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2. Caracteristiques des hospitalisations au Canada d'enfants ayant contracte une infection aigue par le SRAS-CoV-2 en 2020

Author

Drouin, Olivier, Hepburn, Charlotte Moore, Farrar, Daniel S., Baerg, Krista, Chan, Kevin, Cyr, Claude, Donner, Elizabeth J., Embree, Joanne E., Farrell, Catherine, Forgie, Sarah, Giroux, Ryan, Kang, Kristopher T., King, Melanie, Laffin, Melanie, Luu, Thuy Mai, Orkin, Julia, Papenburg, Jesse, Pound, Catherine M., Price, Victoria E., Purewal, Rupeena, Sadarangani, Manish, Salvadori, Marina I., Top, Karina A., Viel-Theriault, Isabelle, Kakkar, Fatima, and Morris, Shaun K.

Subjects
Infection, Health
Abstract

Contexte : Les facteurs de risque de complications graves de l'infection par le SRAS-CoV-2 n'ont pas ete bien etablis chez les enfants. Nous avons voulu decrire les hospitalisations pediatriques associees au SRAS-CoV-2 au Canada et identifier les facteurs de risque de maladie grave. Methodes : Nous avons procede a une etude prospective nationale en utilisant l'infrastructure du Programme canadien de surveillance pediatrique (PCSP). Les hospitalisations d'enfants ayant contracte une infection par le SRAS-CoV-2 confirmee en laboratoire de microbiologie ont ete rapportees du 8 avril au 31 decembre 2020 au moyen de questionnaires hebdomadaires en ligne distribues au reseau du PCSP, qui compte plus de 2800 pediatres. Nous avons categorise les hospitalisations comme suit : liees a la COVID-19, infections decouvertes fortuitement, ou hospitalisations pour des raisons sociales ou de controle des infections, et degage les facteurs de risque associes a la gravite de la maladie chez les patients hospitalises. Resultats : Sur les 264 hospitalisations d'enfants ayant contracte le SRAS-CoV-2 au cours de la periode de l'etude de 9 mois, 150 (56,8 %) ont ete associees a la COVID-19 et 100 (37,9 %o) etaient des cas decouverts fortuitement (admission pour d'autres raisons et decouverte fortuite du SRAS-CoV-2 par depistage positif). Les nourrissons (37,3 %) et les adolescents (29,6 %) representaient la majorite des cas. Parmi les hospitalisations liees a la COVID-19, 52 patients (34,7 %) etaient atteints d'une forme grave de la mala die, dont 42 (28,0 % des cas lies a la COVID-19) ont eu besoin d'une forme d'assistance respiratoire ou hemodynamique, et 59 (39,3 %o) presentaient au moins 1 comorbidite sous-jacente. Les enfants atteints d'obesite, de maladies neurologiques chroniques ou de maladies pulmonaires chroniques, a l'exclusion de l'asthme, etaient plus susceptibles de presenter une forme grave ou critique de la COVID-19. Interpretation : Parmi les enfants hospitalises au Canada chez lesquels on a diagnostique une infection par le SRAS-CoV-2 au debut de la pandemie de COVID-19, la decouverte fortuite du SRAS-CoV-2 a ete frequente. Chez les enfants hospitalises pour une COVID-19 aigue, l'obesite et les comorbidites neurologiques et respiratoires ont ete associees a une gravite accrue., En date du 31 decembre 2020, le Canada comptait 581 427 cas confirmes d'infection par le SRAS-CoV-2 (1). Comme dans d'autres pays, la plupart des infections confirmees ont ete diagnostiquees [...]

Published
2021
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3. Characteristics of children admitted to hospital with acute SARS-CoV-2 infection in Canada in 2020

Author

Drouin, Olivier, Hepburn, Charlotte Moore, Farrar, Daniel S., Baerg, Krista, Chan, Kevin, Cyr, Claude, Donner, Elizabeth J., Embree, Joanne E., Farrell, Catherine, Forgie, Sarah, Giroux, Ryan, Kang, Kristopher T., King, Melanie, Laffin, Melanie, Luu, Thuy Mai, Orkin, Julia, Papenburg, Jesse, Pound, Catherine M., Price, Victoria E., Purewal, Rupeena, Sadarangani, Manish, Salvadori, Marina I., Top, Karina A., Viel-Theriault, Isabelle, Kakkar, Fatima, and Morris, Shaun K.

