Respiratory and Other Infections Following COVID

Andrea J Allen1, Nhat Nguyen1, Vitaly Lorman1

  • 1Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Pediatrics
|August 4, 2025
PubMed

Insights

Children who had SARS-CoV-2 infection did not have a higher risk of subsequent respiratory syncytial virus (RSV) or other infections. This study compared infection risks in children with SARS-CoV-2 versus influenza and other respiratory illnesses.

Area of Science:

  • Pediatric Infectious Diseases
  • Virology
  • Epidemiology

Background:

  • The 2022 surge in respiratory syncytial virus (RSV) cases prompted investigation into potential contributing factors, including immune suppression following SARS-CoV-2 infection.
  • Understanding the impact of SARS-CoV-2 on subsequent infection risks in children is crucial for public health strategies.

Purpose of the Study:

  • To compare the risk of subsequent respiratory syncytial virus (RSV) and other infections in children with and without prior SARS-CoV-2 infection.
  • To evaluate the association between SARS-CoV-2 infection and the incidence of other respiratory illnesses in pediatric populations.

Main Methods:

  • A retrospective cohort study utilized electronic health records from 27 US health systems.
  • Children under 5 years with SARS-CoV-2 infection were compared to those with influenza or other respiratory tract infections.
  • Inverse probability of treatment weighting and weighted logistic regression were applied to analyze outcomes over 15 to 180 days.

Main Results:

  • Children with SARS-CoV-2 infection showed lower odds of subsequent RSV compared to those with influenza (aOR 0.73) or other respiratory infections (aOR 0.78).
  • The odds of any respiratory tract infection and any infection were also lower in the SARS-CoV-2 group compared to the influenza group.
  • No increased risk of RSV or other infections was observed within 6 months following SARS-CoV-2 infection.

Conclusions:

  • SARS-CoV-2 infection in children was not associated with an increased risk of subsequent RSV, respiratory, or any type of infection within 6 months.
  • Findings suggest that SARS-CoV-2 infection does not heighten susceptibility to other common childhood infections in the short term.
  • The hypothesis of SARS-CoV-2-induced immune suppression leading to increased RSV risk was not supported by this study.
Abstract

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