVID-19 pandemic “effect size” on clinical and financial outcomes in a structural model [ 9 , 30 , 41 , 45 , 56 , 60 , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] ]. Previous publications have also not provided information on the relationship between the COVID-19 pandemic, patient condition, cost risk, and clinical and financial outcomes, as well as the effect of the season as a confounder in two structural models, the child model and the adult model.…”

Human Respiratory Syncytial Virus Infections among Hospitalized Children in Poland during 2010–2020: Study Based on the National Hospital Registry

“…In the UK, the RSV season is defined as the period from October to March with a peak incidence in December [ 5 , 31 , 32 ]. In two studies from Switzerland and Croatia, the increased incidence occurred between November and March, with the peak incidence in January [ 33 , 34 ]. The results presented in our study confirm trends observed in other European countries.…”