Hosseinpour Sadeghi Reihaneh, Pourakbari Babak, Mahmoudi Shima, Ahmadi Reza, Jafari Erfaneh, Sajedi Moghaddam Sadaf, Sotoudeh Anvari Maryam, Khodabandeh Mahmoud, Mamishi Setareh
Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Biotechnology Centre, Silesian University of Technology, Gliwice, Poland.
BMC Infect Dis. 2025 Jul 11;25(1):910. doi: 10.1186/s12879-025-11293-8.
The COVID-19 pandemic has profoundly altered the epidemiology of viral respiratory infections; however, other respiratory viruses besides SARS-CoV-2 continue to cause illness in hospitalized children. This study aimed to assess the frequency of common respiratory viruses, other than SARS-CoV-2, in children hospitalized with respiratory symptoms during the COVID-19 pandemic, and to examine rates of co-infection with multiple viruses.
This study included 92 pediatric patients admitted to the Children's Medical Center in Tehran, Iran, between December 2021 and March 2022, all of whom tested negative for SARS-CoV-2 by Real-time PCR. Nasal swabs were collected and PCR/RT-PCR tests were used to identify other respiratory viruses, including Influenza A (FluA), Influenza B (FluB), Respiratory Syncytial Virus (RSV), Parainfluenza Virus (PIV), Human Cytomegalovirus (CMV), Adenovirus (ADV), Human Coronavirus OC43 (HCOV-OC43), and Metapneumovirus (MPV). Clinical information, including symptoms, laboratory results, and patient outcomes, was also gathered and analyzed.
Among the 92 patients, 67.3% (n = 62) tested positive for at least one of the targeted respiratory viruses. FluB was the most prevalent, detected in 60.9% (n = 56) of cases, followed by CMV in 12% (n = 11), and HCOV-OC43 in 5.4% (n = 5). RSV and ADV were each identified in 2 patients (2.2%), while PIV was found in 3 patients (3.2%), including two cases of PIV-1 and one case of PIV-3. No cases of FluA or MPV were detected. Co-infections occurred in 13 patients (14.1%), with FluB exhibiting the highest rate of co-infection, particularly alongside CMV in 7 cases, followed by PIV (3 cases), ADV (2 cases), and HCOV-OC43 (2 cases). Laboratory comparisons among patients with single-virus infections (FluB, CMV, and HCOV-OC43), those with no detected virus, and those with co-infections revealed a statistically significant difference in lymphocyte counts (p-value = 0.027).
While the focus during the pandemic has largely been on SARS-CoV-2, other respiratory viruses, particularly Influenza B, continue to affect hospitalized children. The frequent occurrence of co-infections with multiple viruses underscores the need for comprehensive diagnostic testing to accurately identify respiratory pathogens in pediatric patients. These results highlight the importance of sustained monitoring and management of diverse respiratory viruses beyond SARS-CoV-2, given their continued clinical relevance.
新冠疫情深刻改变了病毒性呼吸道感染的流行病学；然而，除严重急性呼吸综合征冠状病毒2（SARS-CoV-2）外，其他呼吸道病毒仍在导致住院儿童患病。本研究旨在评估新冠疫情期间因呼吸道症状住院的儿童中，除SARS-CoV-2外常见呼吸道病毒的感染频率，并检测多种病毒合并感染的发生率。
本研究纳入了2021年12月至2022年3月期间入住伊朗德黑兰儿童医学中心的92例儿科患者，所有患者经实时聚合酶链反应（PCR）检测SARS-CoV-2均为阴性。采集鼻拭子，采用PCR/逆转录PCR（RT-PCR）检测来鉴定其他呼吸道病毒，包括甲型流感病毒（FluA）、乙型流感病毒（FluB）、呼吸道合胞病毒（RSV）、副流感病毒（PIV）、人巨细胞病毒（CMV）、腺病毒（ADV）、人冠状病毒OC43（HCOV-OC43）和偏肺病毒（MPV）。还收集并分析了包括症状、实验室检查结果及患者转归等临床信息。
92例患者中，67.3%（n = 62）至少检测出一种目标呼吸道病毒呈阳性。FluB最为常见，60.9%（n = 56）的病例检测到该病毒，其次是CMV，占12%（n = 11），HCOV-OC43占5.4%（n = 5）。RSV和ADV各在2例患者（2.2%）中检出，PIV在3例患者（3.2%）中发现，包括2例1型副流感病毒和1例3型副流感病毒。未检测到FluA或MPV病例。13例患者（14.1%）发生合并感染，FluB的合并感染率最高，尤其是与CMV合并感染7例，其次是PIV（3例）、ADV（2例）和HCOV-OC43（2例）。对单病毒感染（FluB、CMV和HCOV-OC43）患者、未检测到病毒的患者以及合并感染患者进行实验室比较，发现淋巴细胞计数存在统计学显著差异（p值 = 0.027）。
虽然疫情期间主要关注的是SARS-CoV-2，但其他呼吸道病毒，尤其是乙型流感病毒，仍在影响住院儿童。多种病毒合并感染的频繁发生凸显了进行全面诊断检测以准确识别儿科患者呼吸道病原体的必要性。这些结果强调了持续监测和管理除SARS-CoV-2外各种呼吸道病毒的重要性，因为它们仍具有临床相关性。
