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Objectives The aim of this study was to estimate the impact of the COVID-19 pandemic on the circulation of non-SARS-CoV-2 respiratory viruses and clinical characteristics of COVID-19 in hospitalized children. Methods 226 and 864 children admitted to Children's City Clinical Hospital with acute respiratory infection in September-November of 2018 and 2020 in Moscow were tested for respiratory viruses using multiplex PCR and Mycoplasma pneumoniae/Chlamydia pneumoniae using ELISA. Results The detection rate of non-SARS-CoV-2 viruses in 2020 was lower than in 2018, 16.9% vs 37.6%. An increase in the median age of children with the respiratory viruses was observed during the pandemic (3 years vs 1 year). There was no significant difference in the frequency of ICU admission among children with SARS-CoV-2 and other respiratory virus infections (2.7% vs 2.9%). SARS-CoV-2 and hRV, hMPV, hAdV showed significantly lower than expected co-detection rates during co-circulation. An increase in BMI or bacterial coinfections lead to an increased risk of ICU admission and a longer duration of COVID-19 in children. Conclusions The COVID-19 pandemic led to significant changes in the epidemiological characteristics of non-SARS-CoV-2 respiratory viruses during the autumn peak of the 2020 pandemic, compared to the same period in 2018.

The chronic form of tick-borne encephalitis (TBE) is understudied and seems to be linked exclusively to Siberian and Far Eastern TBE virus (TBEV) subtypes. There are limited clinical descriptions demonstrating that chronic TBE can resemble an amyotrophic lateral sclerosis (ALS)-like disease. Here, we present a description of a clinical case of progressive chronic TBEV infection with a relapse 35 years after the initial acute infection following a tick bite. The disease manifested as an ALS-like syndrome with bulbar signs, progressive muscle weakness and atrophy, decreased reflexes, and eventual respiratory failure and death. There is no clear differentiation between chronic TBE and postencephalitic syndrome described in European sources. The reactivation of TBEV infection was supported by the presence of anti-TBEV antibodies in serum and antibodies to E protein and to the nonstructural protein NS1 in the CSF. These findings support the diagnosis of a relapse of chronic TBE in this patient.

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