{
    "abstract": "This population-level retrospective cohort study measured seasonal patterns of pediatric hospitalizations, pediatric intensive care unit (PICU) admissions, and average age of children diagnosed with acute respiratory diseases (ARD) during pre-pandemic, COVID-19 pandemic, and late/post-pandemic periods.\nFrom September 2010 through August 2024, all hospitalizations for ARD among children <18 years old were identified from the provincial Discharge Abstract Database, in Alberta, Canada. Seasonal autoregressive integrated moving average (SARIMA) models were developed based on pre-pandemic trends and predicted expected weekly outcomes with 95% confidence intervals (95% CI) from March 2020 onward. Observed and expected outcomes with 95% CI were compared to measure impacts during peak seasons.\nThere were 52,839 ARD hospitalizations: 16,003 (30.29%) bronchiolitis, 7958 (15.06%) influenza-like illness, 14,366 (27.19%) pneumonia, 2989 (5.66%) croup, 10,266 (19.43%) asthma exacerbation, and 1257 (2.38%) COVID-19. Further, 4433 (8.39%) hospitalizations included a PICU admission. During the pre-pandemic period, hospitalizations for ARD had a biennial pattern, where the peak incidence was highest every other winter season. During the pandemic and late/post-pandemic periods, the average weekly incidence of hospitalization for ARD/100,000 children decreased 91.25% during winter 2020-2021 (1.03 observed vs. 11.81 [95% CI 7.30, 16.33] expected), increased 47.98% during winter 2022-2023 (18.06 observed vs. 12.20 [95% CI 7.06, 17.34] expected), and returned near pre-pandemic incidence during winter 2023-2024 (12.87 observed vs. 11.87 [95% CI 6.08, 17.67] expected) compared with incidence predicted by the SARIMA model. During winter 2022-2023 when hospitalizations surged, there was no significant change in the average weekly incidence of PICU admissions for ARD/100,000 children (2.07 observed vs. 1.26 [95% CI 0.26, 2.27] expected), nor percent PICU admissions (10.21% observed vs. 10.11% [95% CI 5.50, 14.73] expected), nor in average age (31.95 months observed vs. 34.20 months [95% CI 25.89, 42.52] expected).\nHospitalizations for pediatric ARD decreased dramatically during winter 2020-2021, surged during winter 2022-2023, and returned near pre-pandemic incidence during winter 2023-2024. There was no lasting change in PICU admissions nor average age. Ongoing surveillance will describe the evolving seasonal pattern of ARD during the post-pandemic period.\nNone.",
    "authors": [
        {
            "affiliation": "Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.",
            "firstname": "Christine D",
            "initials": "CD",
            "lastname": "Lukac"
        },
        {
            "affiliation": "Maternal and Child Data and Analytics, Alberta Health Services, Calgary, AB, Canada.",
            "firstname": "Brett",
            "initials": "B",
            "lastname": "Simms"
        },
        {
            "affiliation": "Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.\nAlberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.\nFaculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada.",
            "firstname": "Grace P S",
            "initials": "GPS",
            "lastname": "Kwong"
        },
        {
            "affiliation": "Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.\nAlberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.\nDepartment of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.\nHotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.\nO'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.\nCenter for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.",
            "firstname": "Jessalyn K",
            "initials": "JK",
            "lastname": "Holodinsky"
        },
        {
            "affiliation": "Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.\nAlberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.\nDepartment of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.\nMaternal Newborn Child and Youth Strategic Clinical Network, Alberta Health Services, Calgary, AB, Canada.\nDepartment of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.",
            "firstname": "David W",
            "initials": "DW",
            "lastname": "Johnson"
        },
        {
            "affiliation": "Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.\nDepartment of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.\nAlberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.\nO'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.\nDepartment of Microbiology, Immunology & Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.",
            "firstname": "James D",
            "initials": "JD",
            "lastname": "Kellner"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2025 The Author(s).",
    "doi": "10.1016/j.lana.2025.101024\n10.1016/S0140-6736(22)00478-0\n10.7189/jogh.05.010408\n10.1016/S2214-109X(19)30264-5\n10.1001/jamanetworkopen.2021.24650\n10.1093/infdis/jiab606\n10.1016/j.eclinm.2023.102089\n10.1016/S1473-3099(22)00525-4\n10.1016/S1473-3099(23)00630-8\n10.1016/S0140-6736(22)01016-9\n10.1001/jamanetworkopen.2023.39884\n10.1093/cid/ciaa1475\n10.3346/jkms.2022.37.e215\n10.1002/lary.31366\n10.1016/S1473-3099(24)00081-1\n10.1038/s41562-021-01079-8\n10.1371/journal.pone.0150416\n10.1371/journal.pone.0244746\n10.1177/2333392820939801\n10.1002/ppul.21162\n10.1111/j.1399-3038.2005.00346.x\n10.1016/j.lana.2023.100582\n10.1136/bmj-2023-075665\n10.1001/jamanetworkopen.2020.37227\n10.1016/S1473-3099(23)00200-1\n10.1093/cid/ciae140\n10.1001/jamanetworkopen.2024.16077\n10.1542/peds.2020-039115\n10.1001/jamanetworkopen.2024.10746",
    "journal": "Lancet regional health. Americas",
    "keywords": [
        "Acute respiratory diseases",
        "Bronchiolitis",
        "Children",
        "Croup",
        "Hospital admissions",
        "Influenza-like illness",
        "Intensive care admissions",
        "Pediatric",
        "Pneumonia",
        "Population surveillance",
        "Respiratory tract infections",
        "Retrospective cohort study",
        "Seasonal autoregressive integrated moving average (SARIMA) models",
        "Time series analysis"
    ],
    "methods": null,
    "publication_date": "2025-04-22",
    "pubmed_id": "40260184\n35598608\n26445672\n31303294\n34529066\n35030633\n37483545\n36063828\n38141633\n35785792\n37883085\n32986804\n35851860\n38415842\n38368891\n33686204\n26958849\n33411792\n32782916\n19953656\n16426258\n37705884\n37487604\n33576819\n37141913\n38602423\n38861259\n33972381\n38728028",
    "results": null,
    "title": "Hospitalizations for all-cause pediatric acute respiratory diseases in Alberta, Canada, before, during, and after the COVID-19 pandemic: a population-level retrospective cohort study from 2010 to 2024.",
    "xml": "<Element 'PubmedArticle' at 0x788505dabf10>"
}