Acute Respiratory Infection Patients Research Articles

Exploring the effect of clinical case definitions on influenza vaccine effectiveness estimation at primary care level: Results from the end-of-season 2022–23 VEBIS multicentre study in Europe

BackgroundWithin influenza vaccine effectiveness (VE) studies at primary care level with a laboratory-confirmed outcome, clinical case definitions for recruitment of patients can vary. We used the 2022–23 VEBIS primary care European multicentre study end-of-season data to evaluate whether the clinical case definition affected IVE estimates. MethodsWe estimated VE using a multicentre test-negative case-control design. We measured VE against any influenza and influenza (sub)types, by age group (0–14, 15–64, ≥65 years) and by influenza vaccine target group, using logistic regression. We estimated IVE among patients meeting the European Union (EU) acute respiratory infection (ARI) case definition and among those meeting the EU influenza-like illness (ILI) case definition, including only sites providing information on specific symptoms and recruiting patients using an ARI case definition (as the EU ILI case definition is a subset of the EU ARI one). ResultsWe included 24 319 patients meeting the EU ARI case definition, of whom 21 804 patients (90 %) meet the EU ILI case definition, for the overall pooled VE analysis against any influenza. The overall and influenza (sub)type-specific VE varied by ≤2 % between EU ILI and EU ARI populations. DiscussionAmong all analyses, we found similar VE estimates between the EU ILI and EU ARI populations, with few (10%) additional non-ILI ARI patients recruited. These results indicate that VE in the 2022–23 influenza season was not affected by use of a different clinical case definition for recruitment, although we recommend investigating whether this holds true for next seasons.

Prevalence of Respiratory Viruses in Children With Acute Respiratory Infections in Shanghai, China, From 2013 to 2022.

A variety of viruses can cause acute respiratory infections (ARIs), resulting in a high disease burden worldwide. To explore the dominant viruses and their prevalence characteristics in children with ARIs, comprehensive surveillance was carried out in the Pudong New Area of Shanghai. Between January 2013 and December 2022, the basic and clinical information, and respiratory tract specimens of 0-14 years old children with ARIs were collected in five sentinel hospitals in Shanghai Pudong. Each specimen was tested for eight respiratory viruses, and the positive rates of different age groups, case types (inpatient or outpatient) were analyzed. In our study, 30.67% (1294/4219) children with ARIs were positive for at least one virus. Influenza virus (IFV) was the most commonly detected respiratory virus (349/4219, 8.27%), followed by respiratory syncytial virus (RSV) (217/4219, 5.14%), para-influenza virus (PIV) (215/4219, 5.10%), and human coronavirus (HCoV, including 229E, OC43, NL63, and HKU1) (184/4219, 4.36%). IFV was the leading respiratory virus in outpatients aged 5-14 years (201/1673, 12.01%); RSV was the most prevalent respiratory virus in both inpatients (61/238, 25.63%) and outpatients (4/50, 8.00%) for ARI patients aged <6 months old. For PIV, HMPV, HCoV, and HRV, the risk of infection usually was higher among young children. Co-infection with more than two viruses was seen in 3.25% (137/4219). IFV and RSV played important roles in ARIs among children, but the risk populations were different. There are needs for targeted diagnosis and treatment and necessary immunization and non-pharmaceutical interventions.

Post-pandemic trends: Epidemiological and etiological insights into acute respiratory infections in southern China

Data on people suspected with acute respiratory infections (ARIs) from August 2022 to December 2023 in southern China were analyzed. Following the COVID-19 pandemic, the positive detection rates of respiratory pathogens increased to 56.9%. Influenza A virus (IAV) emerged as the predominant prevalence pathogen (52.1%), followed by Mycoplasma pneumoniae (Mp: 21.2%), and SARS-CoV-2 (11.6%). Mp, IAV, and Human rhinovirus (HRV) infection were the primary etiologies of ARIs patients under age 18, accounting for 49.4%, 48.6%, and 21.7%, respectively. Mp, HRV, Respiratory syncytial virus (RSV), and Adenovirus (ADV) contributed to ARIs cases in virtually every month in this group, with Mp being particularly notable for its consistent presence and high co-infection rate (31.0%). IAV was predominant in the 19 to 59 age group (88.6%), SARS-CoV-2 was responsible for most of ARIs in the elderly group (82.5%). This study provides valuable insights into the dynamic nature of respiratory pathogens post COVID-19 era.

Pattern of Antibiotic Use Among Children With Acute Respiratory Infections in Saudi Arabia: Clinical Assessment.

