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Published on: November 10, 2023
Changes in Seasonal Patterns for Common Pediatric Respiratory Viruses During the COVID Pandemic
Tara Lozy1,2, Rimma Perotte3,4,5, Austin Eigen6
1Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ.
Insights
The COVID-19 pandemic disrupted pediatric respiratory virus seasonality, causing initial declines followed by resurgences exceeding pre-pandemic levels. Human interactions significantly influence viral seasonality, impacting disease spread and mitigation strategies.
Area of Science:
- Epidemiology
- Virology
- Public Health
Background:
- The COVID-19 pandemic and associated nonpharmaceutical interventions (NPIs) significantly altered the epidemiology of common pediatric respiratory viruses.
- Understanding these shifts is crucial for managing pediatric respiratory illnesses and preparing for future public health crises.
Purpose of the Study:
- To quantify the impact of the COVID-19 pandemic and NPIs on the prevalence and seasonality of pediatric respiratory viruses.
- To analyze deviations from historical incidence rates and seasonal patterns.
Main Methods:
- Retrospective chart review within a large health network.
- Time series analyses using seasonal autoregressive integrated moving average (SARIMA) models.
- Comparison of incidence rates to historical trends.
Main Results:
- A sharp decrease in non-COVID viral infections occurred at the pandemic's onset (March 2020), coinciding with NPIs.
- Non-COVID infections rebounded to higher-than-pre-pandemic levels by Spring 2021.
- Pandemic significantly disrupted viral seasonality: influenza A and human metapneumovirus peaks shifted, RSV had an unusual Spring/Summer season, parainfluenza type 1 was active in an even-numbered year, and influenza B diminished.
Conclusions:
- Human interactions are a key driver of pediatric respiratory viral seasonality, alongside climate.
- Understanding the influence of human behavior on disease transmission is vital for effective pandemic mitigation and preventing subsequent outbreaks of other illnesses.
Objectives:
Observed alterations in seasonal patterns of common pediatric respiratory viruses during and immediately after the COVID-19 pandemic had far-reaching implications for the care of ill children. Here, we quantify the effects of the pandemic and related nonpharmaceutical interventions on the prevalence and seasonality of common pediatric respiratory illnesses.
Methods:
We performed a retrospective chart review within a large health network to identify incidence rates of common respiratory viruses and compared them to historical trends. Time series analyses using seasonal autoregressive integrated moving average models were utilized to identify seasonal patterns for the different virus types and quantify deviations from expected incidence rates.
Results:
Overall, we noted a steep decline in non-COVID viral infection rates at the onset of the COVID pandemic in March 2020, largely coincident with the institution of mask mandates and lockdown measures. This trend continued until the Spring of 2021, at which time non-COVID infections resurged to rates higher than pre-COVID levels. In addition, the historically observed seasonality of these viruses was significantly disrupted by the pandemic. In particular, the historical peaks for influenza A and human metapneumovirus shifted from February and March, respectively, to bimodal peaks in December 2021 and May 2022; respiratory syncytial virus demonstrated an unprecedented Spring/Summer season in 2021; parainfluenza type 1 was unusually active in 2022, an even-numbered year; and influenza B virtually disappeared during and immediately after the pandemic.
Conclusions:
Our observations add to the growing body of literature supporting the hypothesis that human interactions are one of the key drivers of pediatric respiratory viral seasonality in addition to climate. Understanding the effect of human interactions on disease spread is crucial for the development of effective mitigation measures for future pandemics while avoiding dangerous spikes of other illnesses once those interventions are lifted.
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