Impact of the SARS-CoV-2 Pandemic on the Prevalence and Incidence of Gastrointestinal Viruses in Children up to Five Years Old: a Retrospective Cohort Study

Maldonado-Barrueco, Alfredo; García-Rodríguez, Julio; Yániz-Ramirez, Jorge; Serrano-Vaquero, Irene; Parra-Alonso, Juan Carlos; Vega-Nieto, Carlos; Ruiz-Carrascoso, Guillermo

doi:10.1128/spectrum.02669-21

Cited by 14 publications

(16 citation statements)

References 30 publications

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“…Surveillance Study Team also reported a similar seasonal pattern. 21 Some similar evidence has been found in several national studies, such as in Spain, 22 the Czech Republic, 23 Germany, 24 Norway, 25 England, 26 and the United States. 27 In autumn and winter, the temperature is relatively low and may influence transmissibility, host susceptibility, and the resistance of norovirus to environmental conditions.…”

Section: Discussionsupporting

confidence: 75%

Epidemiological characteristics of norovirus infection in pediatric patients during the COVID‐19 pandemic

Wang

et al. 2023

Journal of Medical Virology

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To assess the epidemiological characteristics of norovirus infection. We included 5564 patients under the age of 18 years who visited the hospital in which the study took place from December 2020 to November 2022 with a primary diagnosis of acute diarrhea. Clinical information was extracted from the electronic health record system. We calculated the prevalence of norovirus infection by age, gender, season, year, and type of patients. A nonlinear association between age and prevalence rates was assessed using a restricted cubic spline regression model. A total of 5564 patients completed the test for human norovirus, among whom 1442 (25.9%) tested positive. The prevalence of norovirus infection was significantly lower in 2022 than in 2021 (35.9% vs. 53.7%, p < 0.001), and the highest prevalence was observed in winter (35.1%) and then followed by autumn (27.5%). Regarding the age pattern, the highest rate was seen in children aged 1-3 years (37.5%). Children at age 1.5 years may have the highest risk of having norovirus infection (P nonlinear < 0.001). The prevalence of norovirus infection of norovirus during the COVID-19 pandemic was similar to that before the pandemic shown in literatures. A relatively high rate was observed in cool seasons and in younger children (i.e., 1-3 years).

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Section: Discussionsupporting

confidence: 75%

Epidemiological characteristics of norovirus infection in pediatric patients during the COVID‐19 pandemic

Wang

et al. 2023

Journal of Medical Virology

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“…Samples were collected more than two years prior to analysis, which could compromise their integrity [ 53 ]. The study setting might have experienced a further change in enteropathogen burden since 2018 in part due to the coronavirus disease 2019 (COVID-19) pandemic as has been observed elsewhere [ 54 , 55 ]. However, this does not invalidate the hypotheses generated by the findings regarding enteropathogen dynamics, but rather suggests that continuous surveillance is critical for adapting and maximizing diarrheal illness prevention.…”

Section: Discussionmentioning

confidence: 99%

Differences in epidemiology of enteropathogens in children pre- and post-rotavirus vaccine introduction in Kilifi, coastal Kenya

et al. 2022

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Background Kenya introduced Rotarix® (GlaxoSmithKline Biologicals, Rixensart, Belgium) vaccination into its national immunization programme beginning July 2014. The impact of this vaccination program on the local epidemiology of various known enteropathogens is not fully understood. Methods We used a custom TaqMan Array Card (TAC) to screen for 28 different enteropathogens in 718 stools from children aged less than 13 years admitted to Kilifi County Hospital, coastal Kenya, following presentation with diarrhea in 2013 (before vaccine introduction) and in 2016–2018 (after vaccine introduction). Pathogen positivity rate differences between pre- and post-Rotarix® vaccination introduction were examined using both univariate and multivariable logistic regression models. Results In 665 specimens (92.6%), one or more enteropathogen was detected, while in 323 specimens (48.6%) three or more enteropathogens were detected. The top six detected enteropathogens were: enteroaggregative Escherichia coli (EAggEC; 42.1%), enteropathogenic Escherichia coli (EPEC; 30.2%), enterovirus (26.9%), rotavirus group A (RVA; 24.8%), parechovirus (16.6%) and norovirus GI/GII (14.4%). Post-rotavirus vaccine introduction, there was a significant increase in the proportion of samples testing positive for EAggEC (35.7% vs. 45.3%, p = 0.014), cytomegalovirus (4.2% vs. 9.9%, p = 0.008), Vibrio cholerae (0.0% vs. 2.3%, p = 0.019), Strongyloides species (0.8% vs. 3.6%, p = 0.048) and Dientamoeba fragilis (2.1% vs. 7.8%, p = 0.004). Although not reaching statistical significance, the positivity rate of adenovirus 40/41 (5.8% vs. 7.3%, p = 0.444), norovirus GI/GII (11.2% vs. 15.9%, p = 0.089), Shigella species (8.7% vs. 13.0%, p = 0.092) and Cryptosporidium spp. (11.6% vs. 14.7%, p = 0.261) appeared to increase post-vaccine introduction. Conversely, the positivity rate of sapovirus decreased significantly post-vaccine introduction (7.8% vs. 4.0%, p = 0.030) while that of RVA appeared not to change (27.4% vs. 23.5%, p = 0.253). More enteropathogen coinfections were detected per child post-vaccine introduction compared to before (mean: 2.7 vs. 2.3; p = 0.0025). Conclusions In this rural Coastal Kenya setting, childhood enteropathogen infection burden was high both pre- and post-rotavirus vaccination introduction. Children who had diarrheal admissions post-vaccination showed an increase in coinfections and changes in specific enteropathogen positivity rates. This study highlights the utility of multipathogen detection platforms such as TAC in understanding etiology of childhood acute gastroenteritis in resource-limited regions.

