Zhao Xinfeng, Zhu Xiaoxiao, Wang Jie, Ye Cuiying, Zhao Shiyong
Hangzhou Children's Hospital, Hangzhou, 310014, PR China.
Taizhou hospital of Zhejiang Province, Taizhou, 318000, PR China.
Virus Res. 2025 May;355:199558. doi: 10.1016/j.virusres.2025.199558. Epub 2025 Mar 13.
To investigate the infection of children with respiratory tract infection in Hangzhou from 2019 to 2023, and to explore the epidemiological characteristics of respiratory tract virus infection before and after the prevalence of novel coronavirus. A retrospective analysis was conducted on oral and pharyngeal swabs from 302,680 children with acute respiratory infections. Colloidal gold-based assays were used to detect viral antigens, including adenovirus (ADV), influenza A (FluA), influenza B (FluB), and respiratory syncytial virus (RSV). The detection rates of different viruses were statistically analyzed, and comparisons were made regarding infection status before and after the COVID-19 pandemic, mixed infections, seasonal variations, and different age groups. Among the 302,680 samples, 65,493 tested positive for respiratory pathogens, resulting in a positive rate of 21.64 %. The highest positive rate was found for FluA single infections (12.77 %), while mixed infections were primarily observed with ADV combined with other respiratory viruses. There was a significant statistical difference in the overall detection rate of respiratory viruses before (2019), during (2020-2022), and after (2023) the COVID-19 pandemic (χ²=18,074.97, P < 0.001). The positivity rates for FluA (χ²=31,866.75, P < 0.001), FluB (χ²=255.407, P < 0.001), RSV (χ²=338.76, P < 0.001), and ADV (χ²=4110.093, P < 0.001) also showed significant differences before, during, and after the pandemic. The epidemic seasons for FluA and FluB were winter and spring, while ADV did not exhibit a distinct seasonal pattern, and RSV had a peak incidence in winter. The highest positivity rate for ADV was observed in children aged 2-5 years (4.33 %), for FluA in the 5-15-year-old group (17.15 %), for FluB in those over 15 years (4.86 %), and for RSV in children aged 0-2 years (4.37 %). There were significant differences in virus infection positive rates across different age groups (χ²=2615.084, P < 0.001). Additionally, the overall positive rate differed significantly by gender (χ²=87.317, P < 0.001).The four common respiratory pathogens exhibit distinct epidemiological features in terms of age and seasonality. The COVID-19 pandemic has altered the epidemiology of respiratory viruses, particularly in terms of the peak seasons of infection. Clinically, attention should be given to the potential for co-infection with multiple pathogens.
为调查2019年至2023年杭州地区儿童呼吸道感染情况，探索新型冠状病毒流行前后呼吸道病毒感染的流行病学特征。对302680例急性呼吸道感染儿童的口咽拭子进行回顾性分析。采用胶体金法检测病毒抗原，包括腺病毒（ADV）、甲型流感病毒（FluA）、乙型流感病毒（FluB）和呼吸道合胞病毒（RSV）。对不同病毒的检出率进行统计学分析，并比较新冠疫情前后的感染状况、混合感染情况、季节变化及不同年龄组的情况。在302680份样本中，65493份呼吸道病原体检测呈阳性，阳性率为21.64%。甲型流感病毒单一感染的阳性率最高（12.77%），混合感染主要为腺病毒与其他呼吸道病毒合并感染。新冠疫情前（2019年）、疫情期间（2020 - 2022年）和疫情后（2023年）呼吸道病毒的总体检出率存在显著统计学差异（χ² = 18074.97，P < 0.001）。甲型流感病毒（χ² = 31866.75，P < 0.001）、乙型流感病毒（χ² = 255.407，P < 0.001）、呼吸道合胞病毒（χ² = 338.76，P < 0.001）和腺病毒（χ² = 4110.093，P < 0.001）的阳性率在疫情前、期间和之后也显示出显著差异。甲型流感病毒和乙型流感病毒的流行季节为冬季和春季，而腺病毒没有明显的季节性模式，呼吸道合胞病毒在冬季发病率最高。腺病毒阳性率最高的是2至5岁儿童（4.33%），甲型流感病毒是5至15岁组（17.15%），乙型流感病毒是15岁以上人群（4.86%），呼吸道合胞病毒是0至2岁儿童（4.37%）。不同年龄组的病毒感染阳性率存在显著差异（χ² = 2615.084，P < 0.001）。此外，总体阳性率在性别上也有显著差异（χ² = 87.317，P < 0.001）。这四种常见的呼吸道病原体在年龄和季节性方面表现出不同的流行病学特征。新冠疫情改变了呼吸道病毒的流行病学，特别是在感染高峰季节方面。临床上，应关注多重病原体合并感染的可能性。
