Clinical impact of pandemic related changes on the epidemiology of respiratory tract infections

Introduction Following lockdown periods and restricting public health measures, an increase of respiratory infections was observed worldwide. Consequently, several reports highlighted an increased burden on children's hospitals compromising medical care of acutely and chronically ill children. This study aimed to characterize changes in the epidemiological pattern of circulating viral infections.

Methods We assessed the number of patients with respiratory infections and the annual distribution of virus detections between 2019 and 2022 based on 4809 clinical samples of 4131 patients in a German pediatric tertiary care center. We then investigated the impact of lockdown periods on spectra of circulating viruses, pattern of coinfections, age and seasonality of these infections in children.

Results A fourfold increase in the total number of respiratory virus detections was observed in 2022 vs 2019 with a doubling comparing 2021 to 2022. In contrast to previous years, constant high rates of Rhinovirus infections with no typical seasonal pattern were observed all over 2022 while other viruses showed fewer changes in terms of seasonality. SARS-CoV-2, parainfluenza- and human metapneumovirus detections increased significantly in 2022 (2019 vs 2022 p<0,01). Coinfections with multiple viruses occurred significantly more often since 2021 as compared to prepandemic years, especially in very young children (2019 vs 2022 p<0,01).

Conclusion Compared to pre-pandemic years, we demonstrate a dramatic increase in pediatric respiratory tract infections with an incrementing spectrum of viruses and an outstanding gain in Rhinovirus infections leading to a high rate of hospital admissions, particularly in conjunction with other viruses. This is acutely causing a shortage of medical care and increases the risk of chronic respiratory diseases such as asthma, thus leading to a long-lasting burden on the health system.

Publication History

Article published online:
09 March 2023