Steinberg Ruth, Troxler Simone, Dac Léa Ho, Kentgens Anne-Christianne, Bovermann Xenia, Aebi Christoph, Frey Urs, Bittel Pascal, Agyeman Philipp, Latzin Philipp, Korten Insa
Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland.
BMJ Open Respir Res. 2025 Mar 26;12(1):e003044. doi: 10.1136/bmjresp-2024-003044.
Respiratory virus infections are a major cause of morbidity in early life. During the SARS-CoV-2 pandemic, non-pharmaceutical interventions (NPIs) lead to worldwide changes in respiratory virus epidemiology. However, evidence regarding virus circulation in the outpatient setting remains largely unknown. The aim of this study is to longitudinally assess respiratory viruses in healthy infants before and during the SARS-CoV-2 pandemic in Switzerland.
In this prospective observational birth cohort study, we followed 34 infants throughout the first year of life before and during the SARS-CoV-2 pandemic. We analysed 648 biweekly nasal swabs for nine different respiratory viruses by Multiplex-PCR and assessed respiratory symptoms, COVID-19 infections of family members and childcare status in weekly interviews. 712 nasal swabs from 32 infants analysed before the pandemic and published previously served as control group.
During the period with strict NPIs (pandemic I), most common respiratory viruses were not detected, with a rebound (driven by Adenovirus and Parainfluenza virus) after most NPIs were relaxed (pandemic II): prepandemic: 27%, pandemic I: 19%, pandemic II: 33%; historic: 36% of collected swabs per period, p<0.001. Human rhinovirus (HRV) prevalence persisted during NPIs presence, mainly in the form of asymptomatic HRV detection: prepandemic=24%, pandemic I=19%, pandemic II=25%, historic: 25%, p=0.3. SARS-CoV-2 detection (asymptomatic and symptomatic) was low, and only present after NPIs were relaxed: pandemic II=2.4%. No severe COVID-19 infections were reported.
In our cohort, infants did not contribute largely to spread of SARS-CoV-2. The role of persisting asymptomatic HRV prevalence is still unclear, but it might help to maintain population immunity to prevent more severe infections. Our results underscore the importance of capturing asymptomatic viruses via longitudinal community-based data assessment to better understand virus transmission.
呼吸道病毒感染是儿童早期发病的主要原因。在新冠疫情期间，非药物干预措施（NPIs）导致了全球呼吸道病毒流行病学的变化。然而，关于门诊环境中病毒传播的证据仍然知之甚少。本研究的目的是纵向评估瑞士新冠疫情之前和期间健康婴儿的呼吸道病毒情况。
在这项前瞻性观察性出生队列研究中，我们在新冠疫情之前和期间对34名婴儿进行了为期一年的跟踪。我们通过多重聚合酶链反应（Multiplex-PCR）对648份每两周采集一次的鼻拭子进行了9种不同呼吸道病毒的分析，并在每周的访谈中评估了呼吸道症状、家庭成员的新冠感染情况以及儿童保育状况。之前分析的32名婴儿在疫情前的712份鼻拭子作为对照组。
在严格实施非药物干预措施期间（疫情I期），未检测到最常见的呼吸道病毒，在大多数非药物干预措施放宽后（疫情II期）出现了反弹（由腺病毒和副流感病毒驱动）：疫情前：27%，疫情I期：19%，疫情II期：33%；历史数据：每个时期采集拭子的36%，p<0.001。人鼻病毒（HRV）的流行率在实施非药物干预措施期间持续存在，主要以无症状HRV检测的形式出现：疫情前=24%，疫情I期=19%，疫情II期=25%，历史数据：25%，p=0.3。新冠病毒检测（无症状和有症状）率较低，且仅在非药物干预措施放宽后出现：疫情II期=2.4%。未报告严重的新冠感染病例。
在我们的队列中，婴儿对新冠病毒的传播贡献不大。无症状HRV持续流行的作用仍不清楚，但它可能有助于维持群体免疫力以预防更严重的感染。我们的结果强调了通过基于社区的纵向数据评估来捕捉无症状病毒以更好地理解病毒传播的重要性。
