Understanding changes in acute care and mortality patterns among children and youth with medical complexity (CMC) during the COVID-19 pandemic

Children have been less likely to have severe outcomes from COVID-19 during the pandemic. Reports suggest children have also had fewer acute illnesses requiring hospitalization, particularly those hospitalizations that are caused by communicable diseases, such as respiratory infections. Acute respiratory infections substantially impact health outcomes of children with medical complexity - defined as those children with chronic conditions that result in increased health needs, disabilities, and high healthcare use. While the full scope of restrictions that existed in the worst phases of the pandemic--such as school closures--have caused harms to children with medical complexity, there may be value in continued use of some less restrictive public health measures, such as masking, handwashing, social distancing, and vaccination, to protect children with medical complexity, particularly during periods with high rates of community transmission of viral respiratory infections. We propose to begin to understand this phenomenon by analyzing data from across Canada (except Quebec) to compare rates of hospitalization, ICU admissions and death within hospitals during the pandemic compared to previous non-pandemic years. We will look specifically at changes in hospital admissions that include severe respiratory illnesses. We will evaluate rates for children with specific types of medical complexity that are at particular risk of severe respiratory illness, such as children with brain-based disabilities. Our strong partnership with knowledge users with input from youth and families will ensure that study findings inform preparedness for future health emergencies that threaten the health outcomes of children with medical complexity.