Impact of COVID-19 on viral respiratory infection epidemiology in young children: A single-center analysis

Abstract

BackgroundThe COVID-19 pandemic impacts different health aspects. Concomitant with the adoption of non-pharmaceutical interventions (NPIs) to reduce the spread of SARS-CoV-2, global surveillance studies reported a reduction in occurrence of respiratory pathogens like influenza A and B virus (IAV & IBV) and respiratory syncytial virus (RSV). We hypothesized to observe this collateral benefit on viral respiratory infection epidemiology in young children.MethodsRespiratory samples of children aged below 6 years, presenting at the outpatient clinic, emergency department, or pediatric infectious diseases department of the University Hospitals Leuven, between April 2017 and April 2021 were retrospectively analyzed. The occurrence (positivity rate), and seasonal patterns of viral respiratory infections were described. Chi-squared or Fisher's exact test (and Bonferroni correction) were used to explore differences in occurrence between 2020-2021 and previous 12-month (April to April) periods.ResultsWe included 3020 samples (453 respiratory panels, 2567 single SARS-CoV-2 PCR tests). IAV and IBV were not detected from March and January 2020, respectively. For IAV, positivity rate in 2020–2021 (0%, n = 0) was significantly different from 2018-2019 (12.4%, n = 17) (p < 0.001) and 2019-2020 (15.4%, n = 19) (p < 0.001). IBV positivity rate in 2020-2021 (0%, n = 0) was not significantly different from previous periods. RSV occurrence was significantly lower in 2020–2021 (3.2%, n = 3), compared to 2017-2018 (15.0%, n = 15) (p = 0.006), 2018–2019 (16.1%, n = 22) (p = 0.002) and 2019-2020 (22.8%, n = 28) (p < 0.001). The RSV (winter) peak was absent and presented later (March-April 2021). Positivity rate of parainfluenza virus 3 (PIV-3) was significantly higher in 2020-2021 (11.8%, n = 11) than 2017-2018 (1%, n = 1) (p = 0.002). PIV-3 was absent from April 2020 to January 2021, whereas no clear seasonal pattern was distinguished the other years. For the other viruses tested, no significant differences in occurrence were observed between 2020-2021 and previous periods. From March 2020 onwards, 20 cases (0.7%) of SARS-CoV-2 were identified.ConclusionThese findings reinforce the hypothesis of NPIs impacting the epidemiology of influenza viruses and RSV in young children. Compared to previous periods, no IAV and IBV cases were observed in the 2020-2021 study period, and the RSV peak occurred later. Since the pandemic is still ongoing, continuation of epidemiological surveillance, even on a larger scale, is indicated.

Respiratory syncytial virus in children: epidemiology and clinical impact post-COVID-19

“…In Australia, a rapid decline in laboratory-proven RSV episodes and bronchiolitiscoded hospital admissions was observed following implementation of significant NPIs, resulting in the near absence of the 2020 winter season [8 && ]. Similar reductions were observed in other countries [9][10][11] with numerous authors raising concern that a surge in unexpected RSV activity could overwhelm health systems already at capacity [5,8 && , [12][13][14][15]. In late 2020, an unprecedented epidemic occurred in multiple Australian jurisdictions with activity first detected in New South Wales (NSW), followed by Western Australia (WA) and Victoria in early 2021 [8 && ].…”

“…In Australia, a rapid decline in laboratory-proven RSV episodes and bronchiolitis-coded hospital admissions was observed following implementation of significant NPIs, resulting in the near absence of the 2020 winter season [8 ▪▪ ]. Similar reductions were observed in other countries [9–11] with numerous authors raising concern that a surge in unexpected RSV activity could overwhelm health systems already at capacity [5,8 ▪▪ ,12–15].…”

Impact of non-pharmaceutical interventions on circulating respiratory viruses during the COVID-19 pandemic in Turkey

“…Since children are more susceptible and vulnerable to viral respiratory infections, viral resurgence would be expected to be more common at this age. 28 It should also be noted that due to the crowded and closed environment in schools, the spread of respiratory viruses may be increased.…”

Impacts of COVID-19 Pandemic on Seizure Control in Children with Epilepsy

“…In other words, same restrictions applied to SARS-CoV-2 also suppressed seasonal respiratory viruses' circulations that epidemics were substantially reduced in the early phases of the COVID-19 pandemic [21,48]. However, as quarantine restrictions including reopening of schools were gradually eased after the first wave of COVID-19, infections by seasonal respiratory viruses by transmission via the respiratory route were notably increased in late 2020 and early 2021 [49,50]. Most importantly and relevant for transmission, childcare and daycare centers mostly reopened and remained open during these restriction periods.…”