Rhinovirus persistence during the COVID‐19 pandemic—Impact on pediatric acute wheezing presentations

Abstract

Rhinoviruses have persisted throughout the COVID‐19 pandemic, despite other seasonal respiratory viruses (influenza, parainfluenza, respiratory syncytial virus, adenoviruses, human metapneumovirus) being mostly suppressed by pandemic restrictions, such as masking and other forms of social distancing, especially during the national lockdown periods. Rhinoviruses, as nonenveloped viruses, are known to transmit effectively via the airborne and fomite route, which has allowed infection among children and adults to continue despite pandemic restrictions. Rhinoviruses are also known to cause and exacerbate acute wheezing episodes in children predisposed to this condition. Noninfectious causes such as air pollutants (PM 2.5 , PM 10 ) can also play a role. In this retrospective ecological study, we demonstrate the correlation between UK national sentinel rhinovirus surveillance, the level of airborne particulates, and the changing patterns of pediatric emergency department presentations for acute wheezing, before and during the COVID‐19 pandemic (2018–2021) in a large UK teaching hospital.

Pediatric respiratory admissions and related viral infections during the COVID‐19 pandemic

“…Thus, the COVID‐19 pandemic and social distancing did not similarly affect all respiratory viruses. The persistence of adenovirus, HMPV, parainfluenza viruses and possibly also rhinovirus, in our study, may explain the observation of the unchanged occurrence of respiratory admissions for asthma, wheezing, and croup, which are known to be associated with these infections 18,35–37 …”

“…The persistence of adenovirus, HMPV, parainfluenza viruses and possibly also rhinovirus, in our study, may explain the observation of the unchanged occurrence of respiratory admissions for asthma, wheezing, and croup, which are known to be associated with these infections. 18,[35][36][37] Importantly, even though we did not observe a reduction in the overall detection of some respiratory viruses, we did notice a change F I G U R E 3 Respiratory viruses (RSV, influenza viruses, HMPV, adenovirus, and parainfluenza viruses) observed weekly prevalence and forecasted weekly prevalence, during the study period (January 2015-August 2021). Forecasts were computed using unobserved-components time series models (UCM procedure in STATA 15.1).…”

“…These reports show a decrease in admissions for croup, viral wheeze, URTI, pneumonia, bronchiolitis, asthma, stridor, wheezing, 10–14,16–18 and as well as a decrease in emergency department visits for respiratory diseases during the COVID‐19 pandemic 19,20 …”

Comparison of common human respiratory pathogens among hospitalized children aged ≤ 6 years in Hainan Island, China, during spring and early summer in 2019–2021

“…Influenza A viruses and RVs allowed the rapid increase of RV infections. 18 In this study, RV was also found to be a substantial…”

“…The reason was proposed that although surgical face masks can prevent the transmission of seasonal influenza viruses, they may not be effective to prevent the transmission of RVs which is a nonenveloped virus. Further, it has been suggested that the high prevalence of RV infections during the COVID‐19 pandemic was due to the decrease in the prevalence of Influenza A virus infections: the lack of viral interference between I nfluenza A viruses and RVs allowed the rapid increase of RV infections 18 . In this study, RV was also found to be a substantial respiratory pathogen in 2019, 2020, and 2021; however, no significant difference was observed in the infection ratio among the three years.…”