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Changes in children respiratory infections pre and post COVID-19 pandemic

Yuanyuan Yue1,2, Dan Wu1,2, Qian Zeng1,2

  • 1Clinical Laboratory, Children's Hospital Affiliated to Shandong University, Jinan, China.

Frontiers in Cellular and Infection Microbiology
|April 22, 2025
PubMed

Insights

Non-pharmaceutical interventions (NPIs) during COVID-19 impacted acute respiratory infection (ARI) pathogen prevalence in children. Post-pandemic, many ARI pathogen rates increased, suggesting a resurgence due to NPI release and reduced immunity.

Area of Science:

  • Pediatric infectious diseases
  • Epidemiology
  • Public health interventions

Background:

  • Non-pharmaceutical interventions (NPIs) significantly altered the landscape of acute respiratory infection (ARI) pathogen prevalence during the COVID-19 pandemic.
  • Understanding these shifts is crucial for managing pediatric respiratory health.

Purpose of the Study:

  • To analyze the changes in the prevalence of 13 common ARI pathogens in children before, during, and after the COVID-19 pandemic.
  • To assess the long-term impact of NPIs on pediatric respiratory pathogen circulation.

Main Methods:

  • Real-time PCR data for 337,310 clinical samples were collected between January 2018 and January 2024.
  • Pathogen prevalence rates were compared across three periods: pre-pandemic, during the pandemic, and post-pandemic.

Main Results:

  • Specific pathogens like Influenza A (Flu A), Mycoplasma pneumoniae (MP), Adenovirus (ADV), Streptococcus pneumoniae (SP), Haemophilus influenzae (HI), Staphylococcus aureus (SA), and Klebsiella pneumoniae (KPN) decreased during the pandemic, while Influenza B (Flu B) and Pseudomonas aeruginosa (PAE) increased.
  • Post-pandemic, rates of Flu A, ADV, Respiratory Syncytial Virus (RSV), Rhinovirus (RhV), SP, HI, KPN, PAE, and SA rose, whereas MP, Flu B, and Parainfluenza virus (PIV) declined.

Conclusions:

  • NPIs effectively interrupted the transmission of many ARI pathogens.
  • The lifting of NPIs, coupled with diminished population immunity, likely contributed to the observed resurgence of certain ARI pathogens in children.
Abstract

Keywords:
COVID-19childrennon-pharmaceutical interventionsqPCRrespiratory infection

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