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“…However, in 2021 there was a surge of RVA cases in these countries. Like RVA, a decrease in cases of norovirus GII, sapovirus, adenovirus 40/41 and astrovirus was reported in 2020 in Spain 8 and Korea 9 compared to previous years. However, this decrease in virus detecMon has been followed by remarkable outbreaks in 2021 5,10 .…”

Section: Introduc-onmentioning

confidence: 93%

“…Of the 130 RVA posiMve detected during the study, 87 (66.9%) and 70 (53.8%) successively 207 sequenced in the VP7 and VP4 segment, respecMvely. The years 2019, 2020 and 2021 were 208 predominated by the G3P [8] genotype (n=48, 80.0%). In 2022, we observed replacement of 209 the G3P [8] genotype with mulMple genotypes: G2P [4] (n=2), G9P [8] (n=10), and G9P [4]…”

Section: Rva Genotypes and Vaccina-on Status Of Posi-ve Cases 206mentioning

confidence: 99%

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Temporal changes in the positivity rate of common enteric viruses among paediatric admissions in coastal Kenya, in the period spanning the COVID-19 pandemic, 2019-2022

Lambisia

Murunga

Mutunga

et al. 2023

Preprint

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Background The non-pharmaceutical interventions (NPIs) implemented to curb the spread of SARS_CoV_2 early in the COVID_19 pandemic years, disrupted the activity of other respiratory viruses. There is limited data from low and middle income countries (LMICs) to determine whether COVID_19 NPIs also impacted the epidemiology of enteric viruses. We investigated the changes in infection patterns of common enteric viruses among hospitalised children who presented with diarrhoea to a referral hospital in coastal Kenya, in the period spanning the COVID_19 pandemic. Methods A total of 870 stool samples from children under 13 years of age admitted to Kilifi County Hospital between January 2019, and December 2022 were screened for rotavirus group A (RVA), norovirus genogroup II (GII), astrovirus, sapovirus, and adenovirus type F40/41 using realtime reverse transcription polymerase chain reaction. The proportions positive across the four years were compared using the chi-squared test statistic. Results One or more of the five virus targets were detected in 282 (32.4%) cases. A reduction in the positivity rate of RVA cases was observed from 2019 (12.1%, 95% confidence interval (CI) 8.7% to 16.2%) to 2020 (1.7%, 95% CI 0.2% to 6.0%; p < 0.001). However, in the 2022, RVA positivity rate rebounded to 23.5% (95% CI 18.2% to 29.4%). For norovirus GII, the positivity rate fluctuated over the four years with its highest positivity rate observed in 2020 (16.2%; 95% C.I, 10.0% to 24.1%). No astrovirus cases were detected in 2020 and 2021, but the positivity rate in 2022 was similar to that in 2019 (3.1% (95% CI 1.5% to 5.7%) vs 3.3% (95% CI 1.4% to 6.5%)). A higher case fatality rate was observed in 2021 (9.0%) compared to the 2019 (3.2%), 2020 (6.8%) and 2022 (2.1%) (p <0.001). Conclusion Our study finds that in 2020 the transmission of common enteric viruses, especially RVA and astrovirus, in Kilifi Kenya may have been disrupted due to the COVID_19 NPIs. After 2020, local enteric virus transmission patterns appeared to return to prepandemic levels coinciding with the removal of most of the government COVID_19 NPIs.

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Impact of the SARS-CoV-2 Pandemic on the Prevalence and Incidence of Gastrointestinal Viruses in Children up to Five Years Old: a Retrospective Cohort Study

Cited by 14 publications

References 30 publications

Epidemiological characteristics of norovirus infection in pediatric patients during the COVID‐19 pandemic

Epidemiological characteristics of norovirus infection in pediatric patients during the COVID‐19 pandemic

Differences in epidemiology of enteropathogens in children pre- and post-rotavirus vaccine introduction in Kilifi, coastal Kenya

Temporal changes in the positivity rate of common enteric viruses among paediatric admissions in coastal Kenya, in the period spanning the COVID-19 pandemic, 2019-2022

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