Association of Nonpharmaceutical Interventions During the COVID-19 Pandemic With Invasive Pneumococcal Disease, Pneumococcal Carriage, and Respiratory Viral Infections Among Children in France

Abstract

IMPORTANCEAn association between pneumococcal nasopharyngeal carriage and invasive pneumococcal disease (IPD) has been previously established. However, it is unclear whether the decrease in IPD incidence observed after implementation of nonpharmaceutical interventions (NPIs) during the COVID-19 pandemic was associated with concomitant changes in pneumococcal carriage and respiratory viral infections. OBJECTIVE To assess changes in IPD incidence after the implementation of NPIs during the COVID-19 pandemic and examine their temporal association with changes in pneumococcal carriage rate and respiratory viral infections (specifically respiratory syncytial virus [RSV] and influenza cases) among children in France. DESIGN, SETTING, AND PARTICIPANTS This cohort study used interrupted time series analysis of data from ambulatory and hospital-based national continuous surveillance systems of pneumococcal

Trends in pediatric ambulatory community acquired infections before and during COVID-19 pandemic: A prospective multicentric surveillance study in France

“… 31 Furthermore, for pneumococcus and meningococcus, viral infections play an important role in the occurrence of disease. 27 , 32 The resurgence of RSV and influenza outbreak may explain the increase in the frequency of infections due to these bacterial species. To our knowledge, the role of viral infections in promoting streptococcal infections is less documented.…”

The COVID-19 Pandemic as an Opportunity for Unravelling the Causative Association between Respiratory Viruses and Pneumococcus-Associated Disease in Young Children: A Prospective Study

“…In addition, no change in serotype distribution was found, similar to findings from France. 8 Therefore, it is unlikely that changes in carriage played an important role in the drastic disease incidence dynamics during COVID-19. This is the first report of the carriage dynamics during the resurgence of pneumococcus-associated diseases.…”

“…Respiratory syncytial virus (RSV), human metapneumovirus (hMPV), influenza viruses (flu), and parainfluenza viruses (PIV) have been associated with either community-acquired alveolar pneumonia (CAAP; considered mostly bacterial, in particular pneumococcal), 1 or invasive pneumococcal disease (IPD). [1][2][3][4][5][6][7][8][9][10][11][12] However, for other common viruses, such as adenoviruses (AdV) and rhinoviruses (RhV), there is little evidence of a causal association with pneumococcal disease in young children. 13 The use of Pneumococcal Conjugate Vaccines (PCVs) is associated with reductions in rates of hospitalization for viral pneumonia and non-pneumonia lower respiratory tract infections (LRIs) in young children.…”

The Pneumococcus–Respiratory Virus Connection—Unexpected Lessons From the COVID-19 Pandemic

“…Unfortunately, other viruses beyond RSV and influenza were not examined individually or might have been captured in the category of influenzalike illness. 3 For example, human metapneumovirus is also implicated in pneumococcal disease. 1 As implicated viruses reemerged sequentially since mid-2021, with apparently parallel trends for IPD,…”

“…Elsewhere in JAMA Network Open, Rybak and colleagues 3 shed new light on the potential role of 2 respiratory viruses, RSV and influenza, in the pathogenesis of invasive pneumococcal disease (IPD) in children. The authors conducted an impressive multicenter study using several nationwide prospective surveillance programs in France, including a multiple-hospital IPD surveillance system, a national continuous surveillance program involving children in 70 metropolitan areas, a national continuous surveillance system of influenza-like illness (as a proxy for influenza cases, which can also capture the activity of other respiratory viruses), and a national laboratory surveillance program for RSV cases.…”