This study aimed to evaluate the common clinical diagnoses and treatment management of acute respiratory infections (ARIs) in children and determine when antibiotics are recommended and prescribed. A retrospective review of medical charts was carried out at King Salman Bin Abdulaziz Medical City (KSAMC) Hospital to assess pediatric patients diagnosed with ARIs aged 0-14 years, excluding those requiring antibiotics for conditions other than ARIs. Data, including demographic diagnoses and treatment management, were extracted using consecutive sampling, and statistical analyses were conducted using Jamovi software. A total of 285 pediatric patients were included, with a median age of 3 (IQR = 1-6) years and a male predominance of 59.2%. Bronchopneumonia was the most common respiratory disease, diagnosed in 39.1% of participants. The median durations for illness and hospital admission were four and three days, respectively. Clinical evaluations showed an average respiratory rate of 28±10.5 breaths per minute and a mean oxygen saturation of 96.4±3.46% through pulse oximetry. The use of antibiotics was commonly prescribed in ARI patients only when accompanied by certain bacterial infections (46.32%). ARIs are a common viral health issue among children, emphasizing that not all ARIs in children are caused by bacteria and that antibiotics should only be used when there is a bacterial infection present. Enhanced diagnostic precision, patient awareness, and provider education are the global community's recommendations to prevent the presence of antibiotic resistance and the irrational use of antibiotics.

Acute Effect of Particulate Matter 2.5 (PM2.5) on Acute Upper Respiratory Tract Infection in Chiang Mai, Thailand

Background: Air pollution, especially PM2.5, is one of the most concerning problems around the world, leading to health problems. There are few studies on acute upper respiratory tract infection (URTI), especially in adults. Objective: To investigate the association between PM2.5 and acute URTI. Materials and Methods: Retrospective data analyses of patients between 2017 and 2019 who visited the outpatient department in Maharaj Nakorn Chiang Mai Hospital with acute URTI was performed. The authors also collected the daily data of PM2.5, PM10, O₃, NO₂, temperature, and humidity from the center of Chiang Mai Province. The Pearson correlation method was used to identify correlations between acute URTI and those variables. Results: The data of 104,711 patients with acute URTI were collected. Acute nasopharyngitis, acute pharyngitis, and acute tonsillitis were the three most common diseases. The highest level of PM2.5 each year was in January to February. The results were also the same for PM10, O₃, and NO₂. The present study revealed that PM2.5 had a significant correlation with number of acute respiratory infection patients, r=0.17 (p&lt;0.001), which meant higher level of PM2.5 was associated with higher number of patients. The results were also the same for PM10, O₃, and NO₂. For temperature and humidity, the results were the opposite correlations, which meant the higher the temperature and humidity, the fewer patients were observed that day. The present study also found the regression question, which was every 1 point higher of PM2.5, there would be 19% more patients that day. Conclusion: There was a relationship between pollution, especially PM2.5 and acute URTI. The higher level of PM2.5 is related to an increased number of URTI patients. It is the same results for PM10, O₃, and NO₂. Keywords: Fine particulate matter; PM2.5; Acute upper respiratory tract infections

Impact of the COVID-19 pandemic on the prevalence of respiratory viral pathogens in patients with acute respiratory infection in Shanghai, China.

This study aimed to evaluate the impact of nonpharmaceutical interventions (NPIs) taken to combat COVID-19 on the prevalence of respiratory viruses (RVs) of acute respiratory infections (ARIs) in Shanghai. Samples from ARI patients were collected and screened for 17 respiratory viral pathogens using TagMan low density microfluidic chip technology in Shanghai from January 2019 to December 2020. Pathogen data were analyzed to assess changes in acute respiratory infections between 2019 and 2020. A total of 2,744 patients were enrolled, including 1,710 and 1,034 in 2019 and 2020, respectively. The total detection rate of RVs decreased by 149.74% in 2020. However, detection rates for human respiratory syncytial virus B (RSVB), human coronavirus 229E (HCoV229E), human coronavirus NL63 (HCoVNL63), and human parainfluenza virus 3 (HPIV3) increased by 91.89, 58.33, 44.68 and 24.29%, in 2020. The increased positive rates of RSVB, HPIV3, resulted in more outpatients in 2020 than in 2019. IFV detection rates declined dramatically across gender, age groups, and seasons in 2020. NPIs taken to eliminate COVID-19 had an impact on the prevalence of respiratory viral pathogens, especially the IFVs in the early phases of the pandemic. Partial respiratory viruses resurged with the lifting of NPIs, leading to an increase in ARIs infection.

