{"doi":"10.1016/j.acap.2021.08.008","title":"Trends in Pediatric Viral Symptoms, Influenza Testing, and SARS-CoV-2 Testing From a Statewide Electronic Health Record Consortium, January 2017 to July 2021","abstract":"OBJECTIVE: The heterogeneous implementation and uptake of nonpharmaceutical interventions (NPIs) during the coronavirus disease 2019 (COVID-19) pandemic amplified the need for locally responsive disease surveillance mechanisms. Using data from a newly developed statewide electronic health record (EHR) consortium in Minnesota, we sought to characterize trends in pediatric viral symptoms, influenza testing, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing. METHODS: We conducted a serial cross-sectional analysis of EHR data from 1/1/2017 to 7/30/2021 across 8 large health systems in Minnesota. We included patients ≤18 years of age with any SARS-CoV-2 test, influenza test, or documented diagnostic code which met our viral symptom definition. We plotted week-by-week trends in viral symptoms, SARS-CoV-2 and influenza testing, and test positivity, stratified between children (0-11 years) and adolescents (12-18 years). RESULTS: We identified 1,079,924 patients ≤18 years of age with viral symptoms or testing; 880,669 (81.5%) were children ≤11 years. Influenza testing and influenza test positivity remained well below historical averages from March 2020 through mid-May 2021. Peaks in viral symptoms during this time were concomitant with peaks in SARS-CoV-2 testing and test positivity, whereas influenza testing and test positivity remained stagnant. Influenza test positivity rates increased substantively among children from May through July 2021. CONCLUSIONS: Viral illness and influenza testing among pediatric patients were below historical averages throughout the COVID-19 pandemic. Ongoing increases in influenza test positivity may merit clinical and public health awareness and intervention. Future NPI policies can be better targeted with insights from collaborative EHR-based surveillance, which enhances real-time, locally sensitive measurement of disease outbreaks.","journal":"Academic Pediatrics","year":2021,"id":208911,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8368,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":371263,"name":"Alicen B. Spaulding","orcid":"0000-0002-4687-3259","position":1,"is_corresponding":false},{"id":793109,"name":"Peter Bodurtha","orcid":"0009-0009-8368-3399","position":2,"is_corresponding":false},{"id":690875,"name":"Claire Neely","orcid":"0000-0003-4811-3437","position":3,"is_corresponding":false},{"id":385061,"name":"Tyler N. A. Winkelman","orcid":"0000-0002-9581-5223","position":4,"is_corresponding":false},{"id":562100,"name":"Rohan Khazanchi","orcid":"0000-0003-2230-0517","position":0,"is_corresponding":true}],"reference_count":25,"raw_metadata":null,"created_at":"2026-07-18T23:52:01.526969Z","pmid":"34411765","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}