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Updated: Oct 14, 2025
Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses
Published on: November 10, 2023
Respiratory Infections in Children During a Covid-19 Pandemic Winter
Susanne C Diesner-Treiber1,2, Peter Voitl1,2,3, Julian J M Voitl1
1First Vienna Pediatric Medical Center, Vienna, Austria.
Insights
COVID-19 measures significantly reduced seasonal respiratory viruses like influenza and RSV in young children. However, rhino-/enterovirus and adenovirus circulation continued, with coronavirus NL63 peaking after lockdown measures were lifted.
Area of Science:
- Pediatric infectious diseases
- Epidemiology
- Public health
Background:
- The COVID-19 pandemic necessitated public health interventions, including social distancing, mask-wearing, and hand hygiene.
- These measures were anticipated to impact the transmission dynamics of other respiratory pathogens.
- Understanding the effect on common seasonal viruses in vulnerable pediatric populations is crucial.
Purpose of the Study:
- To prospectively investigate the circulation of 22 non-SARS-CoV-2 respiratory pathogens in young children during the COVID-19 pandemic.
- To assess the impact of pandemic-related public health measures on the epidemiology of these pathogens.
- To identify pathogens that were suppressed or unaffected by the implemented containment strategies.
Main Methods:
- A prospective, longitudinal study involving 390 children aged 0-24 months admitted with acute respiratory infection.
- Nasal swabs were analyzed using Multiplex PCR to detect 22 common respiratory pathogens.
- Clinical data and treatment were documented, and associations with lockdown measures were evaluated.
Main Results:
- Rhino-/enterovirus (41.4%) and adenovirus (2.2%) were the most prevalent pathogens detected.
- Respiratory Syncytial Virus (RSV), metapneumovirus, and influenza were notably absent during the study period.
- Coronavirus NL63 (13.6%) showed a significant peak in early 2021, coinciding with the relaxation of lockdown measures (OR 4.371).
Conclusions:
- COVID-19 containment measures effectively suppressed the seasonal circulation of influenza, RSV, and metapneumovirus in infants and toddlers.
- Rhino-/enterovirus and adenovirus transmission persisted despite public health interventions.
- Lockdown measures were inversely associated with coronavirus NL63 infections, suggesting a complex interplay between interventions and pathogen dynamics.
Abstract:
Background: The Covid-19 pandemic compelled the implementation of measures to curb the SARS CoV-2 spread, such as social distancing, wearing FFP2 masks, and frequent hand hygiene. One anticipated ramification of these measures was the containment of other pathogens. This prospective, longitudinal study aimed to investigate the spread of 22 common seasonal non-SARS-CoV-2 pathogens, such as RSV and influenza, among children with an acute respiratory infection during a pandemic. Methods: Three hundred ninety children (0-24 months) admitted to Vienna's largest pediatric center with acute respiratory infection (November 2020-April 2021) were included in this study. The researchers tested nasal swabs for 22 respiratory pathogens by Multiplex PCR, documented clinical features and treatment, and evaluated data for a potential connection with the lockdown measures then in force. Results: The 448 smears revealed the most common pathogens to be rhino-/enterovirus (41.4%), adenovirus (2.2%), and coronavirus NL63 (13.6%). While the first two were active throughout the entire season, coronaviruses peaked in the first trimester of 2021 in conjunction with the lift of the lockdown period (OR 4.371, 95%CI 2.34-8.136, P < 0.001). RSV, metapneumovirus, and influenza were absent. Conclusion: This prospective, longitudinal study shows that Covid-19 measures suppressed the seasonal activity of influenza, RSV, and metapneumovirus among very young children, but not of rhino-/enterovirus and adenovirus. The 0-24 month-olds are considered the lowest risk group and were only indirectly affected by the public health measures. Lockdowns were negatively associated with coronaviruses infections.
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