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. 2024 Feb;52(1):209-218.
doi: 10.1007/s15010-023-02085-w. Epub 2023 Aug 29.

Old foes following news ways?-Pandemic-related changes in the epidemiology of viral respiratory tract infections

Nicole Maison  1   2   3 , Jimmy Omony  4 , Sophia Rinderknecht  5 , Laura Kolberg  6 , Melanie Meyer-Bühn  6 , Erika von Mutius  5   4   7 , Johannes Hübner  6 , Ulrich von Both  6   8
Affiliations

Old foes following news ways?-Pandemic-related changes in the epidemiology of viral respiratory tract infections

Nicole Maison et al. Infection. 2024 Feb.

Abstract

Introduction: Following lockdown periods and restricting public health measures in response to the COVID-19 pandemic, respiratory tract infections (RTIs) rose significantly worldwide. This led to an increased burden on children's hospitals compromising medical care of acutely and chronically ill children. We characterized changes in the epidemiological pattern of circulating respiratory viral infections.

Methods: We assessed the number of patients with RTIs and the annual distribution of virus detections between 2019 and 2022 based on 4809 clinical samples (4131 patients) from a German pediatric tertiary care-center. We investigated the impact of lockdown periods on spectra of circulating respiratory viruses, pattern of coinfections, age, and seasonality of infections.

Results: A fourfold increase in the number of respiratory virus detections was observed in 2022 vs 2019 with numbers doubling in 2022 (vs 2021). In 2022, seasonal patterns of circulating virus, particularly Adeno and seasonal Coronavirus were far less pronounced compared to previous years, in fact almost disappeared for Rhinoviruses.". SARS-CoV-2, Parainfluenza- and human Metapneumovirus detections increased significantly in 2022 (2019 vs 2022, p < 0.01). Coinfections with multiple viruses occurred more frequently since 2021 compared to pre-pandemic years, especially in younger children (2019 vs 2022, p < 0.01).

Conclusion: Compared to pre-pandemic years, we observed a dramatic increase in pediatric RTIs with an incrementing spectrum of viruses and a predominance in Rhino/Enterovirus infections - leading to a high rate of hospital admissions, particularly in conjunction with other viruses. This caused an acute shortage in medical care and may also be followed by an increase of virus-triggered secondary chronic respiratory diseases like asthma-rendering a burden on the health system.

Keywords: Epidemiology; Pandemic; Respiratory tract infection; Respiratory viruses; Rhinovirus.

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Conflict of interest statement

Nicole Maison, Jimmy Omony, Ulrich von Both, Johannes Huebner, Sophia Rinderknecht, Laura Kohlberg, Melanie Meyer-Buehn have no conflict of interest. Erika von Mutius received consulting fees and funding for the research project “Impact of COVID 19 pandemic on patients with asthma and wheeze” from OM Pharma S.A.

Figures

Fig. 1
Fig. 1
Monthly distribution of respiratory viruses detected, including Influenza A/B, RSV, Parainfluenzavirus, Metapneumovirus, Adenovirus, seasonal Coronaviruses, SARS-CoV-2 and Rhinovirus (blue) and number of patients infected (orange), years 2019–2022
Fig. 2
Fig. 2
Cumulative numbers of respiratory virus detections (years 2019–2022)
Fig. 3
Fig. 3
Seasonal pattern of number of respiratory virus infections A Respiratory syncytial virus, B Adenovirus, C Influenza A/B, D Rhinovirus, E Seasonal Coronavirus, F SARS-CoV-2, G Parainfluenza, H Metapneumovirus
Fig. 4
Fig. 4
Percentage of male and mean age in years of patients with viral respiratory tract infections (years 2019–2022)
Fig. 5
Fig. 5
Percentage of single and multiple virus detections, years 2019–2022
Fig. 6
Fig. 6
Heat map diagram showing respiratory viral co-infections: co-infections occurred most frequently in 2022, in combination with Rhinovirus and Parainfluenza, SARS-CoV-2 or RSV, and SARS-CoV-2 with RSV
See this image and copyright information in PMC

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