De Arcos-Jiménez Judith Carolina, Martinez-Ayala Pedro, Quintero-Salgado Ernestina, Lopez-Romo Rosendo, Briseno-Ramirez Jaime
Laboratory of Microbiological, Molecular, and Biochemical Diagnostics (LaDiMMB), CUTlajomulco, University of Guadalajara, Tlajomulco de Zuñiga, Jalisco, Mexico.
State Public Health Laboratory, Guadalajara, Mexico.
Front Public Health. 2025 Mar 28;13:1494463. doi: 10.3389/fpubh.2025.1494463. eCollection 2025.
The COVID-19 pandemic significantly disrupted the epidemiology of respiratory viruses, altering seasonal patterns and reducing circulation. While recovery trends have been observed, factors associated with severe acute respiratory infections (SARIs) during pre- and post-pandemic periods remain underexplored in middle-income countries.
This study aimed to analyze the trends in respiratory virus circulation and identify factors associated with SARI in patients attending a tertiary care university hospital in western Mexico over a six-year period spanning the pre-pandemic, pandemic, and post-pandemic phases.
A retrospective study was conducted using data from 19,088 symptomatic patients tested for respiratory viruses between 2018 and 2024. Viral trends were analyzed through interrupted time series (ITS) modeling, incorporating locally estimated scatterplot smoothing (LOESS) and raw positivity rates. Additionally, ITS analysis was performed to evaluate temporal changes in SARI proportions across different phases of the pandemic. Multivariate logistic regression models were applied to determine independent risk factors for SARI across different time periods.
During the pandemic (2020-2021), respiratory virus positivity rates significantly declined, particularly for influenza, which experienced a sharp reduction but rebounded post-2022. Respiratory syncytial virus (RSV) demonstrated a delayed resurgence, whereas other respiratory viruses exhibited heterogeneous rebound patterns. ITS modeling of SARI proportions revealed a significant pre-pandemic increasing trend, followed by a slower rise during the pandemic, and a sharp post-pandemic drop in early 2022, before resuming an upward trajectory. Among older adults (>65 years), a marked increase in SARI was observed at the beginning of the pandemic, while younger groups showed more stable patterns. Logistic regression identified advanced age, male sex, cardiovascular disease, obesity, and immunosuppression as major risk factors for SARI, while vaccination consistently showed a protective effect across all periods and subgroups.
The COVID-19 pandemic induced persistent shifts in respiratory virus circulation, disrupting seasonal dynamics and modifying the burden of SARI. The findings underscore the importance of continuous surveillance, targeted vaccination programs, and early diagnostics to mitigate severe outcomes. These results highlight the need for adaptive public health strategies in middle-income countries to address evolving respiratory disease threats.
新冠疫情严重扰乱了呼吸道病毒的流行病学，改变了季节性模式并减少了病毒传播。虽然已观察到恢复趋势，但在中等收入国家，大流行前和大流行后时期与严重急性呼吸道感染（SARI）相关的因素仍未得到充分研究。
本研究旨在分析呼吸道病毒传播趋势，并确定在墨西哥西部一所三级护理大学医院就诊的患者在大流行前、大流行和大流行后六个阶段中与SARI相关的因素。
进行了一项回顾性研究，使用了2018年至2024年间19088例接受呼吸道病毒检测的有症状患者的数据。通过中断时间序列（ITS）建模分析病毒趋势，纳入局部加权散点平滑法（LOESS）和原始阳性率。此外，进行ITS分析以评估大流行不同阶段SARI比例的时间变化。应用多变量逻辑回归模型确定不同时间段SARI的独立危险因素。
在大流行期间（2020 - 2021年），呼吸道病毒阳性率显著下降，尤其是流感病毒，其经历了急剧下降但在2022年后反弹。呼吸道合胞病毒（RSV）显示出延迟复苏，而其他呼吸道病毒表现出异质性反弹模式。SARI比例的ITS建模显示，大流行前有显著上升趋势，大流行期间上升较慢，2022年初大流行后急剧下降，随后恢复上升轨迹。在老年人（>65岁）中，在大流行开始时观察到SARI显著增加，而年轻群体表现出更稳定的模式。逻辑回归确定高龄、男性、心血管疾病、肥胖和免疫抑制是SARI的主要危险因素，而疫苗接种在所有时期和亚组中始终显示出保护作用。
新冠疫情导致呼吸道病毒传播持续变化，扰乱了季节性动态并改变了SARI的负担。研究结果强调了持续监测、有针对性的疫苗接种计划和早期诊断对减轻严重后果的重要性。这些结果凸显了中等收入国家需要采取适应性公共卫生策略来应对不断演变的呼吸道疾病威胁。