Epidemic profile of common respiratory viruses in association SARS CoV-2 among SARI and ARI-two year study.

COVID-19/SARS CoV-2 continue to pose a threat to human health and placed millions of livelihoods at risk. Surveillance for the other circulating seasonal viruses during this pandemic is necessary to understand the manifestations of the CoV-2 pandemic and their incidence. A detailed study survey was performed on subjects with acute respiratory infections (ARI) and severe acute respiratory infection (SARI) in the King Institute of Preventive Medicine and Research, Chennai from April 2020 to March 2022. A total of 1480 patients presenting with either SARI (41.8%) or ARI (58.1%) were screened for SARS CoV-2 and other respiratory viruses. The SARS CoV-2 real-time PCR was carried out using ICMR-approved kits and other respiratory viruses were detected using the commercially available real-time kit. Out of the 620 SARI patients, 198 (31.9%) were positive for SARS CoV-2 RNA. Out of the 860 ARI patients, 352 (40.9%) were positive for SARS CoV-2 RNA. Among the 550 patients positive for SARS CoV-2, 7 (1.2%) were positive coexistent with other respiratory viruses. Among the 930 patients with negative SARS CoV-2, 222 (23.8%) were positive for other common respiratory viruses (p = 0.001). Influenza viruses (36.9%) predominated followed by RSV (31.9%) and Parainfluenza virus (13.5%). This study suggests that viral coinfections are significantly higher among SARS CoV-2 negative individuals (23.8 vs. 1.2%). It is possibly due to viral interference and the competitive advantage of SARS CoV-2 in modulating the host immunity. Continuous surveillance is necessary for understanding the viral co-infection mechanisms.

Profil Penggunaan Obat Antibiotik pada Penderita Infeksi Saluran Pernapasan Akut (ISPA) di Puskesmas Kabupaten Gorontalo

Acute respiratory infection (ARI) is a disease with a high prevalence. Most ARIs that occur are caused by viruses and do not require antibiotics. This study aims to determine whether or not Acute Respiratory Infection (ARI) patients at Gorontalo Regency Health Center treated with antibiotic and to determine the appropriate drugs, appropriate indication, appropriate patients, and appropriate dose in Acute Respiratory Infection (ARI) patients. This study is conducted retrospectively by taking data from the medical records of 300 ARI patients. Patient characteristics by sex are: male patients are 49% and females 51%. Most patients with ARI occurred at the age of 0-5 years are 155 cases (51.7%), 6-10 years are 47 cases (15.7%), 21-25 years are 39 cases (13%), 16-20 years are 31 cases (10.3%), and 11-15 years are 28 cases (9.3%). The research findings discover that the use of antibiotic drug in ARI patients comprises Amoxicillin for 51 cases (17%), Amoxicillin syrup for 13 cases (4,3%), Amoxicillin powder for 46 cases (15,3%), Cotrimoxazole for 2 cases (0,6%), Cefadroxil for 2 cases (0,6%), and Ciprofloxacin for 1 case (0,5%). In the meantime, those who are not treated with antibiotic drug are 185 cases (61,7%). Additionally, the use of drugs includes appropriate drugs for 86,7%, appropriate indications for 62,3%, appropriate doses for 72,3%, and appropriate patients for 100% which have been in accordance with clinical practice manual book in the primary health facility.

Analysis of respiratory virus detection in hospitalized children with acute respiratory infection during the COVID-19 pandemic

ObjectiveIt is now understood that the Coronavirus disease 2019 (COVID-19) pandemic and its associated containment measures have influenced the epidemiology of other respiratory viruses. This study aimed to characterize respiratory virus infections in pediatric patients hospitalized for acute respiratory infections (ARIs) in East China both prior to and during the COVID-19 pandemic.MethodsWe collected nasal secretions from 9782 pediatric ARI patients admitted to Shaoxing Maternal and Child Health Care Hospital between January 2018 and December 2022. We analyzed and compared changes in viral detection rates, epidemiological features, and clinical characteristics.ResultsA total of 1633 strains from 7 common respiratory viruses were identified, with an overall positive rate of 16.35% (n = 821/5021) in 2018–2019 and 17.06% (n = 812/4761) in 2020–2022. Compared to 2018–2019, the positive rate for RSV significantly increased in 2020–2022, while detection rates for ADV, PIV-2, PIV-3, and flu-B showed reductions (P < 0.05). The RSV-positive rate experienced a more significant increase in winter compared to other seasons both before and during COVID-19 (P < 0.05), whereas PIV-3 predominantly circulated in spring and summer before COVID-19.ConclusionDuring the COVID-19 pandemic, marked variations in age distribution and seasonality of respiratory virus infections were observed among hospitalized children with ARIs in East China. Non-pharmaceutical interventions (NPIs) implemented during the pandemic yielded a limited impact on common respiratory viruses.

