| Objective:Since February 2020,an outbreak of novel coronavirus pneumonia(hereinafter referred to as "COVID-19")has emerged in Changchun City,Jilin Province,China.By collecting and analyzing the clinical data of children diagnosed with communityacquired pneumonia(CAP)in the Department of Pediatric Respiratory Medicine at the First Hospital of Jilin University(hereinafter referred to as "JLU First Hospital")before and after the COVID-19 outbreak,we aim to understand the changes in common respiratory virus infection patterns and epidemic characteristics.This information will provide a theoretical basis for formulating prevention,control,and treatment plans.Method:We retrospectively collected cases of children diagnosed with CAP and had nasal/pharyngeal swabs tested for seven respiratory pathogens(including respiratory syncytial virus [RSV],adenovirus [ADV],influenza A virus [FluA],influenza B virus [FluB],parainfluenza virus type 1 [PIV1],parainfluenza virus type 2 [PIV2],and parainfluenza virus type 3 [PIV3])in the Department of Pediatric Respiratory Medicine at JLU First Hospital from February 1,2018,to January 31,2022.Univariate analysis was used to compare the differences in detected viral types between the pre-epidemic group(February 1,2018-January 31,2020)and post-epidemic group(February 1,2020-January31,2022).At the same time,we analyzed the correlation between common respiratory pathogen infections before and after the epidemic and other clinical data(gender,age,month).Result:1.A total of 5508 eligible pediatric patients were included in this study,(with 3164 cases before the outbreak of COVID-19 and 2344 cases after the outbreak).Among them,there were 1106 positive cases before the outbreak(687 males and 419 females,with a male-to-female ratio of 1.64:1);and 880 positive cases after the outbreak,(533 males and 347 females,with a male-to-female ratio of 1.54:1).2.The overall detection rate of seven common respiratory viruses increased significantly after the outbreak(detection rates before and after the outbreak were 34.96% and 37.54%,respectively),with statistical significance(P<0.05).The detection rate of single virus infection also increased significantly after the outbreak(detection rates before and after the outbreak were 34.48% and 37.07%,respectively),with statistical significance(P<0.05).RSV was still most commonly detected both before and after the outbreak;among mixed infections,RSV+PIV3 remained most common both before and after.Before the epidemic,RSV had highest detection rate followed by ADV while afterwards it was PIV3 that had highest detection rate followed by RSV.Both RSV & PIV3 showed significant increase in their detection rates post-outbreak compared to pre-outbreak(RSV’s pre-and post-outbreak detection rates being 17.83% and 27.60% respectively,while for PIV3 they are 4.90% and 6.87% respectively)with statistical significance(P<0.05);ADV、FluA、FluB showed decrease in their respective detections post-outbreak compared to pre-outbreak(ADV’s pre-and post-outbreak detections being 5.09% and 0.60%,for FluA they are 2.53% and 0.00%,and for FluB they are 2.50% and 0.85%),with statistical significance(P<0.05).3.The overall detection rate of respiratory viruses in male and female pediatric patients increased after the outbreak compared to before(detection rates for males and females before and after the outbreak were 37.64% and 36.50%,37.39% and 32.68%,respectively),with statistical significance observed in the change of detection rates among females before and after the outbreak(P<0.05).Before the outbreak,male pediatric patients had a higher overall detection rate than female pediatric patients,with statistically significant differences observed between sexes(P<0.05).4.There were significant differences in changes of overall virus detection rates across different age groups both before and after the outbreak(P<0.05).Overall virus detection rates decreased gradually with increasing age,with children aged 0-1 years having the highest overall virus detection rate.After the outbreak,RSV had the highest proportion of detections across all age groups(with a highest proportion detected in children aged 0-1 years,at 37.45%),followed by PIV3 and ADV.After the outbreak,RSV and PIV3 virus detection rates were higher than those before for each age group;statistically significant differences were observed in changes of RSV detections between pre-outbreak versus post-outbreak periods across ages from 0-1 year old up to ages from 3-6 years old,as well as for PIV3 detections among children aged from 3-6 years old(P<0.05).After the outbreak,detection rates of ADV、FluA、FluB,and PIV1 in all age groups decreased compared to pre-outbreak periods.Statistically significant differences were observed in changes of ADV and FluA detections between preoutbreak versus post-outbreak periods in all age groups,and for FluB detections among children aged from 1-6 years old(P<0.05).5.After the outbreak,the overall detection rate of respiratory viruses decreased in spring and summer(to 33.6% and 16.08%,respectively)compared to before(42.72% and 19.3%,respectively),but increased in autumn and winter(to 35.15% and 57.06%,respectively)compared to before(24.63 %and50.47 %,respectively);statistically significant differences were observed for all seasons except for summer(P<0.05).Before and after the outbreak,RSV was most commonly detected during spring,autumn,and winter;followed by PIV3,while PIV3 was most commonly detected during summer after the outbreak.After the outbreak,detection rates of RSV were higher than those before for each season with statistical significance observed(P<0.05);PIV3 detections in fall and winter seasons were higher after the outbreak compared to pre-outbreak periods with statistical significance observed for autumn and winter seasons(P<0.05).Conclusion:1.The outbreak of COVID-19 and the control measures taken have changed the trend of common respiratory virus infections in pediatric patients with CAP to some extent.After the outbreak,the infection rates of ADV,FluA,and FluB decreased significantly,while those of RSV and PIV3 increased significantly.2.Before and after the outbreak,there was a decreasing trend in overall detection rates of common respiratory viruses with increasing age;however,children aged 0-1 years still had the highest overall virus detection rate.Although there was no change in this characteristic before versus after the outbreak,dominant virus types did change.Before the outbreak,among CAP pediatric patients under 3 years old,RSV had a significantly higher detection rate than other six viruses;whereas for preschoolers & school-age children,ADV had highest detections.After the outbreak,detection rates of RSV were highest in all ages.3.The seasonality pattern for respiratory viral infections shifted earlier after the outbreak;prior to this event winter and spring were predominant seasons but afterwards it became autumn and winter as main seasons for these infections to occur. |
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