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. 2025 Jul;44(7):1611-1619.
doi: 10.1007/s10096-025-05133-5. Epub 2025 Apr 17.

Impact of the COVID-19 pandemic on the respiratory syncytial virus infections in children admitted with community acquired pneumonia: a retrospective study at a tertiary hospital of Northeast China

Xiaoyi Xu #  1 , Leilei Wu #  2 , Yi Liu  3
Affiliations

Impact of the COVID-19 pandemic on the respiratory syncytial virus infections in children admitted with community acquired pneumonia: a retrospective study at a tertiary hospital of Northeast China

Xiaoyi Xu et al. Eur J Clin Microbiol Infect Dis. 2025 Jul.

Abstract

Purpose: The COVID-19 pandemic has markedly altered the infection landscape of various pathogens. This study aimed to evaluate the pandemic's impact on the infection dynamics of respiratory syncytial virus (RSV) among children with community acquired pneumonia (CAP).

Methods: Pediatric CAP patients were enrolled to compare the prevalence and characteristics of RSV infections before (2018-2019), during (2020-2022), and after (2023) the COVID-19 pandemic.

Results: A total of 991 RSV-positive and 6644 RSV-negative pediatric CAP patients were included. Key findings indicated that RSV-positive patients were younger and had fewer respiratory co-infections with specific pathogens. Following a notable decline in 2019, the RSV positivity rate increased significantly in 2020, then continuously decreased until 2022, and rebounded markedly in 2023. Compared to the pre-pandemic period, there were significant changes in the age distribution, gender composition, and co-infection patterns with specific pathogens among both RSV-positive and RSV-negative patients during and after the pandemic. Seasonal distribution of RSV positive patients and positivity rates in 2018 and 2019 typically peaked in winter. However, the seasonal patterns of RSV positive patients shifted significantly during and after the pandemic, characterized by a sharp decrease in February 2020, no resurgence at the end of 2022, and a delayed peak in April 2023. The seasonal trend of the positivity rate was also disrupted.

Conclusions: The COVID-19 pandemic has profoundly transformed the infection landscape of RSV in pediatric CAP patients, as evidenced by shifts in positivity rates, demographic characteristics, co-infection patterns, and seasonal trends.

Keywords: COVID-19; Community acquired pneumonia; Epidemiology; Pediatrics; Respiratory syncytial virus.

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Conflict of interest statement

Declarations. Ethics approval: The study protocol was approved by the ethics committee of the Hongqi Hospital Affiliated to Mudanjiang Medical University (No. 2023574). Consent to participate: As a retrospective study, the need for informed consent was waived by the ethics committee of Hongqi Hospital Affiliated to Mudanjiang Medical University. Consent for publication: As a retrospective study, the need for informed consent was waived by the ethics committee of Hongqi Hospital Affiliated to Mudanjiang Medical University. Competing interests: The authors declare no competing interests.

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