EVALUATION OF THE USE OF THE DRUG IN PATIENTS ACUTE RESPIRATORY TRACT INFECTION (ARI) NON PNEUMONIA AT PUSKESMAS SIGUMPAR

Acute Respiratory Infection (ARI) is one of the main causes of patient visits to health centers (40%-60%) and hospitals (15%-30%). In Indonesia the level of use of antibiotics is still quite high. The unwise use of antibiotics and the incorrect application of standard precautions in health care facilities an lead to the occurrence of resistane. This study aims to determine the evaluation of drug use in non-pneumonia Aucute Respiratory Infection (ARI) patients at the Sigumpar Health Center. This Type of research is an observational study with a descriptive design and data taken retrospectively. The total sample of 101 medical records was taken by purposive sampling technique. The patients who often suffer from non-pneumonia acute respiratory infections at the Sigumpar Health Center occur in the age group of 6-11 years, namely children by 20,79%. Based on the results of this study, the most widely used drugs were analgesic-antipyretic (69.30%), antihistamine (65.34%), vitamins (62.37%), mucolytics (48.51%), expectorants (32.67%), antibiotics (27.72%) and corticosteroids (23.76%). The use antibiotics for non-pneumonia ARI patients at the Sigumpar Health Center was 27,72% so that it was categorized as not in accordance with the provisions of the Inonesian Ministry of Health in 2017 that the use of antibiotics in non-pneumonia ARI patients was ? 20%.

Molecular epidemiology of circulating human adenoviruses among acute respiratory infection patients seeking healthcare facilities in West Bengal, India

Human adenovirus (HAdV) causes acute respiratory infections leading to mortality in children. This study analyzes the circulating respiratory HAdV genotypes in West Bengal, India during 2018-2022 among symptomatic patients. The overall positivity rate was 6.8%, out of which 26.4% were co-infected with other respiratory viruses. Children aged 2 to 5 years were mostly infected. Phylogenetic analysis revealed that the recombinant HAdV-B type 7/3, which has remarkable outbreak potential, predominantly circulated in this region followed by the non-recombinant HAdV-B type 3/3. Moreover, the amino acid sequences encoded by both the hexon and fiber genes of these two circulating strains possessed a few mutations that mostly diverged from the prototype strain, although the divergence was less pronounced in case of the amino acids encoded by the fiber gene of HAdV-B type 3/3. Overall, the results underscore the need for continuous surveillance of respiratory HAdV types to combat future possible epidemics.

Analysis of the common respiratory viruses in children with acute respiratory infection in a hospital in Lanzhou City from 2021 to 2022

To explore the situation of 8 common respiratory pathogens in children with acute respiratory infection (ARI) from 2021 to 2022.The retrospective study selected 8 710 ARI patients from September 2021 to August 2022 in the Maternal and Child Health Hospital of Gansu Province as the study object, patients aged 0 to 17 years old, including 5 048 male children and 3 662 female children. Indirect immunofluorescence was used to detect 8 common respiratory pathogens, including influenza virus A (FluA), influenza virus B (FluB), parainfluenza virus (PIV), respiratory syncytial virus (RSV), adenovirus (ADV), Mycoplasma pneumoniae (MP), Chlamydia pneumoniae (CP), and Coxsackie virus group B (CoxB) IgM antibodies. χ2 test was used to analyze the results. The results showed that 1 497 of 8 710 children with ARI were positive, with a positive rate of 17.19%. The detection rate of MP among 8 common respiratory pathogens was 11.34%, accounting for 66.0%, followed by FluB, CoxB, PIV, RSV, ADV, FluA and CP, accounting for 13.83%, 9.55%, 6.01%, 2.61%, 1.47%, 0.40% and 0.13%, respectively. Respiratory tract viruses (FluA, FluB, RSV, ADV, PIV, CoxB) accounted for 33.86%.There were significant differences in the detection rates of PIV, ADV and MP among children of different genders (χ2=6.814, 5.154 and 17.784, P<0.05). The detection rate of school-age children (6-17 years old) was the highest, accounting for 33.27% (184/553). The detection rates of 8 common respiratory pathogens in patients with ARI were higher in spring and winter and lower in summer and autumn. To sum up, from 2021 to 2022, MP and FluB infection were dominant in ARI patients in our hospital. The peak period of 8 common respiratory pathogens was in spring and winter. The physical examination rate of 8 common respiratory pathogens in ARI patients aged 6-17 years old was the highest.

