key: cord-0851418-k4v8a16s
authors: Groves, Helen E; Papenburg, Jesse; Mehta, Kayur; Bettinger, Julie A; Sadarangani, Manish; Halperin, Scott; Morris, Shaun
title: 1188. The Effect Of The COVID-19 Pandemic On Influenza-Related Hospitalization, Intensive Care Admission And Mortality In Canadian Children
date: 2021-12-04
journal: Open Forum Infect Dis
DOI: 10.1093/ofid/ofab466.1380
sha: abde1b14ab800ab338ea2b23596264dfccf2bf88
doc_id: 851418
cord_uid: k4v8a16s

BACKGROUND: The COVID-19 pandemic resulted in unprecedented implementation of wide-ranging public health measures globally. During the pandemic, dramatic decreases in seasonal influenza virus detection have been reported worldwide. Information on pediatric influenza-related hospitalizations is limited. We describe influenza-related hospitalization in Canadian children during the 2020/2021 influenza season compared to ten previous seasons. METHODS: Data on influenza-related hospitalizations, intensive care unit (ICU) admissions and in-hospital deaths in children across Canada were obtained from the Canadian Immunization Monitoring Program, ACTive (IMPACT). This national surveillance initiative comprises 90% of all tertiary care pediatric beds in Canada. The total study period included eleven influenza seasons from September 2010 to April 2021 inclusive. Time series modelling was used to compare trends in influenza-related hospitalizations during the 2020/2021 season (September 2020 to April 2021 inclusive) with the ten previous seasons. RESULTS: During the 2020/2021 influenza season there were no pediatric influenza infection-related hospitalizations. This was a significant decrease compared to the predicted total influenza-related hospitalizations for this period (p< 0.001). No pediatric ICU admission or deaths were reported for the 2020/2021 influenza season. CONCLUSION: We show complete absence of influenza infection-related hospitalization in children in Canada during the 2020/2021 season. This significant decrease is likely related in large part to non-pharmacological public health interventions implemented during the COVID-19 pandemic, although the potential role of viral interference is unknown. Our findings suggest measures such as use of facemasks, hand-washing, distancing and school closures may be beneficial for influenza control and mitigation of future influenza epidemics. DISCLOSURES: Helen E. Groves, PhD, MBBCh BAO, Abbvie (Other Financial or Material Support, Dr. Groves reports personal fees from Honoraria received from Abbvie for education meeting presentation, not relevant to the submitted work.) Jesse Papenburg, MD, AbbVie (Grant/Research Support, Other Financial or Material Support, Personal fees)Medimmune (Grant/Research Support)Sanofi Pasteur (Grant/Research Support)Seegene (Grant/Research Support, Other Financial or Material Support, Personal fees) Manish Sadarangani, BM BCh, DPhil, GlaxoSmithKline (Grant/Research Support)Merck (Grant/Research Support)Pfizer (Grant/Research Support)Sanofi Pasteur (Grant/Research Support)Seqirus (Grant/Research Support)Symvivo (Grant/Research Support)VBI Vaccines (Research Grant or Support) Shaun Morris, MD, MPH, DTM&H, FRCPC, FAAP, GSK (Speaker’s Bureau)Pfizer (Advisor or Review Panel member)Pfizer (Grant/Research Support)

Background. cCMV infection is a major contributor to childhood neurologic and cognitive disabilities including sensorineural hearing loss (SNHL). Neonatal treatment with ganciclovir/valganciclovir improves hearing outcomes, but its impact on neurodevelopmental outcomes remains an important knowledge gap. We describe the neurodevelopmental outcomes of children with cCMV infection and evaluate the effect of neonatal antiviral therapy on outcomes.

Methods. Since 2013, infants with cCMV infection referred to Nationwide Children's Hospital's NEO-ID Clinic have had a complete evaluation at diagnosis as well as follow-up neurodevelopmental assessments. Pertinent demographic, clinical, laboratory, radiographic, and follow-up data were obtained and managed using REDCap. Neurodevelopmental assessments were performed using Bayley Scales of Infant and Toddler Development (BSID) III/IV (cognitive, language, motor domains) at ~ 24 months of age. The Gross Motor Function Classification System was used to classify functional motor impairment. Neurodevelopmental outcomes were compared by receipt of antiviral therapy in early infancy.

Results. 95 infants (mean ± SD; gestational age 35 ± 5 wk, birth weight 2121 ± 948 g; Table 1 ) with cCMV infection had follow-up neurodevelopmental assessments. 62% had central nervous system involvement, 37% had SNHL, 23% developed cerebral palsy (CP), and 6% were diagnosed with autism spectrum disorder. The majority had normal BSID scores (≥ 85) in cognitive and motor domains (65% and 54%, respectively) while 48% had normal scores in the language domain. 35% had severe impairment (< 70) in ≥ 1 domain (Table 2) . 9 children had clinically inapparent cCMV infection; 2 (22%) had abnormalities on BSID testing (1, cognitive score: 80; 1, cognitive, language, and motor scores: 65, 68, 73, respectively). 11 (12%) children, including 6 who received antiviral therapy, had severe neurodevelopmental impairment, with CP and severe (< 70) BSID scores in both the cognitive and motor domains. Background. The COVID-19 pandemic resulted in unprecedented implementation of wide-ranging public health measures globally. During the pandemic, dramatic decreases in seasonal influenza virus detection have been reported worldwide. Information on pediatric influenza-related hospitalizations is limited. We describe influenza-related hospitalization in Canadian children during the 2020/2021 influenza season compared to ten previous seasons.

