Abstract
BACKGROUND AND OBJECTIVES: Croup and bronchiolitis are common reasons for hospitalization in children, and the role of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on utilization outcomes for these conditions is not well understood. To compare health care utilization including the rates of hospitalization, readmission, length of stay, and ICU admission for croup and bronchiolitis in children with and without evidence of concurrent SARS-CoV-2 infection over the pandemic period. METHODS: This retrospective cohort study used inpatient and outpatient electronic health record data from PEDSnet institutions to examine health services use for children aged 30 days to 14 years with SARS-CoV-2 infection and diagnosed with croup or bronchiolitis. The time frame (March 2020-May 2022) was divided into predelta, delta, and omicron variant periods. Multivariable mixed effects logistic and log gamma regression models were used to calculate adjusted odds ratios for factors linked to utilization outcomes for children with versus without SARS-CoV-2 infections. Disease burden was described by variant time period. RESULTS: Across all time periods, among subjects with croup and bronchiolitis, 9.65% of croup patients and 3.92% of bronchiolitis patients were SARS-CoV-2-positive. The omicron variant period had the highest number of SARS-CoV-2 cases for both croup and bronchiolitis. After controlling for patient-level variables and hospital variability, we found no statistically significant differences in utilization outcomes comparing children with and without SARS-CoV-2. CONCLUSIONS: Pediatric patients with croup and bronchiolitis and positive SARS-CoV-2 polymerase chain reaction testing did not exhibit a significant increase in hospital and ICU admissions, which may have implications for future staffing models and public health recommendations.
| Original language | English (US) |
|---|---|
| Pages (from-to) | e432-e438 |
| Journal | Hospital Pediatrics |
| Volume | 14 |
| Issue number | 10 |
| DOIs | |
| State | Published - Oct 1 2024 |
Funding
We thank the PEDSnet Data Coordinating Center at Children's Hospital Philadelphia and the clinical informatics team at Children's Hospital Colorado for their assistance with obtaining and preparing the data set for the study. Funded by the National Institutes of Health agreement OTA OT2HL161847-01 as part of the Researching COVID to Enhance Recovery program of research. Dr Tyler is supported by grant K08HS026512 from the Agency for Healthcare Research. The funders had no role in the design or conduct of this study. The views and conclusions contained in this document are those of the authors and should not be interpreted as representing the official policies, either expressed or implied, of the National Institutes of Health. CONFLICT OF INTEREST DISCLOSURES: Dr Rao reports previous grant support from GSK and Biofire. Dr Bakel reports current grant support from Pfizer. Dr Jhaveri is a consultant for AstraZeneca, Seqirus, and Dynavax; receives an editorial stipend from Elsevier and the Pediatric Infectious Diseases Society; and receives royalties from Up To Date/Wolters Kluwer. The other authors have indicated they have no conflicts of interest relevant to this article to disclose.
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Pediatrics
