Transmission of paediatric respiratory syncytial virus and influenza in the wake of the COVID-19 pandemic

Williams, Thomas C; Sinha, Ian; Barr, Ian G.; Zambon, Maria

doi:10.2807/1560-7917.es.2021.26.29.2100186

Cited by 62 publications

(62 citation statements)

References 21 publications

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“…Nevertheless, during the study period, all infants attending the PED with respiratory symptoms were tested for SARS-CoV-2 infection, in all the participating centres except one: in the latter, the swab was performed in all infants with bronchiolitis requiring hospital observation or admission. While reporting a low prevalence of bronchiolitis during the winter season, we could have missed a delayed spread of bronchiolitis, as already reported in Australia and France,29 30 as our data have been collected until April 2021. However, we did not observe a late raise in the number of bronchiolitis diagnoses in the last weeks of the study period.…”

Section: Discussionmentioning

confidence: 82%

Prevalence of SARS-CoV-2 positivity in infants with bronchiolitis: a multicentre international study

et al. 2022

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BackgroundBronchiolitis is the leading acute respiratory tract infection in infants during the winter season. Since the beginning of the SARS-CoV-2 pandemic, a reduction in the number of bronchiolitis diagnoses has been registered.ObjectiveThe present study aimed to describe the incidence and clinical features of bronchiolitis during the 2020–2021 winter season in a large cohort of children in Europe and Israel, and to clarify the role of SARS-CoV-2.Setting, patients, interventionsWe conducted a multicentre observational cross-sectional study in 23 paediatric emergency departments in Europe and Israel. Clinical and demographic data about all the cases of infants diagnosed with bronchiolitis from 1 October 2020 to 30 April 2021 were collected. For each enrolled patient, diagnostic tests, treatments and outcomes were reported.Main outcome measuresThe main outcome was the prevalence of SARS-CoV-2-positive bronchiolitis.ResultsThree hundred and fourteen infants received a diagnosis of bronchiolitis during the study period. Among 535 infants who tested positive for SARS-CoV-2, 16 (3%) had bronchiolitis. Median age, male sex predominance, weight, history of prematurity and presence of comorbidities did not differ between the SARS-CoV-2-positive and SARS-CoV-2-negative groups. Rhinovirus was the most common involved pathogen, while respiratory syncytial virus (RSV) was detected in one case. SARS-CoV-2 bronchiolitis had a mild clinical course, with one patient receiving oxygen supplementation and none requiring paediatric or neonatal intensive care unit admission.ConclusionsDuring the SARS-CoV-2 pandemic, a marked decrease in the number of bronchiolitis diagnoses and the disappearance of the RSV winter epidemic were observed. SARS-CoV-2-related bronchiolitis was rare and mostly displayed a mild clinical course.

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Section: Discussionmentioning

confidence: 82%

Prevalence of SARS-CoV-2 positivity in infants with bronchiolitis: a multicentre international study

et al. 2022

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“…However, we are in an uncertain epidemiological period for paediatric respiratory aetiology, with decreased influenza transmission and paediatric respiratory hospital admissions, coinciding with COVID-19 control measures [ 43 - 47 ]. Low infant exposure to common respiratory pathogens during the pandemic may result in subsequent outbreaks, as is already being reported for RSV [ 48 ]. Therefore, epidemiological research questions should ensure the local COVID-19 context is considered, and if/how control strategies have mitigated or exacerbated the paediatric pneumonia burden.…”

Section: Discussionmentioning

confidence: 99%

Paediatric pneumonia research priorities in the context of COVID-19: An eDelphi study

