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. 2023 Jun 16;18(6):e0287395.
doi: 10.1371/journal.pone.0287395. eCollection 2023.

Changes in hospitalizations and emergency department respiratory viral diagnosis trends before and during the COVID-19 pandemic in Ontario, Canada

Steven Habbous  1   2 , Susy Hota  3 , Vanessa G Allen  1   3   4 , Michele Henry  1 , Erik Hellsten  1
Affiliations

Changes in hospitalizations and emergency department respiratory viral diagnosis trends before and during the COVID-19 pandemic in Ontario, Canada

Steven Habbous et al. PLoS One. .

Abstract

Introduction: Population-level surveillance systems have demonstrated reduced transmission of non-SARS-CoV-2 respiratory viruses during the COVID-19 pandemic. In this study, we examined whether this reduction translated to reduced hospital admissions and emergency department (ED) visits associated with influenza, respiratory syncytial virus (RSV), human metapneumovirus, human parainfluenza virus, adenovirus, rhinovirus/enterovirus, and common cold coronavirus in Ontario.

Methods: Hospital admissions were identified from the Discharge Abstract Database and exclude elective surgical admissions and non-emergency medical admissions (January 2017-March 2022). Emergency department (ED) visits were identified from the National Ambulatory Care Reporting System. International Classification of Diseases (ICD-10) codes were used to classify hospital visits by virus type (January 2017-May 2022).

Results: At the onset of the COVID-19 pandemic, hospitalizations for all viruses were reduced to near-trough levels. Hospitalizations and ED visits for influenza (9,127/year and 23,061/year, respectively) were nearly absent throughout the pandemic (two influenza seasons; April 2020-March 2022). Hospitalizations and ED visits for RSV (3,765/year and 736/year, respectively) were absent for the first RSV season during the pandemic, but returned for the 2021/2022 season. This resurgence of hospitalizations for RSV occurred earlier in the season than expected, was more likely among younger infants (age ≤6 months), more likely among older children (aged 6.1-24 months), and less likely to comprise of patients residing in higher areas of ethnic diversity (p<0.0001).

Conclusion: During the COVID-19 pandemic, there was a reduced the burden of other respiratory infections on patients and hospitals. The epidemiology of respiratory viruses in the 2022/23 season remains to be seen.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Hospital admissions over time.
Hospital admissions associated with influenza (A), respiratory syncytial virus (B), human metapneumovirus (C), and rhinovirus/enterovirus.
Fig 2
Fig 2. Emergency department visits over time.
Emergency department visits associated with influenza (A), respiratory syncytial virus (B), human metapneumovirus (C), and rhinovirus/enterovirus.
Fig 3
Fig 3. Timeline of interventions.
Timing of restrictions and mandates related to gatherings, school events, and masking relative to the respiratory syncytial virus (RSV) seasons.
See this image and copyright information in PMC

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