Subjects
Children -- Diseases, Pediatric research -- 2020 AD, Hospital patients -- Statistics -- Demographic aspects -- 2020 AD, Health
Abstract

Background: Risk factors for severe outcomes of SARS-CoV-2 infection are not well established in children. We sought to describe pediatric hospital admissions associated with SARS-CoV-2 infection in Canada and identify risk factors for more severe disease. Methods: We conducted a national prospective study using the infrastructure of the Canadian Paediatric Surveillance Program (CPSP). Cases involving children who were admitted to hospital with microbiologically confirmed SARS-CoV-2 infection were reported from Apr. 8 to Dec. 31 2020, through weekly online questionnaires distributed to the CPSP network of more than 2800 pediatricians. We categorized hospital admissions as related to COVID-19, incidental, or for social or infection control reasons and determined risk factors for disease severity in hospital. Results: Among 264 hospital admissions involving children with SARS-CoV-2 infection during the 9-month study period, 150 (56.8%) admissions were related to COVID-19 and 100 (37.9%) were incidental infections (admissions for other reasons and found to be positive for SARS-CoV-2 on screening). Infants (37.3%) and adolescents (29.6%) represented most cases. Among hospital admissions related to COVID-19, 52 (34.7%) had critical disease, 42 (28.0%) of whom required any form of respiratory or hemodynamic support, and 59 (39.3%) had at least 1 underlying comorbidity. Children with obesity, chronic neurologic conditions or chronic lung disease other than asthma were more likely to have severe or critical COVID-19. Interpretation: Among children who were admitted to hospital with SARS-CoV-2 infection in Canada during the early COVID-19 pandemic period, incidental SARS-CoV-2 infection was common. In children admitted with acute COVID-19, obesity and neurologic and respiratory comorbidities were associated with more severe disease., As of Dec. 31, 2020, Canada had 581427 confirmed cases of SARS-CoV-2 infection. (1) Similar to other countries, most confirmed infections were in adults, in part because of initial testing [...]

Published
2021
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5. Severe Respiratory Disease Among Children With and Without Medical Complexity During the COVID-19 Pandemic

Author

Belza, Christina, primary, Pullenayegum, Eleanor, additional, Nelson, Katherine E., additional, Aoyama, Kazuyoshi, additional, Fu, Longdi, additional, Buchanan, Francine, additional, Diaz, Sanober, additional, Goldberg, Ori, additional, Guttmann, Astrid, additional, Hepburn, Charlotte Moore, additional, Mahant, Sanjay, additional, Martens, Rachel, additional, Nathwani, Apsara, additional, Saunders, Natasha R., additional, and Cohen, Eyal, additional

Published
2023
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6. New and continuing physician-based outpatient mental health care among children and adolescents during the COVID-19 pandemic in Ontario, Canada: a population-based study

Author

Toulany, Alene, primary, Vigod, Simone, additional, Kurdyak, Paul, additional, Stukel, Therese A., additional, Strauss, Rachel, additional, Fu, Longdi, additional, Guttmann, Astrid, additional, Guan, Jun, additional, Cohen, Eyal, additional, Chiu, Maria, additional, Hepburn, Charlotte Moore, additional, Moran, Kimberly, additional, Gardner, William, additional, Cappelli, Mario, additional, Sundar, Purnima, additional, and Saunders, Natasha, additional

Published
2023
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7. Utilization of Physician-Based Mental Health Care Services Among Children and Adolescents Before and During the COVID-19 Pandemic in Ontario, Canada

Author

Saunders, Natasha Ruth, Kurdyak, Paul, Stukel, Therese A., Strauss, Rachel, Fu, Longdi, Guan, Jun, Fiksenbaum, Lisa, Cohen, Eyal, Guttmann, Astrid, Vigod, Simone, Chiu, Maria, Hepburn, Charlotte Moore, Moran, Kimberly, Gardner, William, Cappelli, Mario, Sundar, Purnima, and Toulany, Alene

Subjects
Male, Ontario, Adolescent, SARS-CoV-2, Child Health, COVID-19, Cross-Sectional Studies, Mental Health, Child, Preschool, Physicians, Pediatrics, Perinatology and Child Health, Humans, Female, Child, Pandemics, Original Investigation
Abstract