et al. 2022

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Background Pneumonia remains the leading cause of infectious deaths in children under-five globally. We update the research priorities for childhood pneumonia in the context of the COVID-19 pandemic and explore whether previous priorities have been addressed. Methods We conducted an eDelphi study from November 2019 to June 2021. Experts were invited to take part, targeting balance by: gender, profession, and high (HIC) and low- and middle-income countries (LMIC). We followed a three-stage approach: 1. Collating questions, using a list published in 2011 and adding newly posed topics; 2. Narrowing down, through participant scoring on importance and whether they had been answered; 3. Ranking of retained topics. Topics were categorized into: prevent and protect, diagnosis, treatment and cross-cutting. Results Overall 379 experts were identified, and 108 took part. We started with 83 topics, and 81 further general and 40 COVID-19 specific topics were proposed. In the final ranking 101 topics were retained, and the highest ranked was to “explore interventions to prevent neonatal pneumonia”. Among the top 20 topics, epidemiological research and intervention evaluation was commonly prioritized, followed by the operational and implementation research. Two COVID-19 related questions were ranked within the top 20. There were clear differences in priorities between HIC and LMIC respondents, and academics vs non-academics. Conclusions Operational research on health system capacities, and evaluating optimized delivery of existing treatments, diagnostics and case management approaches are needed. This list should act as a catalyst for collaborative research, especially to meet the top priority in preventing neonatal pneumonia, and encourage multi-disciplinary partnerships.

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“…These data demonstrate that child deaths caused by (seasonal) infections are potentially substantially modifiable at population level. Impressive reductions in respiratory syncytial virus (RSV) and other respiratory virus infections in the winter months were reported in the first pandemic year 33. Indeed, while some pathogens appeared to rebound to normal seasonal levels after opening of schools and nurseries, and lifting of social distancing,34 RSV appeared to remain suppressed through the simple measures of mask wearing and enhanced hand washing 35.…”

Section: Discussionmentioning

confidence: 99%

“…Impressive reductions in respiratory syncytial virus (RSV) and other respiratory virus infections in the winter months were reported in the first pandemic year. 33 Indeed, while some pathogens appeared to rebound to normal seasonal levels after opening of schools and nurseries, and lifting of social distancing, 34 RSV appeared to remain suppressed through the simple measures of mask wearing and enhanced hand washing. 35 However, with the end of social distancing regulations in England, alongside the large cohort of immune-naïve children at risk, protected by the lockdown measures in 2020, the ongoing burden of RSV in young children is predicted to he high throughout the winter of 2021/2022.…”

Section: Original Researchmentioning

confidence: 99%

Child mortality in England during the first year of the COVID-19 pandemic

et al. 2021

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ObjectivesTo quantify the relative risk (RR) of childhood deaths across the whole of England during the first year of the COVID-19 pandemic, compared with a similar period of 2019.DesignThis work is based on data collected by the National Child Mortality Database (NCMD). Deaths from 1 April 2020 until 31 March 2021 (2020–2021) were compared with those from the same period of 2019–2020. RR and excess mortality were derived for deaths in 2020–2021 vs 2019–2020.SettingAll deaths reported to NCMD in England of children under 18 years of age, between April 2019 and March 2021.Participants6490 deaths of children, under the age of 18 years, reported to the NCMD over the study period.ResultsChildren had similar demographics in the 2 years. There were 356 (198–514) fewer deaths in 2020–2021 than in 2019–2020 (RR 0.90 (0.85 to 0.94), p<0.001). Deaths from infection (RR 0.49 (0.38 to 0.64)) and from other underlying medical conditions (RR 0.75 (0.68 to 0.82)) were lower in 2020–2021 than 2019–2020, and weak evidence (RR 0.50 (0.23 to 1.07), p=0.074) that this was also true of deaths from substance abuse.ConclusionsChildhood mortality in England during the first year of the SARS-CoV-2 pandemic was lower than expected, with over 300 fewer deaths than the preceding 12 months. The greatest reduction was in children less than 10 years old. It is important that we learn from this effect that potentially offers alternative ways to improve the outcome for the most vulnerable children in our society.

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Transmission of paediatric respiratory syncytial virus and influenza in the wake of the COVID-19 pandemic

Cited by 62 publications

References 21 publications

Prevalence of SARS-CoV-2 positivity in infants with bronchiolitis: a multicentre international study

Prevalence of SARS-CoV-2 positivity in infants with bronchiolitis: a multicentre international study

Paediatric pneumonia research priorities in the context of COVID-19: An eDelphi study

Child mortality in England during the first year of the COVID-19 pandemic

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