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. 2025 Apr;53(2):717-725.
doi: 10.1007/s15010-025-02494-z. Epub 2025 Mar 11.

Persistently high burden of acute respiratory infections requiring hospitalization in German pediatric hospitals, fall/winter 2023-2024

Svenja Dreßen  1 , Josephine Schneider  2 , Maren Doenhardt  3 , Natalie Diffloth  2 , Tobias Tenenbaum  4 , Dominik T Schneider  5 , Andreas Trotter  6 , Nicole Toepfner  2 , Reinhard Berner  2 ; DGPI Ad hoc-ARI-register working group
Collaborators, Affiliations

Persistently high burden of acute respiratory infections requiring hospitalization in German pediatric hospitals, fall/winter 2023-2024

Svenja Dreßen et al. Infection. 2025 Apr.

Abstract

Purpose: During fall 2021, children's hospitals in Germany faced a surge in RSV-related hospitalizations, whereas during fall/winter 2022-2023, RSV and influenza infections both led to increased inpatient admissions. Our study prospectively assessed severe acute respiratory infections, their causative pathogens, and the resulting disease burden on German children's hospitals for the fall/winter 2023-2024 season.

Methods: From October 3, 2023 through April 16, 2024, children hospitalized with ARI as a primary diagnosis were monitored via a national survey established by the German Society for Pediatric Infectious Diseases (DGPI). Weekly data was collected on total hospital admissions, ARI-related admissions by pathogen (SARS-CoV-2, RSV, influenza, other), ICU admissions with ARI as a primary diagnosis, and respiratory support.

Results: Overall, 23% of German children's hospitals (77/334 centers) submitted 1234 survey reports. ARI-related hospital admissions surged starting in November 2023 and peaked in late December 2023 (53.4% of all admissions), in parallel with a peak in the average number of newly-admitted patients (aNA) with RSV (2.5 aNA). In comparison to the 2022/2023 season, fewer newborns and infants were admitted for ARI (4.7%, p < 0.001/1.9%, p = 0.05) and fewer required ICU treatment (5.3%, p = 0.02/5.6%, p = 0.001 respectively). In 74.9% of ICU patients, ventilation support was required-9.1% less than in the previous season.

Conclusion: The clinical burden on pediatric hospitals and ICUs is strongly influenced by the changing, annually circulating pathogens and affected age group. Therefore, a continuous, systematic, dynamic collection of ARI data is critical for assessing the ARI-related morbidity and the associated burden on health care systems.

Keywords: Acute respiratory infection; Children; Hospitalization; Influenza; RSV; SARS-CoV-2.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests. Institutional review board statement: There was a review by the Board of the DGKJ and the DGPI. Informed consent statement: Not applicable.

Figures

Fig. 1
Fig. 1
A New hospital admissions with respiratory tract infections, average cases per day per reporting hospital. B Number of patients receiving ICU treatment due to a respiratory tract infection, average cases per day per reporting hospital with an in-house ICU. *Pathogen detection pending/not performed
Fig. 2
Fig. 2
A1 Average number of new RSV admissions, average cases per day per reporting hospital. A2 Average number of RSV patients receiving ICU treatment, average cases per day per reporting hospital with an in-house ICU. B1 Average number of new Influenza admissions, average cases per day per reporting hospital. B2 Average number of Influenza patients receiving ICU treatment, average cases per day per reporting hospital with an in-house ICU. As there was no calendar week 53 at the end of 2023, average value was calculated for illustrative purposes only
See this image and copyright information in PMC

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