Heemskerk Susanne, Baliatsas Christos, Stelma Foekje, Nair Harish, Paget John, Spreeuwenberg Peter
Nivel - Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK.
Influenza Other Respir Viruses. 2025 Jan;19(1):e70066. doi: 10.1111/irv.70066.
During the COVID-19 pandemic, atypical respiratory syncytial virus (RSV) circulation patterns emerged, with the occurrence of RSV activity outside the typical winter season. This study investigates the impact of COVID-19 and associated non-pharmaceutical interventions (NPIs) on RSV seasonality.
The onset, offset and peak of RSV epidemics from 2018 to 2022 across 12 European countries were determined using the 3% positivity threshold method. A multilevel longitudinal logit regression model for proportions assessed the associations between five NPIs (school closures, mask use, workplace measures, public gathering restrictions and closure of public spaces) and RSV, utilising RSV surveillance data, two NPI databases (ECDC-JRC and Oxford) and COVID-19 surveillance data.
Before 2020, consistent RSV seasonality patterns were observed, but the seasonal increase of RSV-positive cases in winter remained absent during the COVID-19 pandemic (2020-2022). Analysis revealed inconsistent associations between individual NPIs and RSV. The associations differed depending on the data source used (ECDC-JRC or Oxford), not only in magnitude but also in the direction of the coefficients. Public gathering restrictions and closure of public spaces exhibited significant negative associations with RSV incidence. However, this was only observed when using surveillance data for the entire epidemiological year and not when only examining weeks with increased RSV activity.
This study highlights the need for standardised international data collection and procedures for infectious disease modelling, as varying NPI implementations, NPI registration and RSV surveillance across countries complicate the understanding of RSV dynamics during the pandemic. Caution is recommended when interpreting the effects of NPIs on RSV circulation.
在新冠疫情期间，非典型呼吸道合胞病毒（RSV）的传播模式出现变化，在典型冬季以外的季节也有RSV活动发生。本研究调查了新冠疫情及相关非药物干预措施（NPIs）对RSV季节性的影响。
采用3%阳性阈值法确定了2018年至2022年期间12个欧洲国家RSV疫情的开始、结束和高峰时间。利用RSV监测数据、两个NPI数据库（欧洲疾病预防控制中心-联合研究中心和牛津大学）以及新冠疫情监测数据，通过一个用于比例的多水平纵向逻辑回归模型评估了五项NPIs（学校关闭、口罩使用、工作场所措施、公共集会限制和公共场所关闭）与RSV之间的关联。
2020年之前，观察到了一致的RSV季节性模式，但在新冠疫情期间（2020 - 2022年），冬季RSV阳性病例的季节性增加并未出现。分析显示，个体NPIs与RSV之间的关联并不一致。这些关联因所使用的数据源（欧洲疾病预防控制中心-联合研究中心或牛津大学）而异，不仅在幅度上，而且在系数方向上都有所不同。公共集会限制和公共场所关闭与RSV发病率呈现出显著的负相关。然而，这仅在使用整个流行病学年度的监测数据时观察到，而在仅检查RSV活动增加的周数时未观察到。
本研究强调了传染病建模需要标准化的国际数据收集和程序，因为各国不同的NPIs实施情况、NPI登记以及RSV监测使得在疫情期间理解RSV动态变得复杂。在解释NPIs对RSV传播的影响时建议谨慎。
