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Analyzing infections caused by 11 respiratory pathogens in children: Pre- and post-COVID-19 pandemic trends in China
Huamei Li1, Ying Yang2, Ran Tao1
1Department of Clinical Laboratory, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, China.
Insights
Following COVID-19 restrictions, pediatric respiratory pathogen detection rates significantly increased in 2023 compared to 2022. Key pathogens like influenza and Mycoplasma pneumoniae surged, alongside shifts in epidemic seasons and susceptible age groups.
Area of Science:
- Pediatric infectious diseases
- Epidemiology
- Respiratory virology and bacteriology
Background:
- The lifting of COVID-19 restrictions in China in December 2022 led to widespread infections.
- Understanding the impact on other respiratory pathogens in children is crucial for public health.
- Changes in pathogen circulation patterns post-pandemic require investigation.
Purpose of the Study:
- To analyze the epidemiological shifts of pediatric respiratory pathogens before and after the COVID-19 pandemic.
- To compare pathogen detection rates and identify changes in seasonality and susceptible populations.
- To inform future public health strategies for managing pediatric respiratory infections.
Main Methods:
- Retrospective analysis of 44,704 children with acute respiratory infections.
- Multiplex polymerase chain reaction (PCR) testing for 11 respiratory pathogens.
- Comparison of data from February-December 2022 versus February-December 2023.
Main Results:
- Overall pathogen detection rate (74.80% vs. 56.01%) and coinfection rates (12.21% vs. 5.89%) were significantly higher in 2023.
- Increased detection of Influenza A, Influenza B, human parainfluenza virus, human metapneumovirus, respiratory syncytial virus, and Mycoplasma pneumoniae in 2023.
- Decreased detection of human adenovirus and human bocavirus; stable rates for Chlamydia, human rhinovirus, and human coronavirus.
Conclusions:
- Post-COVID-19 pandemic, a significant increase in pediatric respiratory pathogen detection and coinfection rates was observed.
- Resurgence of seasonal patterns for influenza and parainfluenza, an outbreak of Mycoplasma pneumoniae, and altered RSV seasonality occurred.
- Increased susceptibility in neonates (0-28 days) and older children (>3 years) highlights the need for vigilance regarding respiratory disease trends.
Abstract:
With the lifting of coronavirus disease 2019 (COVID-19) restrictions in December 2022 in China, the population was widely infected with COVID-19. We aim to analyzed changes in the epidemiological characteristics of other respiratory pathogens in children before and after the COVID-19 pandemic. We conducted a retrospective analysis of 44 704 children with acute respiratory infections who underwent 11 respiratory pathogen tests based on multiplex polymerase chain reaction between February and December in both 2022 and 2023. The total pathogen detection rate (24861, 74.80% vs. 6423, 56.01%; p = 0.000) and detection rates of coinfection (4059, 12.21% vs. 676, 5.89%; p = 0.000) in 2023 was significantly higher than that in 2022. The detection rates of influenza A (2567, 7.72% vs. 222, 1.94%; p = 0.000), influenza B (383, 1.15% vs. 37, 0.32%; p = 0.000), human parainfluenza virus (2175, 6.54% vs. 602, 5.25%; p = 0.000), human metapneumovirus (1354, 4.07% vs. 346, 3.01%; p = 0.000), respiratory syncytial virus (3148, 9.47% vs. 870, 7.59%; p = 0.000), and Mycoplasma pneumonia (MP; 9494, 28.56% vs. 1790, 15.61%; p = 0.000) in 2023 were significantly higher than those in 2022, whereas the detection rates of human adenovirus (1124, 3.38% vs. 489, 4.26%; p = 0.000) and human bocavirus (629, 1.89% vs. 375, 3.27%; p = 0.000) were significantly lower than those in 2022. Chlamydia, human rhinovirus, and human coronavirus showed similar detection rates between 2023 and 2022. In 2023, the influenza virus and human parainfluenza virus regained seasonal characteristic, an outbreak of MP infection occurred, the epidemic season of respiratory syncytial virus changed, and the proportion of children with acute respiratory infection aged 0-28 days and over 3 years old increased. Influenza B, metapneumovirus, and human bocavirus were detected in children aged 0-28 days in 2023, but not in 2022. After the COVID-19 pandemic, we should be alert to the increase of respiratory diseases and the change of epidemic season and susceptible age.
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