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April 30, 2026Canadian Medical Association Journal2 citationsOpen Access

Changes in hospital admissions associated with pediatric respiratory syncytial virus after the COVID-19 pandemic in Canada: an active surveillance study

ALAariana LopesJEJoanne EmbreéTJTaj Jadavji

Key Points

  • This study aims to examine the changes in hospital admissions related to pediatric RSV following the COVID-19 pandemic.
  • Conducted active surveillance of hospital-admitted infants and children aged 0 to 16 years at 13 IMPACT centres.
  • Compared RSV-associated hospital admissions in 2022/23 with those from the prepandemic period (2017/18 to 2019/20).
  • Performed seasonal autoregressive integrated moving average (SARIMA) time-series analyses.
  • In 2022/23, there were 5362 RSV-associated hospital admissions, including 1260 (23.5%) ICU admissions, both more than double the prepandemic averages.
  • The median age of admissions increased from 6 to 9 months (p < 0.001).
  • The odds of ICU admission among infants younger than 6 months increased (adjusted odds ratio 1.35, 95% CI 1.2 to 1.52) compared to the prepandemic period.

Abstract

Background: The COVID-19 pandemic affected the epidemiology of respiratory syncytial virus (RSV). We sought to describe tertiary care hospital admissions associated with pediatric RSV in 2022/23 in Canada and to assess pandemic-related changes. Methods: We conducted active surveillance of hospital-admitted infants and children aged 0 to 16 years at 13 Immunization Monitoring Program, Active (IMPACT) centres. We compared RSV-associated hospital admissions in 2022/23 with those in the prepandemic period (2017/18 through 2019/20). We calculated province-specific and age-stratified proportions of all-cause hospital admissions with RSV detection and age-stratified proportions of RSV-associated intensive care unit (ICU) admissions. We performed seasonal autoregressive integrated moving average (SARIMA) time-series analyses. Results: In 2022/23, 5362 RSV-associated hospital admissions occurred, including 1260 (23.5%) ICU admissions, both more than double the prepandemic yearly averages. Overall, the median age increased from 6 (interquartile range IQR 1 to 20) months to 9 (IQR 2 to 27) months (p Interpretation: In 2022/23, the number of RSV-associated hospital admissions and ICU admissions increased dramatically in Canadian pediatric hospitals. The greatest burden remained in infants younger than 6 months. Strategies for RSV immunization for young infants may have a substantial public health impact.

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Cite This Study

Lopes et al. (2026) studied this question.

synapsesocial.com/papers/69f2f1771e5f7920c638714bhttps://doi.org/10.1503/cmaj.251369
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