Sun. Dec 5th, 2021

The Infection Prevention and Control (IPC) measures originally implemented to limit the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during 2020 and 2021 successfully reduced the incidence and transmission of coronavirus disease 2019 ( COVID-19) and other respiratory tract viruses.

Study: A comparison of health care after severe COVID-19, respiratory syncytial virus and influenza in children.  Image credit: L Julia / ShutterstockStudy: A comparison of health care after severe COVID-19, respiratory syncytial virus and influenza in children. Image credit: L Julia / Shutterstock

Most IPC measures have been relaxed in Western countries due to high vaccine coverage. Nevertheless, children remain unvaccinated and many children may have an “immunity debt” due to lack of viral exposure.

Hospital contacts due to severe COVID-19, respiratory syncytial virus (RSV) infection or other respiratory infections (RTIs) can therefore be expected to increase significantly.


There is little evidence to the extent that pediatric COVID-19 patients have increased use of primary care compared with children who are seriously ill with other viral infections, such as RSV infection or influenza. Hospital treatment with RSV infection has been reported to significantly affect post-disease health and morbidity in young children. Nevertheless, its effect, compared to that of COVID-19, has yet to be studied.

In a study recently published in the preprint server medRxiv*, Norwegian researchers used an observational pre-post design based on nationwide data at the individual level to examine whether and for how long, hospital contacts due to COVID-19 resulted in an increase in individual use of health care compared to hospital contacts with RSV- infection and other RTIs in children aged from one to twelve months and one to five years.

About the study

Researchers used nationwide data at the individual level from the Norwegian emergency preparedness register, Beredt C19. The study cohort included all children aged one month to five years who were resident in Norway. All had a hospital contact with COVID-19, RSV infection or other RTI between January 1, 2017 and September 20, 2021 and could be followed for at least four weeks before admission and days after discharge.

Qualified hospital contacts were identified using International Classification of Diseases (ICD10) diagnostic codes and categorized into three mutually exclusive diagnostic categories: COVID19, RSV infection, and other RTIs. Researchers examined the use of primary and specialist physicians after 128 admissions with COVID-19 (among 120 children), 4,009 admissions with RSV infection (among 3,873 children) and 34,457 admissions (among 31,747 children) with other RTIs, among 12,058 children aged 12 months and 23,682 children aged 1-5 years registered with 38,594 admissions from 1 January 2017 to 20 September 2021.

Researchers found a small increase in primary health care in the first four weeks after discharge for children aged 1-12 months with COVID-19 compared with children with RSV infection (0.064 percentage points). For children aged 1-5 years, COVID-19 emissions were associated with a 1-4 week increase in primary health care compared with children with RSV infection (0.068 percentage points) and other RTIs (0.046 percentage points). There was a similar increase in the use of specialist treatment after discharge for children aged 1-12 months in hospital treatment with COVID-19, which lasted for 12 weeks.


This study was the first to compare the severity of the major RTIs in terms of post-disease use of health care. By including hospital contacts for both the new SARS-CoV-2 virus, RS virus, and other RT viruses, including influenza, the study made a significant contribution to understanding the burden of common RTIs on health care when disease control measures were implemented. lempet.

Going forward, the etiological mechanisms of potentially worse post-hospitalization complaints or health-seeking behaviors of COVID-19 than of other RTIs in children should be further explored.

Improved knowledge about post-disease treatment after hospitalization for respiratory infections is important when developing and prioritizing vaccination of young children against RSV, influenza and SARS-CoV-2.

*Important message

medRxiv publishes preliminary scientific reports that are not peer-reviewed and therefore should not be considered as crucial, guide clinical practice / health-related behavior or be treated as established information.


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