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. 2021 Aug;148(2):e2021051462.
doi: 10.1542/peds.2021-051462. Epub 2021 May 13.

Acute Respiratory Illnesses in Children in the SARS-CoV-2 Pandemic: Prospective Multicenter Study

Zaid Haddadin  1 , Jennifer E Schuster  2 , Andrew J Spieker  3 , Herdi Rahman  1 , Anna Blozinski  1 , Laura Stewart  1 , Angela P Campbell  4 , Joana Y Lively  4   5 , Marian G Michaels  6 , John V Williams  6 , Julie A Boom  7   8 , Leila C Sahni  7   8 , Mary Staat  9 , Monica McNeal  9 , Rangaraj Selvarangan  2   10 , Christopher J Harrison  2 , Geoffrey A Weinberg  11 , Peter G Szilagyi  11   12 , Janet A Englund  13 , Eileen J Klein  13 , Aaron T Curns  4 , Brian Rha  4 , Gayle E Langley  4 , Aron J Hall  4 , Manish M Patel  4 , Natasha B Halasa  14
Affiliations

Acute Respiratory Illnesses in Children in the SARS-CoV-2 Pandemic: Prospective Multicenter Study

Zaid Haddadin et al. Pediatrics. 2021 Aug.

Abstract

Objectives: Nonpharmaceutical interventions against coronavirus disease 2019 likely have a role in decreasing viral acute respiratory illnesses (ARIs). We aimed to assess the frequency of respiratory syncytial virus (RSV) and influenza ARIs before and during the coronavirus disease 2019 pandemic.

Methods: This study was a prospective, multicenter, population-based ARI surveillance, including children seen in the emergency departments and inpatient settings in 7 US cities for ARI. Respiratory samples were collected and evaluated by molecular testing. Generalized linear mixed-effects models were used to evaluate the association between community mitigation and number of eligible and proportion of RSV and influenza cases.

Results: Overall, 45 759 children were eligible; 25 415 were enrolled and tested; 25% and 14% were RSV-positive and influenza-positive, respectively. In 2020, we noted a decrease in eligible and enrolled ARI subjects after community mitigation measures were introduced, with no RSV or influenza detection from April 5, 2020, to April 30, 2020. Compared with 2016-2019, there was an average of 10.6 fewer eligible ARI cases per week per site and 63.9% and 45.8% lower odds of patients testing positive for RSV and influenza, respectively, during the 2020 community mitigation period. In all sites except Seattle, the proportions of positive tests for RSV and influenza in the 2020 community mitigation period were lower than predicted.

Conclusions: Between March and April 2020, rapid declines in ARI cases and the proportions of RSV and influenza in children were consistently noted across 7 US cities, which could be attributable to community mitigation measures against severe acute respiratory syndrome coronavirus 2.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: Dr Schuster receives support from Merck; Dr Williams is on boards for Quidel and GlaxoSmithKline; Dr Harrison’s institution receives support from GlaxoSmithKline, Merck, and Pfizer; Dr Englund is a consultant for Sanofi Pasteur and Meissa Vaccines and receives institutional research support from AstraZeneca, GlaxoSmithKline, Pfizer, and Novavax; Dr Halasa has grant funding from Sanofi and Quidel and received an honorarium from an educational grant from Genentech; the other authors have indicated they have no potential conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Numbers of Eligible and Enrolled Acute Respiratory Illness Cases, and Proportions of Respiratory Syncytial Virus (RSV) and Influenza Detection by Week, Stratified by Study Season.
Figure 2.
Figure 2.
Cumulative Proportions of Weekly Respiratory Syncytial Virus (RSV) and Influenza Detection by Study Season.
Figure 3.
Figure 3.
Number of Cases of Respiratory Syncytial Virus (RSV) and Influenza Detection by Week Over the Four-Year Study Period, Stratified by Clinical Setting.
Figure 4.
Figure 4.
Graphic Representation of Predicted Mean A. Eligible Cases and Proportions of B. Respiratory Syncytial Virus (RSV) and C. Influenza Positive Enrolled Cases for the Community Mitigation Period, in Conjunction with Pre-Mitigation Predictions Using A LOWESS Smoother. (*please see Table 1 for specific halting of enrollments at each specific site).
Figure 4.
Figure 4.
Graphic Representation of Predicted Mean A. Eligible Cases and Proportions of B. Respiratory Syncytial Virus (RSV) and C. Influenza Positive Enrolled Cases for the Community Mitigation Period, in Conjunction with Pre-Mitigation Predictions Using A LOWESS Smoother. (*please see Table 1 for specific halting of enrollments at each specific site).
Figure 4.
Figure 4.
Graphic Representation of Predicted Mean A. Eligible Cases and Proportions of B. Respiratory Syncytial Virus (RSV) and C. Influenza Positive Enrolled Cases for the Community Mitigation Period, in Conjunction with Pre-Mitigation Predictions Using A LOWESS Smoother. (*please see Table 1 for specific halting of enrollments at each specific site).
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References

    1. Li Q, Guan X, Wu P, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. March 26 2020;382(13):1199–1207. doi:10.1056/NEJMoa2001316 - DOI - PMC - PubMed
    1. Ebrahim SH, Ahmed QA, Gozzer E, Schlagenhauf P, Memish ZA. Covid-19 and community mitigation strategies in a pandemic. BMJ. March 17 2020;368:m1066. doi:10.1136/bmj.m1066 - DOI - PubMed
    1. Qualls N, Levitt A, Kanade N, et al. Community mitigation guidelines to prevent pandemic influenza—United States, 2017. MMWR Recommendations and Reports. 2017;66(1):1. - PMC - PubMed
    1. Kanu FA, Smith EE, Offutt-Powell T, et al. Declines in SARS-CoV-2 Transmission, Hospitalizations, and Mortality After Implementation of Mitigation Measures-Delaware, March-June 2020. MMWR Morb Mortal Wkly Rep. November 13 2020;69(45):1691–1694. doi:10.15585/mmwr.mm6945e1 - DOI - PMC - PubMed
    1. Hong LX, Lin A, He ZB, et al. Mask wearing in pre-symptomatic patients prevents SARS-CoV-2 transmission: An epidemiological analysis. Travel Med Infect Dis. Jul-Aug 2020;36:101803. doi:10.1016/j.tmaid.2020.101803 - DOI - PMC - PubMed

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