Changes in endemic patterns of respiratory syncytial virus infection in pediatric patients under the pressure of nonpharmaceutical interventions for COVID‐19 in Beijing, China

Jiang, Mingli; Xu, Yan‐Peng; Wu, Hui; Zhu, Rong; Sun, Yu; Chen, Dongmei; Wang, Fang; Zhou, Yutong; Guo, Qi; Wu, Aiping; Qia, Yuan; Zhou, Hangyu; Zhao, Linqing

doi:10.1002/jmv.28411

Cited by 16 publications

(11 citation statements)

References 37 publications

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“…The detection rate of RSV sharply dropped after an outbreak in January 2020 and stayed in a nearly dormant state during the next seven months. However, the detection rates from June to September of 2021 remained abnormally high (over 10%), as reported in Shanghai and Beijing ( Jia et al., 2022 ; Jiang et al., 2022 ). We also found higher proportions of RSV-infected children aged 1–3 years in 2021.…”

Section: Discussionmentioning

confidence: 64%

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Epidemiological characteristics of respiratory viruses in hospitalized children during the COVID-19 pandemic in southwestern China

Zhu

Luo

Yuan

et al. 2023

Front. Cell. Infect. Microbiol.

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BackgroundMultinational studies have reported that the implementation of nonpharmaceutical interventions (NPIs) to control severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission coincided with the decline of other respiratory viruses, such as influenza viruses and respiratory syncytial virus.ObjectiveTo investigate the prevalence of common respiratory viruses during the coronavirus disease 2019 (COVID-19) pandemic.MethodsRespiratory specimens of children with lower respiratory tract infections (LRTIs) hospitalized at the Children’s Hospital of Chongqing Medical University from January 1, 2018 to December 31, 2021 were collected. Seven common pathogens, including respiratory syncytial virus (RSV), adenovirus (ADV), influenza virus A and B (Flu A, Flu B), and parainfluenza virus types 1–3 (PIV1–3), were detected by a multiplex direct immunofluorescence assay (DFA). Demographic data and laboratory test results were analyzed.Results1) A total of 31,113 children with LRTIs were enrolled, including 8141 in 2018, 8681 in 2019, 6252 in 2020, and 8059 in 2021.The overall detection rates decreased in 2020 and 2021 (P < 0.001). The detection rates of RSV, ADV, Flu A, PIV-1, and PIV-3 decreased when NPIs were active from February to August 2020, with Flu A decreasing most predominantly, from 2.7% to 0.3% (P < 0.05). The detection rates of RSV and PIV-1 resurged and even surpassed the historical level of 2018–2019, while Flu A continued decreasing when NPIs were lifted (P < 0.05). 2) Seasonal patterns of Flu A completely disappeared in 2020 and 2021. The Flu B epidemic was observed until October 2021 after a long period of low detection in 2020. RSV decreased sharply after January 2020 and stayed in a nearly dormant state during the next seven months. Nevertheless, the detection rates of RSV were abnormally higher than 10% in the summer of 2021. PIV-3 decreased significantly after the COVID-19 pandemic; however, it atypically surged from August to November 2020.ConclusionThe NPIs implemented during the COVID-19 pandemic affected the prevalence and seasonal patterns of certain viruses such as RSV, PIV-3, and influenza viruses. We recommend continuous surveillance of the epidemiological and evolutionary dynamics of multiple respiratory pathogens, especially when NPIs are no longer necessary.

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Section: Discussionmentioning

confidence: 64%

“…A study in Argentina also showed that the delayed RSV upsurge was related to new viral variants ( Dolores et al., 2022 ). Epidemiological data in Beijing revealed abnormal RSV prevalence in the summer of 2021 along with the shift of subtypes from B to A ( Jiang et al., 2022 ).…”

Section: Discussionmentioning

confidence: 99%

Epidemiological characteristics of respiratory viruses in hospitalized children during the COVID-19 pandemic in southwestern China

Zhu

Luo

Yuan

et al. 2023

Front. Cell. Infect. Microbiol.

