Impact of COVID-19 Nonpharmaceutical Interventions on , Human Respiratory Syncytial Virus, Influenza Virus, and Seasonal Coronavirus Antibody Levels: A Systematic Review.

During the COVID-19 pandemic, nonpharmaceutical interventions (NPIs) were introduced to reduce the spread of SARS-CoV-2. This also resulted in a reduction of notifications of other acute respiratory infections and an altered seasonality when NPIs were lifted. Without circulation of pathogens, waning of antibodies is expected, which is a first indicator of decreased immunity. Here, by performing a systematic literature review, we investigated whether reduced antibody levels due to waning immunity contributed to the altered seasonality after NPIs were lifted. Thirteen articles met the inclusion criteria and reported antibody levels or seroprevalence of human respiratory syncytial virus, seasonal human coronavirus, , and influenza virus. We show that the COVID-19 pandemic most likely led to waning of pathogen-specific antibodies, with the strongest evidence for human respiratory syncytial virus and seasonal human coronavirus and with a larger decrease in children vs adults. Waning antibodies might have resulted in out-of-season activity for these pathogens.