The changing pattern of common respiratory viruses among children from 2018 to 2021 in Wuhan, China

Abstract

Background: Acute respiratory infections in children are a global public health challenge. Owing to the coronavirus disease (COVID-19) pandemic, non-pharmaceutical interventions, including patient isolation, social distancing, hand washing, and mask wearing, have been widely implemented, impacting the transmission of common respiratory viruses. The aim of this study was to clarify the epidemiological features of respiratory viruses in children less than 14 years of age in Wuhan before and after COVID-19.

Methods: Respiratory specimens were collected from patients aged < 14 years at two hospitals in Wuhan, China, from January 2018 to December 2021. Seven respiratory viruses were identified using an immunofluorescence assay. Pathogen profiles and seasonality were analysed.

Results: The number of visits and virus detection rate decreased dramatically after February 2020. The respiratory virus detection rate peaked in January and December and decreased dramatically in February and August. The detection rate was lower in 2021 than in 2018 and 2019. Respiratory syncytial virus (RSV) was identified as the leading pathogen in children aged < 1 year and 1-4 years before and after the COVID-19 pandemic. In children aged 5-14 years, influenza virus was detected at the highest rate before, and RSV after, the COVID-19 pandemic. RSV was the most common virus in coinfections.

Conclusions: This study revealed the epidemiological patterns of common respiratory viruses from 2018 to 2021. The spectrum of pathogens involved in paediatric respiratory infections had partly changed. Non-pharmaceutical interventions resulted in fewer opportunities for the spread of common viruses but also in an "immunity debt" that could have negative consequences when the pandemic is under control in Wuhan.

Keywords: COVID-19; Children; Epidemiologic features; Non-pharmaceutical interventions; Respiratory virus.

Fig. 1

Study flowchart

Fig. 2

Monthly distribution of enrolled children (< 14 years) from 2018 to 2021. The number of patients with ARIs peaked in January and December and was lowest in February and August. The number of patients increased from February to June; thereafter, it decreased gradually until August. In Wuhan, the spring festival is in February, and summer vacation is in August. There was a brief outbreak in August 2021

Fig. 3

Coinfection and distribution data. (A) Viral combinations in coinfections. The horizontal axis represents log2 (Patient + 1); the darker the blue and the larger the dot, the larger the number of cases; the darker the red, the smaller the number of cases. (B) Frequency of detected viral pathogens in children by age group (2018–2021). (C) Monthly distribution of positive cases (2018–2021)