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“…After the outbreak of COVID‐19, multiple non‐pharmaceutical interventions (NPIs), such as wearing masks, handwashing, self‐quarantine and lockdown have been implemented to prevent the spread of COVID‐19. However, the COVID‐19 pandemic and NPIs affected the prevalence of other respiratory pathogens, and there have been several reports of changes in RSV prevalence 24–26 . For example, a review reported that the expected epidemic peaks were not observed in the United States and Tokyo in 2020, but a resurgence occurred in 2021 27 .…”

Section: Discussionmentioning

confidence: 99%

Defining RSV epidemic season in southwest China and assessing the relationship between birth month and RSV infection: A 10‐year retrospective study from June 2009 to May 2019

Fang

Liu

et al. 2023

Journal of Medical Virology

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Respiratory syncytial virus (RSV) is one of the most common causes of lower respiratory tract infections (LRTI). However, only limited information is available regarding its seasonality and its relationship with birth month. A retrospective hospital‐based study was carried out from June 2009 to May 2019 in Chongqing, southwest of China. LRTI cases under 5 years were enrolled in this study and PCR was used to detect 8 respiratory viruses. RSV seasonality was determined using “average annual percentage” (AAP) and “percent positivity” method. A total of 6991 cases were enrolled in this study, with an RSV positivity of 34.5%. From June 2009 to May 2019, we analyzed RSV epidemic season during 10 RSV epidemic years in Chongqing using two methods. The result of AAP method was similar to that of percent positivity method with a 30% threshold, which showed an epidemic season of roughly October to March in the subsequent year, with a small peak in June. On average, the RSV epidemic season in RSV‐A dominant years typically started earlier (week 42 for RSV‐A vs. week 46 for RSV‐B), ended earlier (week 12 for RSV‐A vs. week 14 for RSV‐B), lasted longer (24 weeks for RSV‐A vs. 22 weeks for RSV‐B), and reached its peak earlier (week 2 for RSV‐A vs. week 3 for RSV‐B) than in RSV‐B dominant years. The proportion of severe LRTI was higher in cases of single infection with RSV‐A compared to those of single infection with RSV‐B (26.3% vs. 22.3%, p = 0.024). Among infants under 1 year, those born in May and August through December were more likely to be infected with RSV. Infants born 1–2 months before the epidemic season were relatively more susceptible to RSV infection. In Chongqing, the RSV epidemic was seasonal and usually lasted from October to March of next year with a small peak in summer. Infants born 1–2 months before the epidemic season were relatively more susceptible to RSV infection and this population should be targeted while developing RSV immunization strategies.

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“…Another study in Beijing revealed that the implementation of non-pharmaceutical interventions (NPIs) reduced the incidence of RSV from 31.9% to 4.4% in children. 14 These lines of evidence support the likelihood of a "tripledemic" in China after lifting the "Zero COVID-19" policy.…”

Section: Additional Major Challenges Associated With Lifting the Zero...mentioning

confidence: 93%

Challenges and Opportunities Associated with Lifting the Zero COVID-19 Policy in China

Hu¹,

Zhang²

2023

Explor Res Hypothesis Med

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Chinese government lifted its "Zero COVID-19" policy in December 2022. The estimated COVDI-19 new cases and deaths after the policy change are 167-279 million (about 12.0% to 20.1% of the Chinese population) and 0.68-2.1 million, respectively. Recent data also revealed continuous drops in fertility rate and historically lowest growth in gross domestic production in China. Thus, balancing COVID-19 control and economic recovery in China is of paramount importance yet very difficult. Supply chain disruption, essential service reduction and shortage of intensive care units have been discussed as the challenges associated with lifting "Zero COVID-19" policy. The additional challenges may include triple epidemic of COVID-19, respiratory syncytial virus and influenza, mental health issues of healthcare providers, care givers and patients, impact on human mobility, lack of robust genomic and epidemiological data and long COVID-19. However, the policy-associated opportunities and other challenges are largely untouched, but warrant attention of and prompt reactions by the policy makers, healthcare providers, public health officials and other stakeholders. The associated benefits are quick reach of herd immunity, boost of economy and businesses activities and increase in social activities. At this moment, we must embrace the policy change, effectively mitigate its associated problems and timely and effectively maximize its associated benefits.

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Changes in endemic patterns of respiratory syncytial virus infection in pediatric patients under the pressure of nonpharmaceutical interventions for COVID‐19 in Beijing, China

Cited by 16 publications

References 37 publications

Epidemiological characteristics of respiratory viruses in hospitalized children during the COVID-19 pandemic in southwestern China

Epidemiological characteristics of respiratory viruses in hospitalized children during the COVID-19 pandemic in southwestern China

Defining RSV epidemic season in southwest China and assessing the relationship between birth month and RSV infection: A 10‐year retrospective study from June 2009 to May 2019

Challenges and Opportunities Associated with Lifting the Zero COVID-19 Policy in China

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