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Epidemiology and Clinical Features of Respiratory Viruses in Hospitalized Iranian Children During the COVID-19
Ali Nateghi1, Morvarid Hamrahjoo1, Mohammad Yasaghi1
1Department of Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
Insights
Respiratory virus infections are common in hospitalized children, with human rhinovirus and human metapneumovirus frequently detected. Co-infections increased the risk of severe outcomes, emphasizing the need for ongoing surveillance in pediatric populations.
Area of Science:
- Pediatric infectious diseases
- Virology
- Epidemiology
Background:
- Acute respiratory infections (ARIs) pose a significant global health threat, particularly to children under five, causing millions of deaths annually.
- Respiratory viruses are the primary cause of ARIs, and their circulation patterns have been impacted by the COVID-19 pandemic.
Purpose of the Study:
- To investigate the epidemiology and clinical characteristics of respiratory virus infections in hospitalized children.
- To understand the impact of the COVID-19 pandemic on respiratory virus circulation in a pediatric population in Gorgan, Iran.
Main Methods:
- Collected nasopharyngeal swab samples from 264 hospitalized children between October 2021 and March 2022.
- Utilized a SYBR green-based real-time PCR assay to detect various respiratory viruses, including HPIV, FLU-A/B, HMPV, HRV, RSV, and SARS-CoV-2.
Main Results:
- 88.2% of children tested positive for at least one respiratory virus; 60.2% had co-infections.
- Human rhinovirus (56.4%), human metapneumovirus (53%), and respiratory syncytial virus (18.2%) were the most prevalent viruses.
- RSV was associated with pneumonia, HPIV-1 with cyanosis, and co-infections with severe outcomes like pneumonia and seizures. Human metapneumovirus was most frequent in fatal cases.
Conclusions:
- Acute respiratory infections significantly impact children under five in Golestan Province, Iran, during the COVID-19 pandemic.
- Early detection and continuous surveillance of respiratory viruses are crucial, especially in high-risk pediatric groups and varied geographical regions.
Background:
Acute respiratory infections (ARIs) are a significant global health concern, especially in children under five, causing approximately 4.3 million annual deaths. ARIs are mainly caused by respiratory viruses. The coronavirus disease 2019 (COVID-19) has altered the circulation of respiratory viruses. This study investigates the epidemiology and clinical features of respiratory viruses in hospitalized children during the COVID-19 pandemic in Gorgan, Iran.
Methods:
A total of 264 nasopharyngeal swab samples were collected from hospitalized children between October 2021 to March 2022 at Taleghani Children's Hospital, Gorgan, Iran. The frequency of various respiratory viruses, including human parainfluenza viruses (HPIV1-4), influenza viruses A and B (FLU-A, B), human metapneumovirus (HMPV), human rhinovirus (HRV), respiratory syncytial virus (RSV), and severe acute respiratory syndrome-associated coronavirus 2 (SARS-CoV-2) was detected using a SYBR green-based real-time PCR assay.
Results:
Out of the 264 hospitalized children, 88.2% (233) tested positive for at least one respiratory virus, with 60.2% (159) showing co-infections and 28% (74) having single infections. The most frequently detected were HRV (56.4%), HMPV (53%), and RSV (18.2%). The proportions of HPIV-1, HPIV-2, HPIV-3, HPIV-4, FLU-A, FLU-B, and SARS-CoV-2 were 8.7%, 12.9%, 8%, 7.6%, 1.9%, 0%, and 15.2%, respectively. There was a clear association between specific viruses and some clinical symptoms, such as RSV with pneumonia, and HPIV-1 with cyanosis. Co-infections were linked to severe outcomes, including pneumonia and seizures. Among all 264 patients, 5 died, and 3 of them had underlying diseases. All fatal cases tested positive for at least one virus, with HMPV being the most frequently detected.
Conclusions:
This study highlights the considerable impact of ARIs among children under five in Golestan Province, Iran, during the COVID-19 pandemic. The findings underscore the importance of early detection and ongoing surveillance, particularly in high-risk pediatric populations and across diverse geographic areas.
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