Effect of Effective Cough on Sputum Expulsion in Patients with ARI (Acute Respiratory Infection)

ISPA or ARI (Acute Respiratory Infection) is an acute respiratory illness that lasts about 14 days and usually affects the throat, nose and lungs. A frequent problem in patients with acute respiratory infections is the inability to clear secretions from the airways which can lead to ineffective airway clearance. One of the non-pharmacological management of ARI can be done with effective cough training. The purpose of this study was to determine the effect of effective cough on sputum discharge in patients with ARI at Sumber Kasih General Hospital, Cirebon City in 2022.&#x0D; This research design uses pre experiment with one group pre test-post test design. The research subjects were 90 ARI patients at Sumber Kasih General Hospital, Cirebon City with the sampling technique used was accidental sampling. The research instrument was a sputum discharge observation sheet. &#x0D; The results of the study obtained data from the pretest results showed that sputum discharge in patients with ARI before effective cough training was carried out in the outgoing category, namely 54 people (60%). While the results of the posttest showed that sputum discharge in patients with ARI after effective coughing exercises with the outgoing category was 81 people (90%). Based on the results of the Wilcoxon test, the significance value (sig.2-tailed) &lt;0.05 (p=0.000), then based on the decision-making criteria, Ha is accepted, meaning that effective cough training can increase sputum discharge in patients with ARI at Sumber Kasih General Hospital, Cirebon City.&#x0D; It is hoped that nurses can provide education about effective cough training to increase sputum discharge in patients with ARI, so that patients with ARI are able to practice it at home

Rationality of the Antibiotics Use in Pediatric Acute Respiratory Infection Patients at Ssma Hospital in Pontianak, Indonesia

Acute respiratory tract infections (ARI) in children have a high prevalence that can be caused by bacteria or viruses. Antibiotics are prescribed more often than recommendations in the guidelines. This study aims to evaluate the rationality of antibiotic use and the occurrence of drug interactions in pediatric patients diagnosed with ARI at one of the hospitals in Pontianak based on some parameters such as right drug, right dose, and right duration as well as the incidence of drug interactions. Data collection was carried out based on medical record data which was carried out with a total sampling technique, namely taking all data that met the inclusion criteria.This research is a descriptive cross sectional design and retrospective data collection using patient medical records. Samples were taken by total sampling method. The results obtained from 131 patients consisting of 172 visits, right drug (131), right dose (93), and right duration (77).

Rationality of the Antibiotics Use in Pediatric Acute Respiratory Infection Patients at Ssma Hospital in Pontianak, Indonesia

Rationality of the Antibiotics Use in Pediatric Acute Respiratory Infection Patients at Ssma Hospital in Pontianak, Indonesia

Identification of Acute Respiratory Infection Patients Using RP2 Nested Multiplex PCR Test in Jakarta, Indonesia

Acute Respiratory Infection (ARI) is an acute respiratory disease caused by infectious organisms transmitted between humans. Viruses and bacteria generally cause the cause of ARI infection. Other viruses that can also cause ARI are Influenza, Adenovirus, Enterovirus, and Respiratory Syncytial Virus. This study aims to determine the causes of bacterial or viral ARI infection with RP2 Nested Multiplex RT-PCR. The research methodology is cross-sectional. The sample used was 50 people with purposive sampling technique in patients with ARI who examined bacteria and viruses using RP2 Nested Multiplex RT-PCR. The research was located at the Laboratory of the United States Embassy in Jakarta, Indonesia. The results showed that 26 (52%) men suffered more from ARI patients than 24 women (46%), with the most age group being children, 28 people (56%). The three symptoms that many patients in this study felt were that 40 patients (80%) experienced nasal congestion, 38 patients (76%) experienced fever, and 32 patients (64%) coughed. The results of the organisms in the RP2 nested multiplex RT-PCR examination showed that 100% of the causes of ARI were viruses with the highest prevalence (40%) originating from the Human Rhinovirus/Enterovirus. The reason for ARI in this research is from a virus (100%), so antibiotics are not needed for this patient.