IMPORTANCE: Public health measures to reduce the spread of COVID-19 have heightened distress among children and adolescents and contributed to a shift in delivery of mental health care services. OBJECTIVES: To measure and compare physician-based outpatient mental health care utilization before and during the COVID-19 pandemic and quantify the extent of uptake of virtual care delivery. DESIGN, SETTING, AND PARTICIPANTS: Population-based repeated cross-sectional study using linked health and administrative databases in Ontario, Canada. All individuals aged 3 to 17 years residing in Ontario from January 1, 2017, to February 28, 2021. EXPOSURES: Pre–COVID-19 period from January 1, 2017, to February 29, 2020, and post–COVID-19 onset from March 1, 2020, to February 28, 2021. MAIN OUTCOMES AND MEASURES: Physician-based outpatient weekly visit rates per 1000 population for mental health diagnoses overall and stratified by age group, sex, and mental health diagnostic grouping and proportion of virtual visits. Poisson generalized estimating equations were used to model 3-year pre–COVID-19 trends and forecast expected trends post–COVID-19 onset and estimate the change in visit rates before and after the onset of COVID-19. The weekly proportions of virtual visits were calculated. RESULTS: In a population of almost 2.5 million children and adolescents (48.7% female; mean [SD] age, 10.1 [4.3] years), the weekly rate of mental health outpatient visits was 6.9 per 1000 population. Following the pandemic onset, visit rates declined rapidly to below expected (adjusted relative rate [aRR], 0.81; 95% CI, 0.79-0.82) in April 2020 followed by a growth to above expected (aRR, 1.07; 95% CI, 1.04-1.09) by July 2020 and sustained at 10% to 15% above expected as of February 2021. Adolescent female individuals had the greatest increase in visit rates relative to expected by the end of the study (aRR, 1.26; 95% CI, 1.25-1.28). Virtual care accounted for 5.0 visits per 1000 population (72.5%) of mental health visits over the study period, with a peak of 5.3 visits per 1000 population (90.1%) (April 2020) and leveling off to approximately 70% in the latter months. CONCLUSIONS AND RELEVANCE: Physician-based outpatient mental health care in Ontario increased during the pandemic, accompanied by a large, rapid shift to virtual care. There was a disproportionate increase in use of mental health care services among adolescent female individuals. System-level planning to address the increasing capacity needs and to monitor quality of care with such large shifts is warranted.

Published
2023

9. 50 Risk factors for severe COVID-19 in hospitalized children in Canada: A national prospective study from March 2020–May 2021

Author

Farrar, Daniel, primary, Drouin, Olivier, additional, Hepburn, Charlotte Moore, additional, Baerg, Krista, additional, Chan, Kevin, additional, Cyr, Claude, additional, Donner, Elizabeth, additional, Embree, Joanne, additional, Farrell, Catherine, additional, Forgie, Sarah, additional, Giroux, Ryan, additional, Kang, Kristopher, additional, King, Melanie, additional, Laffin-Thibodeau, Melanie, additional, Luu, Thuy-Mai, additional, Orkin, Julia, additional, Ouldali, Naïm, additional, Papenburg, Jesse, additional, Pound, Catherine, additional, Price, Victoria E, additional, Proulx-Gauthier, Jean-Phillippe, additional, Purewal, Rupeena, additional, Sadarangani, Manish, additional, Salvadori, Marina, additional, Thibeault, Roseline, additional, Top, Karina, additional, Viel-Thériault, Isabelle, additional, Kakkar, Fatima, additional, and Morris, Shaun, additional

Published
2022
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11. Resource use and disease severity of children hospitalized for COVID-19 versus multisystem inflammatory syndrome in children (MIS-C) in Canada.

Author

Farrar, Daniel, Hepburn, Charlotte Moore, Drouin, Olivier, Tal, Tala El, Morin, Marie-Paule, Berard, Roberta, King, Melanie, Thibodeau, Melanie Laffin, Baerg, Krista, Beaudoin-Bussières, Guillaume, Beaufils, Camille, Bennett, Terri-Lyn, Benseler, Susanne, Chan, Kevin, Cyr, Claude, Dahdah, Nagib, Donner, Elizabeth, Embree, Joanne, Farrell, Catherine, and Finzi, Andrés

Subjects
MULTISYSTEM inflammatory syndrome in children, SARS-CoV-2, HOSPITAL care of children, JUVENILE diseases, CORONAVIRUS diseases, COVID-19
Abstract