Methods. Data on influenza-related hospitalizations, intensive care unit (ICU) admissions and in-hospital deaths in children across Canada were obtained from the Canadian Immunization Monitoring Program, ACTive (IMPACT). This national surveillance initiative comprises 90% of all tertiary care pediatric beds in Canada. The total study period included eleven influenza seasons from September 2010 to April 2021 inclusive. Time series modelling was used to compare trends in influenza-related hospitalizations during the 2020/2021 season (September 2020 to April 2021 inclusive) with the ten previous seasons.

Results. During the 2020/2021 influenza season there were no pediatric influenza infection-related hospitalizations. This was a significant decrease compared to the predicted total influenza-related hospitalizations for this period (p< 0.001). No pediatric ICU admission or deaths were reported for the 2020/2021 influenza season.

Conclusion. We show complete absence of influenza infection-related hospitalization in children in Canada during the 2020/2021 season. This significant decrease is likely related in large part to non-pharmacological public health interventions implemented during the COVID-19 pandemic, although the potential role of viral interference is unknown. Our findings suggest measures such as use of facemasks, hand-washing, distancing and school closures may be beneficial for influenza control and mitigation of future influenza epidemics.

Disclosures Background. Worldwide SARS-CoV-2 infections increase every day. Despite the infection is less severe in children, it can be severe and associated with complications. However, local data remain scarce. We sought to describe epidemiological and clinical characteristics of COVID-19 infection in this population across different age groups.

Methods. Observational, multicenter study across 23 Colombian hospitals from 22 different territories. We included all patients from 0 months to 17 years with confirmed SARS-CoV-2 infection by either antigen or RT-PCR testing.

Results. From March 1, 2020, to October 31, 2021, we identified 1,186 patients: neonates (88), 1 to 3 months (130), 4 to 23 months (306), 2 to 4 years (169), 5 to 11 years (229) and 12 to 18 years (226) with confirmed COVID-19 infection. Of those,77(6.2%) were asymptomatic, 631(53.2%) hospitalized, 132(11.2%) required PICU. 58 cases met WHO definition of MIS-C. Patients less than 24 months of age were characterized by fever (74%) and more respiratory distress (30.1%) compared to other groups. Patients >5yo seemed to have a more severe presentation. They had more gastrointestinal (GI) symptoms (31% vs 37.8%), had more need for ICU care given presentation with shock increased with age ( >5yo 9.5%; 5-12yo 10.6%; 12-18yo 11.5%). Lab markers including thrombocytopenia and Lymphopenia were more common on this age group. Antibiotic treatment was common (%%) especially in neonates (40.9%), despite bacterial coinfection was rare (8.7%), length of hospitalization was longer in older than 2-year-old groups. 23(1.9%) patients died, similar across different age groups.

Heat map by age group

COVID 19 Infection in Children in Colombia

Candidate for doctorate in Public Health 11

Assistant proffesor 23 ; 1 Hospital General de Medellin/ Clínica Las Américas Auna

Clínica Versalles/Clínica Farallones/Clínica Palma Real/Clínica occidente, Cali, Valle del Cauca, Colombia; 5 Hospital Infantil Los Ángeles

Club Noel Children's Hospital, Cali, Valle del Cauca, Colombia; 12 Hospital

Centro Médico Imbanaco, Cali, Valle del Cauca, Colombia; 19 Universidad Tecnológica de Pereira

Conclusion. infection in Colombian children presented differently across different age groups. Children older than 5 years had a more severe clinical course and prolonged hospital stays. Clinical findings according to age groups could help clinicians in characterizing and identifying COVID 19 infections in Children.Disclosures. Ivan Felipe Gutiérrez Tobar, n/a, Pfizer and MSD (Advisor or Review Panel member, Research Grant or Support, Speaker's Bureau, Has received support from Pfizer and MSD for participation in congresses and has received conference payments from Pfizer)Pfizer and MSD (Speaker's Bureau, Other Financial or Material Support, Has received support from Pfizer for participation in congresses) Juan P. Rojas -Hernandez, Candidate for doctorate in Public Health, Pfizer (Other Financial or Material Support, Has received support from Pfizer for participation in congresses) Eduardo López Medina, n/a, Pfizer (Other Financial or Material Support, Has received support from Pfizer for participation in congresses) 

Background. Congenital cytomegalovirus (cCMV) is a leading cause of preventable congenital birth defects worldwide. In the United States, approximately 1 in 200 infants are born with cCMV and about 10% exhibit symptoms at birth; of those, 40-60% experience long-term sequelae including sensorineural hearing loss and developmental delays. As routine newborn surveillance is universally absent, it is difficult to assess the absolute burden of cCMV and demonstrate the need for CMV treatment and prevention. Here we describe the global epidemiologic burden of cCMV from 2010-2020 by performing a systematic review of the literature.Methods. Publications from 2000-2020 on CMV-related epidemiologic, economic, and humanistic burden across all ages were identified using Medline, Embase, and LILACS. Epidemiologic burden estimates of cCMV in at-risk age groups (newborns [≤ 1 month] and infants [2 months to 2 years]) were extracted from recent studies published from 2010-2020, excluding previous systematic literature reviews, chart reviews, case series, gray literature, and studies in immunosuppressed populations. The primary outcome measure was seroprevalence, defined by CMV-specific