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Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses

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Published on: November 10, 2023

Impact of COVID-19 on Respiratory Virus Infections in Children, Japan, 2018-2023

Emi Takashita¹, Kohei Shimizu², Chiharu Kawakami^2,3,4

¹Research Center for Influenza and Respiratory Viruses, National Institute of Infectious Diseases, Tokyo, Japan.

Immunity, Inflammation and Disease

|March 12, 2025

Insights

The COVID-19 pandemic caused a significant drop in influenza virus infections for nearly three years. This decline may have led to an increase in rhinovirus infections and a decrease in other enveloped viruses due to virus-virus interactions.

Area of Science:

* Epidemiology of infectious diseases
* Virology
* Public health

Background:

* The emergence of SARS-CoV-2 (COVID-19) in Japan in January 2020.
* Previous findings indicated an increased risk of rhinovirus infections in children during the early COVID-19 pandemic.
* This study investigates the broader impact of COVID-19 on respiratory virus infections nationwide.

Purpose of the Study:

* To assess the effect of the COVID-19 pandemic on the prevalence of various respiratory viruses.
* To explore potential interactions between different respiratory viruses in the context of the pandemic.

Main Methods:

* Analysis of clinical specimens from 4012 patients presenting with respiratory infections.
* Study period: January 2018 to April 2023 in Yokohama, Japan.
* Detection of 15 representative respiratory viruses, including influenza, rhinoviruses, coronaviruses, RSV, and others.

Main Results:

* Influenza virus infections were most significantly impacted, with no detections for nearly three years.
* A notable decrease in influenza virus circulation coincided with the nationwide spread of SARS-CoV-2.
* Other detected viruses included rhinovirus, coxsackievirus, echovirus, enterovirus, human coronaviruses (229E, HKU1, NL63, OC43), human metapneumovirus, human parainfluenza virus, human parechovirus, RSV, human adenovirus, human bocavirus, human parvovirus B19, herpes simplex virus type 1, and varicella-zoster virus.

Conclusions:

* The reduction in influenza infections following SARS-CoV-2 emergence may correlate with increased rhinovirus infections.
* Rhinovirus outbreaks, rather than SARS-CoV-2, might be responsible for decreased enveloped virus infections (RSV, parainfluenza, metapneumovirus, coronaviruses).
* Potential negative virus-virus interactions could explain the observed shifts in respiratory virus prevalence.

Read full analysis

Abstract

Background:

COVID-19, caused by SARS-CoV-2, was first documented in Japan in January 2020. We previously reported an increased risk of rhinovirus infections among children during the early phase of the COVID-19 pandemic. Here, we assessed the impact of COVID-19 on respiratory virus infections after SARS-CoV-2 spread nationwide.

Methods:

We analyzed clinical specimens from 4012 patients with respiratory infections in Yokohama, Japan from January 2018 to April 2023.

Results:

Among 15 representative respiratory viruses we detected (influenza virus, rhinovirus, coxsackievirus, echovirus, enterovirus, human coronavirus 229E, HKU1, NL63, and OC43, human metapneumovirus, human parainfluenza virus, human parechovirus, RSV, human adenovirus, human bocavirus, human parvovirus B19, herpes simplex virus type 1, and varicella-zoster virus), influenza was most affected by the COVID-19 pandemic, with no influenza viruses detected for nearly 3 years.

Conclusions:

The decrease in influenza infections following the emergence of SARS-CoV-2 may have contributed to the previously reported increase in rhinovirus infections. The rhinovirus outbreak, rather than SARS-CoV-2, may have contributed to the decrease in enveloped virus infections (RSV, parainfluenza viruses, metapneumovirus, and coronavirus 229E, HKU1, NL63, and OC43), possibly due to negative virus-virus interactions.

Keywords:

COVID‐19 SARS‐CoV‐2 influenza respiratory syncytial virus rhinovirus viral interference

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