Post-COVID Shifts in Pediatric Respiratory Virus Trends and Hospital Admission Predictors

A recent study documents a marked post‑COVID surge in influenza and adenovirus among hospitalized children.

The cohort shows a clear shift in pathogen mix and patient demographics that changes inpatient respiratory case mix and capacity expectations for pediatric services.

Detection data show that influenza rose from 5.5% to 28.2% in an influenza surge, and adenovirus detections increased from 5.7% to 12.5% in the post‑NPI period among hospitalized pediatric patients. These changes represent a >5‑fold relative rise for influenza and a >2‑fold rise for adenovirus, observed in multiplex PCR and antigen testing at admission. Given the magnitude and rapidity of these rebounds, influenza and adenovirus were likely substantive contributors to respiratory admissions during the rebound period.

Mean age increased from 3.5 to 4.9 years while mean hospital stay shortened from 4.3 to 3.2 days in the post‑emergency cohort. That older inpatient profile, combined with shorter lengths of stay, can change bed‑type requirements, turnover expectations, and throughput patterns on pediatric wards, particularly where school‑aged influenza cases rose disproportionately.

RSV returned to pre‑pandemic seasonal patterns, while parainfluenza virus (PIV) detections decreased to 11.3% in the post‑emergency period, according to the hospital testing series. This selective reconfiguration—RSV seasonality normalizing alongside rebounds in influenza and adenovirus—produces a shifted seasonal burden that differs from the pre‑COVID baseline in both timing and relative pathogen burden.