The epidemiological features of respiratory tract infection using the multiplex panels detection during COVID-19 pandemic in Shandong province, China

Abstract

Respiratory tract infection is one of the most common reasons for both morbidity and mortality worldwide. High attention has been paid to the etiological tracing of respiratory tract infection since the advent of COVID-19. In this study, we aimed to evaluate the epidemiological features of pathogens in respiratory tract infection, especially during COVID-19 pandemic. A total of 7668 patients with respiratory tract infection who admitted to Qilu Hospital of Shandong University from March 2019 to Dec 2021 were retrospectively included. The respiratory tract specimens were detected using a commercial multiplex PCR-based panel assay for common respiratory pathogens including influenza A virus (Flu-A), influenza A virus H1N1 (H1N1), influenza A virus H3N2 (H3N2), influenza B virus (Flu-B), parainfluenza virus (PIV), respiratory syncytial virus (RSV), adenovirus (ADV), Boca virus (Boca), human Rhinovirus (HRV), Metapneumovirus (MPV), Coronavirus (COV), Mycoplasma pneumoniae (MP), and Chlamydia (Ch). The positive rates were compared using a chi-square test. Compared with 2019, the positive rate of pathogen detection during from January 2020 to December 2021 was significantly lower, especially the detection of Flu-A. The positive rate of respiratory pathogen strains was 40.18% during COVID-19 pandemic, and a total of 297 cases (4.69%) of mixed infection with two or more pathogens were detected. There was no statistical difference in the positive rate between male and female patients. However, the positive rates of infection were different among different age groups, with higher incidence of RSV in infancy and toddler group, and MP infection in children and teenager group. While, HRV was the most common pathogen in the adult patients. Moreover, Flu-A and Flu-B were higher in winter, and MP and RSV were higher in spring, autumn and winter. The pathogens such as ADV, BOCA, PIV, and COV were detected without significant seasonal distribution. In conclusion, respiratory pathogen infection rates may vary by age and season, regardless of gender. During the COVID-19 epidemic, blocking transmission routes could help reduce the incidence of respiratory tract infection. The current prevalence of respiratory tract infection pathogens is of great significance for clinical prevention, diagnosis and treatment.

The Seasonality of Respiratory Viruses in a Hong Kong Hospital, 2014–2023

“…A rebound of respiratory virus activity was observed in March and April 2023. Overall, our observation was similar to the change in seasonality in other geographical regions [ 9 , 10 , 11 , 12 ].…”

“…The timeline of a few of these countermeasures is given in Figure 1 . There were reports from a number of regions on the seasonality of respiratory viruses before and during the COVID-19 pandemic, revealing suppression of non-SARS-CoV-2, clinically important respiratory viruses during the period of unusual, global-scale pandemic intervention and their resurgence after ‘returning to normal life’ [ 9 , 10 , 11 , 12 ]. This knowledge provides valuable insights for better preparedness against future outbreaks and pandemics, which is especially important to healthcare providers for situation assessment and wise allocation of manpower and resources to cope with surges of clinical needs.…”

Evaluation and clinical practice of pathogens and antimicrobial resistance genes of BioFire FilmArray Pneumonia panel in lower respiratory tract infections

“…However, traditional etiological methods, such as sputum culture with lengthy culture cycles, fail to detect coinfections and atypical pathogens. Currently, rapid molecular detection methods mostly target respiratory viruses, with limited focus on bacteria [ 5 , 6 ]. Few assays are available for LRTI diagnostics [ 7 – 10 ].…”

Impact of normalized COVID-19 prevention and control measures on lower respiratory tract infection pathogenesis in hospitalized children

“…Notably, the incidence of LRTIs was significantly reduced after the COVID-19 outbreak, suggesting the effectiveness of COVID-19 prevention and control measures in reducing childhood respiratory infections ( 16 , 19 ). Detection rates for different pathogens show significantly variation with age, with the highest rates, particularly for viral infections ( 17 – 21 ), occurring before the age of 3 years, this is attributed to lower immunity and increased environmental contact in young children, coupled with challenges in adhering to preventive measures liking handwashing and mask-wearing ( 18 , 19 ). While the incidence rate of LRTI usually decreases with age, the incidence rate of LRTI increases significantly at the age of 3 years, which may be due to the fact that children begin to learn in early childhood settings at this age ( 22 ).…”

“…These measures have not only effectively contained the large-scale spread of COVID-19, but have also contributed to a reduction in infections and hospitalizations related to common respiratory pathogens in children in China. As a result, the epidemiological characteristics of childhood LRTIs have been affected and the spectrum of common pathogens has changed (16)(17)(18)(19). Notably, the incidence of LRTIs was significantly reduced after the COVID-19 outbreak, suggesting the effectiveness of COVID-19 prevention and control measures in reducing childhood respiratory infections (16,19).…”