Clinical Characteristics of Pediatric Respiratory Tract Infection and Respiratory Pathogen Isolation During the Coronavirus Disease 2019 Pandemic

Tang, Xifeng; Dai, Ge; Jiang, Xiaohui; Wang, Ting; Sun, Hongwei; Huang, Li; Wang, Meijuan; Zhu, Canhong; Jiang, Wujun

doi:10.3389/fped.2021.759213

Cited by 17 publications

(21 citation statements)

References 17 publications

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“…We hypothesize that this observation reflects the lack of RSV circulation in the previous months, with a larger pool of vulnerable infants that had not been previously infected. 6 9 11 14 These findings support the hypothesis that the infection occurring in an expanded older RSV-naïve cohort. 6 8 9 11 It should be noted that the use of steroids for the treatment of bronchiolitis increased during the RSV season coinciding with Wuhan Delta SARS-CoV-2 variant circulation.…”

Section: Discussionsupporting

confidence: 79%

Clinical Phenotype of Respiratory Syncytial Virus Bronchiolitis before and during the Coronavirus Disease 2019 Pandemic

et al. 2022

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Objective The main objective of this report was to comprehensively analyze the clinical characteristics of children hospitalized with respiratory syncytial virus (RSV) infections in 2021 during the coronavirus disease 2019 (COVID-19) pandemic and to compare them with those in the five previous RSV seasons. We hypothesized that the clinical and demographic features of children hospitalized with RSV infection in 2021 were different from those hospitalized in previous respiratory seasons. Study Design In this retrospective observational study, children younger than 2 years hospitalized with RSV bronchiolitis from January 1, 2015, to December 31, 2021, at the Department of Pediatrics of the Hospital Gregorio Marañón, Madrid, Spain, were included. We compared the clinical characteristics of children hospitalized with RSV bronchiolitis in the five seasons before the COVID-19 pandemic and during the subsequent off-seasonal surge of RSV infections. Results We found a significant reduction in hospitalizations for RSV bronchiolitis during the usual winter epidemic period due to the COVID-19 pandemic. Children hospitalized with RSV infection in 2021, during the COVID-19 pandemic, were older than children hospitalized in the prepandemic period (2015–2020; 4.0 [1.6–9.2] vs. 3 [1.5–6.5] months; p < 0.01). We also found shorter duration of oxygen days during the COVID-19 period compared with previous respiratory seasons (3 [2–5] vs. 4 [2–6] days; p = 0.02). Conclusion The COVID-19 pandemic modified the RSV seasonality with a significant reduction in RSV hospitalizations during the expected 2020–2021 season and a reappearance of RSV 7 months later than expected. We also found changes in the median age of children with RSV bronchiolitis during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic compared with the prepandemic RSV seasons and shorter duration of oxygen days suggesting a modest reduction in disease severity. We hypothesize that this observation reflects the lack of RSV circulation in the previous months (April 2020-March 2021), with a larger pool of vulnerable infants that had not been previously infected. Key Points

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Section: Discussionsupporting

confidence: 79%

Clinical Phenotype of Respiratory Syncytial Virus Bronchiolitis before and during the Coronavirus Disease 2019 Pandemic

et al. 2022

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“…Proportions of detected adenoviruses and bocaviruses were significantly higher than in previous seasons ( Table 2A ); no significant differences were detected for the rest of viruses. In 2021-22 most hospitalisations in children were due to ORV without SARS-CoV-2 (83%(183)); only 8%(18) were for SARS-CoV-2 (including 8 coinfections with ORV). The predominant virus was RSV (51.6%) followed by entero/rhinoviruses (31.7%) and bocavirus (20.4%).…”

Section: Resultsmentioning

confidence: 99%

“…However, because of high demand of SARS-CoV-2 tests on hospital laboratories, the testing for ORV has been reduced even in hospitalised patients during the pandemic. A number of reports described detection of ORV in patients hospitalised with ARI or with COVID-19 during the pandemic (8,(15)(16)(17)(18)(19). However, to our knowledge none described results of systematic detection of both ORV and SARS-CoV-2 (not only at physician request) using a panel of multiple RV in a multicenter network including both pandemic years and comparing them with as long as 8 pre-pandemic years.…”

Section: Introductionmentioning

confidence: 99%

The changing landscape of respiratory viruses contributing to respiratory hospitalisations: results from a hospital-based surveillance in Quebec, Canada, 2012-13 to 2021-22

