Lan Siyuan, Gu Changjuan, Lu Shuanglong, Zhou Ning, Qiao Xiaohong
Department of Pediatrics, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China.
Children (Basel). 2024 Sep 17;11(9):1127. doi: 10.3390/children11091127.
After the removal of the three-year epidemic control restrictions, Chinese children were confronted with heightened risks of respiratory infections. We aimed to investigate the post-pandemic (2023) epidemiology of respiratory infections among pediatric inpatients in a tertiary hospital in Shanghai, China, and compare it with the pre-pandemic (2019) levels.
A total of 2644 pediatric inpatients were enrolled based on discharge time and divided into group 2019 ( = 1442) and group 2023 ( = 1202). Information on the demographic characteristics, diagnoses, and pathogen test results (Mycoplasma pneumoniae, MP; Chlamydia pneumoniae, CP; Legionella pneumophila, LP; Influenza A, IFA; Influenza B, IFB; Parainfluenza virus, PIV; respiratory syncytial virus, RSV; Coxsackie virus, COX; Adenovirus, ADV; Epstein-Barr virus, EBV) was collected and analyzed.
Significant increases were found in the overall test positivity rates (64.6% vs. 46.7%), mixed infection rates (17.4% vs. 9%), and proportion of severe cases (25.5% vs. 3.7%) after the pandemic than those before it. Compared with 2019, the incidences of MP, IFA, LP, RSV, and ADV remarkably increased, while those of IFB and COX decreased, with no obvious differences noted for CP, PIV, and EBV in 2023. A significantly higher MP-positive detection rate was noticed in children aged 1-6 years in 2023 than in 2019. The incidence of RSV infection began to rise in August 2023, earlier than the conventional epidemic season.
Compared with the pre-pandemic levels, the overall test positivity rates of atypical pathogens and viruses among pediatric inpatients significantly increased, and alterations in the disease spectrum, epidemic season, and age of prevalence were observed after the COVID-19 pandemic.
在解除为期三年的疫情防控限制后，中国儿童面临呼吸道感染风险增加的情况。我们旨在调查中国上海一家三级医院儿科住院患者在疫情后（2023年）呼吸道感染的流行病学情况，并将其与疫情前（2019年）水平进行比较。
根据出院时间共纳入2644名儿科住院患者，分为2019组（n = 1442）和2023组（n = 1202）。收集并分析了人口统计学特征、诊断以及病原体检测结果（肺炎支原体、MP；肺炎衣原体、CP；嗜肺军团菌、LP；甲型流感病毒、IFA；乙型流感病毒、IFB；副流感病毒、PIV；呼吸道合胞病毒、RSV；柯萨奇病毒、COX；腺病毒、ADV；EB病毒、EBV）等信息。
与疫情前相比，疫情后总体检测阳性率（64.6%对46.7%）、混合感染率（17.4%对9%）和重症病例比例（25.5%对3.7%）均显著增加。与2019年相比，MP、IFA、LP、RSV和ADV感染率显著上升，而IFB和COX感染率下降，2023年CP、PIV和EBV感染率无明显差异。2023年1至6岁儿童MP阳性检出率显著高于2019年。RSV感染发病率于2023年8月开始上升，早于传统流行季节。
与疫情前水平相比，儿科住院患者中非典型病原体和病毒的总体检测阳性率显著增加，新冠疫情后疾病谱、流行季节和发病年龄出现了变化。