Background: Direct comparisons of paediatric hospitalizations for acute coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in children (MIS-C) can inform health system planning. We describe the absolute and relative hospital burden of acute paediatric COVID-19 and MIS-C in Canada. Methods: This national prospective study was conducted via the Canadian Paediatric Surveillance Program from March 2020-May 2021. Children younger than 18 years old and hospitalized for acute COVID-19 or MIS-C were included in the analysis. Outcomes included supplemental oxygen (low-flow oxygen or high-flow nasal cannula), ventilation (non-invasive or conventional mechanical), vasopressors, paediatric intensive care unit (PICU) admission, or death. Adjusted risk differences (aRD) and 95% confidence intervals (CI) were calculated to identify factors associated with each diagnosis. Results: Overall, we identified 330 children hospitalized for acute COVID-19 (including five deaths) and 208 hospitalized for MIS-C (including zero deaths); PICU admission was required for 49.5% of MIS-C hospitalizations versus 18.2% of acute COVID-19 hospitalizations (aRD 20.3; 95% CI, 9.9-30.8). Resource use differed by age, with children younger than one year hospitalized more often for acute COVID-19 (aRD 43.4% versus MIS-C; 95% CI, 37.7-49.1) and more children 5-11 years hospitalized for MIS-C (aRD 38.9% vs. acute COVID-19; 95% CI, 31.0-46.9). Conclusion: While there were more hospitalizations and deaths from acute paediatric COVID-19, MIS-C cases were more severe, requiring more intensive care and vasopressor support. Our findings suggest that both acute COVID-19 and MIS-C should be considered when assessing the overall burden of severe acute respiratory syndrome coronavirus 2 in hospitalized children. [ABSTRACT FROM AUTHOR]

Published
2023
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12. Utilization of Physician-Based Mental Health Care Services Among Children and Adolescents Before and During the COVID-19 Pandemic in Ontario, Canada

Author

Saunders, Natasha Ruth, primary, Kurdyak, Paul, additional, Stukel, Therese A., additional, Strauss, Rachel, additional, Fu, Longdi, additional, Guan, Jun, additional, Fiksenbaum, Lisa, additional, Cohen, Eyal, additional, Guttmann, Astrid, additional, Vigod, Simone, additional, Chiu, Maria, additional, Hepburn, Charlotte Moore, additional, Moran, Kimberly, additional, Gardner, William, additional, Cappelli, Mario, additional, Sundar, Purnima, additional, and Toulany, Alene, additional

Published
2022
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16. Population-based surveillance of severe microcephaly and congenital Zika syndrome in Canada.

Author

Morris, Shaun K., Farrar, Daniel S., Miller, Steven P., Ofner, Marianna, Bitnun, Ari, Nelson, Chantal R. M., Shevell, Michael, Moore, Aideen M., Tataryn, Joanne, Evans, Jane A., Zipursky, Amy R., Hepburn, Charlotte Moore, and Moore Hepburn, Charlotte

Subjects
ZIKA virus infections, MICROCEPHALY, LOW birth weight, DRUG abuse, PHYSICIANS
Abstract

Purpose: To estimate the minimum incidence of congenital Zika syndrome (CZS) and severe microcephaly in Canada and describe key clinical, epidemiological, aetiological and outcome features of these conditions.Methods: Two separate national surveillance studies were conducted on CZS and severe microcephaly using the well-established Canadian Paediatric Surveillance Program from 2016 to 2019. Over 2700 paediatricians across Canada were surveyed monthly and asked to report demographic details, pregnancy and travel history, infant anthropometry, clinical features and laboratory findings of newly identified cases. Reports were reviewed to assign an underlying aetiology of severe microcephaly. Incidence rates were estimated using monthly live birth denominators.Results: Thirty-four infants met the case definition for severe microcephaly and <5 met the case definition for CZS. The associated minimum incidence rates were 4.5 per 100 000 live births for severe microcephaly and 0.1-0.5 per 100 000 live births for CZS. Of severe microcephaly cases, 53% were attributed to genetic causes, 15% to infectious or ischaemic causes and 32% to unknown causes. The median head circumference-for-age Z-score at birth was -3.2 (IQR -3.8 to -2.6), and catch-up growth was often not achieved. Common clinical features included intracranial abnormalities (n=23), dysmorphology (n=19) and developmental delays (n=14). Mothers of infants with non-genetic aetiologies travelled during pregnancy more often (10/16) than mothers of infants with genetic aetiologies (<5/18; p<0.01).Conclusion: Severe microcephaly and CZS are both rare in Canada. Minimum incidence rates can be used as a baseline against which novel or re-emergent causes of severe microcephaly or CZS can be compared. [ABSTRACT FROM AUTHOR]

Published
2021
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18. 24 Characteristics and Outcomes of Hospitalized Children by SARS-Cov-2 Lineage: An IMPACT Surveillance Network Analysis

Author

Farrar, Daniel, Bettinger, Julie, Audet, Annick, Campigotto, Aaron, Deeks, Shelley, Drouin, Olivier, Embree, Joanne, Haddad, Elie, Halperin, Scott, Jadavji, Tajdin, Kazmi, Kescha, Thibodeau, Melanie Laffin, Hepburn, Charlotte Moore, Papenburg, Jesse, Purewal, Rupeena, Sadarangani, Manish, Sauvé, Laura, Wilson, Sarah, Yeung, Rae, Top, Karina, Kakkar, Fatima, and Morris, Shaun

Published
2023
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