Gilca

Amini

Carazo

et al. 2022

Preprint

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Background. A comprehensive description of the combined effect of SARS-CoV-2 and respiratory viruses (RV) other than SARS-CoV-2 (ORV) on hospitalisations is lacking. Aim. To compare viral etiology of acute respiratory infections (ARI) hospitalisations before and during two pandemic years from a surveillance network in Quebec, Canada. Method. We compared detection of ORV and SARS-CoV-2 during 2020-21 and 2021-22 to 8 pre-pandemic influenza seasons in patients hospitalised with ARI who were tested systematically by a multiplex PCR. Results. During pre-pandemic influenza seasons, overall RV detection was 92.7% (1,493) (48.3% respiratory syncytial virus (RSV)) in children and 62.8% (4,339) (40.1% influenza) in adults. Overall RV detection in 2020-21 was 58.6% (29) in children (all ORV) and 43.7% (333) in adults (3.4% ORV, 40.3% SARS-CoV2, both including coinfections). In 2021-22 overall RV detection was 91.0% (201) in children (82.8% ORV, 8.1% SARS-CoV-2, both including coinfections) and 55.5% (527) in adults (14.1% ORV, 41.4% SARS-CoV-2, both including coinfections). Virtually no influenza was detected in 2020-21 and in 2021-22 up to epi-week 2022-9 presented here; no RSV was detected in 2020-21. In 2021-22, detection of RSV was comparable to pre-pandemic years but with an unusually early season. There were significant differences in ORV and SARS-CoV-2 detection between time periods and age groups. Conclusion. Significant continuous shifts in age distribution and viral etiology of ARI hospitalisations occurred during two pandemic years. This reflects evolving RV epidemiology and underscores the need for increased scrutiny of ARI hospitalisation etiology to inform tailored public health recommendations.

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“…Peaks in the HBoV prevalence were observed in summer and autumn in 2017, 2018, and 2019 in this study, whereas HBoV detection rates were significantly lower in summer and autumn 2020 than in previous years, with peaks observed in winter 2020 and spring and summer 2021. This may be related to the government's public interventions to stop the novel coronavirus epidemic, such as prohibiting markets or other forms of gatherings and closing theaters, cafes, and public (9). We need to continuously monitor the prevalence of respiratory viruses.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the clinical features of human bocavirus and metapneumovirus lower respiratory tract infections in hospitalized children in Suzhou, China

et al. 2023

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ObjectiveWe compared the clinical data of hospitalized children with lower respiratory tract infections caused by human bocavirus (HBoV) and human metapneumovirus (hMPV).MethodsIn total, 8,430 children admitted to the Department of Respiration, Children's Hospital of Soochow University for lower respiratory tract infections from January 2017 to October 2021 were enrolled. Seven common respiratory viruses, including respiratory syncytial virus, influenza virus A, influenza virus B, parainfluenza virus (PIV) I, PIV II, PIV III, and adenovirus, were detected by direct immunofluorescence assay, whereas human rhinovirus and hMPV were detected by reverse transcription-polymerase chain reaction. Mycoplasma pneumoniae (MP) and HBoV were detected by real-time fluorescence quantitative polymerase chain reaction. Bacteria was detected in blood, nasopharyngeal secretion, bronchoalveolar lavage specimen or pleural fluid by culture. In parallel, MP was detected by enzyme-linked immunosorbent assay. In addition, we performed metagenomic testing of alveolar lavage fluid from some of the patients in our study.ResultsThe detection rate of HBoV was 6.62% (558/8430), whereas that of hMPV was 2.24% (189/ 8430). The detection rate of HBoV was significantly higher in children aged 1 to <3 years than in other age groups, but there were no significant differences in positivity rates for hMPV by age. Before 2020, the incidence of HBoV infection peaked in summer and autumn, whereas that of hMPV peaked in spring. The epidemiology of both HBoV and hMPV has changed because of the impact of the novel coronavirus. Among the positive cases, the HBoV mixed infection rate was 51.6%, which was similar to that for hMPV mixed infection (44.4%). Comparing clinical characteristics between HBoV and hMPV single infection, the median age of children was 17 months in the HBoV group and 11 months in the hMPV group. In the HBoV single infection group, 31 patients (11.5%) had pulse oxygen saturation of less than 92% on admission, 47 (17.4%) had shortness of breath, and 26 (9.6%) presented with dyspnea. Meanwhile, four patients (3.8%) in the hMPV single infection group had pulse oxygen saturation of less than 92% on admission, eight (7.6%) displayed shortness of breath, and three (2.9%) had dyspnea. The proportion of patients requiring mechanical ventilation and the rate of PICU admission were higher in the HBoV group than in the hMPV group.ConclusionThe prevalence of HBoV infection is higher than that of hMPV infection in children with lower respiratory tract infection in Suzhou, and HBoV is more likely to cause severe infection than hMPV. Public health interventions for COVID-19 outbreaks have affected the prevalence of HBoV and hMPV.

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Clinical Characteristics of Pediatric Respiratory Tract Infection and Respiratory Pathogen Isolation During the Coronavirus Disease 2019 Pandemic

Cited by 17 publications

References 17 publications

Clinical Phenotype of Respiratory Syncytial Virus Bronchiolitis before and during the Coronavirus Disease 2019 Pandemic

Clinical Phenotype of Respiratory Syncytial Virus Bronchiolitis before and during the Coronavirus Disease 2019 Pandemic

The changing landscape of respiratory viruses contributing to respiratory hospitalisations: results from a hospital-based surveillance in Quebec, Canada, 2012-13 to 2021-22

Comparison of the clinical features of human bocavirus and metapneumovirus lower respiratory tract infections in hospitalized children in Suzhou, China

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