Epidemiological characteristics of respiratory viruses in hospitalized children during the COVID-19 pandemic in southwestern China

Abstract

BackgroundMultinational studies have reported that the implementation of nonpharmaceutical interventions (NPIs) to control severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission coincided with the decline of other respiratory viruses, such as influenza viruses and respiratory syncytial virus.ObjectiveTo investigate the prevalence of common respiratory viruses during the coronavirus disease 2019 (COVID-19) pandemic.MethodsRespiratory specimens of children with lower respiratory tract infections (LRTIs) hospitalized at the Children’s Hospital of Chongqing Medical University from January 1, 2018 to December 31, 2021 were collected. Seven common pathogens, including respiratory syncytial virus (RSV), adenovirus (ADV), influenza virus A and B (Flu A, Flu B), and parainfluenza virus types 1–3 (PIV1–3), were detected by a multiplex direct immunofluorescence assay (DFA). Demographic data and laboratory test results were analyzed.Results1) A total of 31,113 children with LRTIs were enrolled, including 8141 in 2018, 8681 in 2019, 6252 in 2020, and 8059 in 2021.The overall detection rates decreased in 2020 and 2021 (P < 0.001). The detection rates of RSV, ADV, Flu A, PIV-1, and PIV-3 decreased when NPIs were active from February to August 2020, with Flu A decreasing most predominantly, from 2.7% to 0.3% (P < 0.05). The detection rates of RSV and PIV-1 resurged and even surpassed the historical level of 2018–2019, while Flu A continued decreasing when NPIs were lifted (P < 0.05). 2) Seasonal patterns of Flu A completely disappeared in 2020 and 2021. The Flu B epidemic was observed until October 2021 after a long period of low detection in 2020. RSV decreased sharply after January 2020 and stayed in a nearly dormant state during the next seven months. Nevertheless, the detection rates of RSV were abnormally higher than 10% in the summer of 2021. PIV-3 decreased significantly after the COVID-19 pandemic; however, it atypically surged from August to November 2020.ConclusionThe NPIs implemented during the COVID-19 pandemic affected the prevalence and seasonal patterns of certain viruses such as RSV, PIV-3, and influenza viruses. We recommend continuous surveillance of the epidemiological and evolutionary dynamics of multiple respiratory pathogens, especially when NPIs are no longer necessary.

Impact of normalized COVID-19 prevention and control measures on lower respiratory tract infection pathogenesis in hospitalized children

“…Firstly, our study indicated that the infection rate of LRTIs was observed to be higher in boys than in girls ( Table 1 ; Figure 1 ), a trend possibly linked to the demographic composition of children in Xiangtan. This finding aligns with domestic investigations ( 23 , 24 ). Compared to 2018–2019, the incidence of LRTIs decreased significantly in 2020–2021, but pathogen positivity and single pathogen positivity increased over the same period, this observation may be attributed to the preventive measures implemented for COVID-19 pandemic ( Table 2 ).…”

“…Overall, pathogenetic studies conducted before and after COVID-19 not only contribute to a more accurate medical basis for clinical diagnosis and treatment, and evidence-based medicine, but also enhance healthcare professionals' comprehension of regional respiratory infection characteristics caused by common pathogens. The study acknowledges limitations such as not testing for other common or rare respiratory pathogens in children such as HRV, Chlamydia and HMPV, and not testing for different subtypes of common viruses, thus not reflecting the epidemiological status of these pathogens (20)(21)(22)(23)(24)(25)(26). To enhance the surveillance of respiratory pathogens in children, more comprehensive multiplex assays are needed to monitor LRTIs for common respiratory pathogens as well as infections with different viral subtypes.…”

The impact of the COVID-19 pandemic on Staphylococcus aureus infections in pediatric patients admitted with community acquired pneumonia

“…Yet, an obvious resurgence was absent in the first quarter of 2020 and the fourth quarters of 2019 and 2022, suggesting a potential peak delayed to 2023. The effects of strict NPIs against COVID-19 may have contributed to alterations in the seasonal patterns of viral infections in other Chinese populations as well 37 , 38 . Typical seasonal patterns were also observed in the number of S. aureus isolates resistant to penicillin, erythromycin, and clindamycin in 2018, 2019, and 2021.…”

Beyond SARS-CoV-2: epidemiological surveillance of respiratory viruses in Jalisco, Mexico

“…Coinfections with multiple respiratory viruses are uncommon, and whether they can complicate the clinical course and management of affected individuals is not well described. Moreover, underlying comorbidities, such as diabetes and hypertension, or unhealthy habits, such as smoking, can increase the risk of severe illness and complications ( 2 , 10 ).…”