The Disappearance of Respiratory Viruses in Children during the COVID-19 Pandemic

Abstract

Background: Social distancing measures are used to reduce the spreading of COVID-19. The aim of this study was to assess the impact of local restrictions on the transmission of respiratory virus infections. Methods: we retrospectively analyzed the nasopharyngeal samples of all patients (0–18 years old) admitted with respiratory symptoms in a large Italian tertiary hospital during the last three seasons from 2018 to 2021. Results: A strong reduction in all viral respiratory infections was observed in the last season (2020–2021) compared to the two previous seasons (−79.69% and −80.66%, respectively). In particular, we found that during the epidemic period 2018–2019 and 2019–2020, the total number of Respiratory Syncytial Virus (RSV) cases was, respectively 726 and 689, while in the last season a total of five cases was detected. In the first months of 2018–2019 and 2019–2020, the total flu infections were 240 and 354, respectively, while in the last season we did not detect any influenza virus. As other viruses, the presence of Rhinovirus declined, but to a lesser extent: a total of 488 cases were assessed compared to the 1030 and 1165 cases of the two previous respective epidemic seasons. Conclusions: Public health interventions and distancing (including continuous use of face masks) settled to counter the pandemic spread of COVID-19 had a macroscopic impact on all respiratory virus transmission and related diseases, with a partial exception of Rhinovirus. The absence of viruses’ circulation could result in a lack of immunity and increased susceptibility to serious infections in the next seasons.

Very Low Incidence of SARS-CoV-2, Influenza and RSV but High Incidence of Rhino-, Adeno- and Endemic Coronaviruses in Children With Acute Respiratory Infection in Primary Care Pediatric Practices During the Second and Third Wave of the SARS-CoV-2 Pandemic

“…Nevertheless, the apparently low incidence of SARS-CoV-2 infections in the pediatric populations has been confirmed in several studies in hospitalized patients. 9 , 17 Furthermore, all of our patients were seen in an outpatient setting reflecting the general pediatric population and infection activity more accurately than hospitalized patients do.…”

Understanding Rhinovirus Circulation and Impact on Illness

“…resulted in a drastic reduction in incidence of respiratory viruses including influenza, adenovirus, and RSV. On the contrary, RV stood out and appeared to cocirculate with SARS-CoV-2 at a similar rate to its habitual seasonal patterns, despite the reduction in contacts due to the public health measures [61,62]. A higher infectivity and prevalence in children, who are less subject to social distancing measures and mask wearing, may explain the lesser impact of public health measures on reducing RV transmissions in comparison to other respiratory viruses [63].…”

Respiratory Syncytial Virus Resurgence in Italy: The Need to Protect All Neonates and Young Infants

“…At the beginning of the emergency, public health measures revealed that the control of SARS-CoV-2 modified the epidemiology of other respiratory viruses including RSV. Consequently, in Italy, as well as in other countries, a strong reduction in all viral respiratory infections was observed in the last season (2020–2021), compared with the previous seasons [ 5 , 6 , 7 ].…”

“…Evidence suggests that children who experienced RSV infection early in life are at risk of developing wheezing, hyperactive airways, bronchospasm, and asthma later in life. Overall, these factors contribute to substantial health care use and economic burden of RSV disease long-term complications, caregiver stress, and loss of work productivity [ 4 , 5 ]. To date, no effective and specific treatment is available to cure RSV, as therapeutic measures are still undergoing preliminary research.…”