Parainfluenza Virus Type 3 Co-infection with Other Respiratory Pathogens Among Hospitalized Children with Acute Respiratory Infections in Wuhan, China

Background: Bacterial and viral co-infections are increasingly recognized as the cause of Acute Respiratory Infection (ARI). The role of co-infection in ARI patients with Parainfluenza Virus type 3 (PIV3) infection is unclear. Objectives: This study aimed to determine the prevalence of PIV3 co-infections in hospitalized children and assess the co-infections' role in ARI patients with PIV3 infections. Methods: Between January 2018 and December 2021, children were confirmed to have a PIV3 infection via throat swabs or nasopharyngeal aspirates. Some digital clinical data were analyzed, including demographic, epidemiological, diagnostic, and laboratory data. Results: During the study period from 2018 to 2021, 2,539 patients were hospitalized with ARI caused by PIV3. Of them, 34.0% had co-infection with other pathogens, and 2.4% had co-infection with more than two pathogens. Mycoplasma pneumoniae was the most common co-infecting pathogen (71.3%), followed by other bacteria (13.3%) and viruses (8.2%). A significantly higher proportion of patients with M. pneumoniae co-infection was found in girls (χ2 = 19.233, P &lt; 0.001). Co-infections with M. pneumoniae were observed principally in patients aged 1 – 2 years (χ2 = 202.130, P &lt; 0.001). In contrast, viral (56.3%) and bacterial (66.1%) co-infections occurred mainly in children younger than one year. The diagnosis of PIV3 as a single infection included pneumonia (41.2%), bronchitis (39.9%), upper respiratory tract infections (15.0%), and laryngitis (3.9%), which were distinguished from those with bacterial co-infections (χ2 = 16.424, P = 0.001) and co-infections with more than two pathogens (χ2 = 11.687, P = 0.010). Co-infections of PIV3 with any pathogen were not associated with admissions to intensive care units or ventilator support. However, the mean hospitalization was significantly higher in M. pneumoniae co-infections (t = 2.367, P = 0.018), bacterial co-infections (t = 2.402, P = 0.016), and co-infections with more than two pathogens (t = 2.827, P = 0.006) than in single PIV3 infection. Conclusions: Parainfluenza virus type 3 frequently occurs with other pathogens. The epidemiological and clinical characteristics of co-infections with different pathogens differed. Mycoplasma pneumoniae co-infections, bacterial co-infections, and co-infections with more than two pathogens lengthened the hospitalization. Bacterial co-infections and co-infections with more than two pathogens increased the severity of ARI and worsened the symptoms.

Immediate and long-term changes in the epidemiology, infection spectrum, and clinical characteristics of viral and bacterial respiratory infections in Western China after the COVID-19 outbreak: a modeling study.

The impact of COVID-19 on the epidemiology, clinical characteristics, and infection spectrum of viral and bacterial respiratory infections in Western China is unknown. We conducted an interrupted time series analysis based on surveillance of acute respiratory infections (ARI) in Western China to supplement the available data. The positive rates of influenza virus, Streptococcus pneumoniae, and viral and bacterial coinfections decreased, but parainfluenza virus, respiratory syncytial virus, human adenovirus, human rhinovirus, human bocavirus, non-typeable Haemophilus influenzae, Mycoplasma pneumoniae, and Chlamydia pneumoniae infections increased after the onset of the COVID-19 epidemic. The positive rate for viral infection in outpatients and children aged <5 years increased, but the positive rates of bacterial infection and viral and bacterial coinfections decreased, and the proportion patients with clinical symptoms of ARI decreased after the onset of the COVID-19 epidemic. Non-pharmacological interventions reduced the positive rates of viral and bacterial infections in the short term but did not have a long-term limiting effect. Moreover, the proportion of ARI patients with severe clinical symptoms (dyspnea and pleural effusion) increased in the short term after COVID-19, but in the long-term, it decreased. The epidemiology, clinical characteristics, and infection spectrum of viral and bacterial infections in Western China have changed, and children will be a high-risk group for ARI after the COVID-19 epidemic. In addition, the reluctance of ARI patients with mild clinical symptoms to seek medical care after COVID-19 should be considered. In the post-COVID-19 era, we need to strengthen the surveillance of respiratory pathogens.

Epidemiological and clinical characteristics of respiratory syncytial virus and influenza infections in hospitalized children before and during the COVID‐19 pandemic in Central China

Globally, the epidemiology of non-SARS-CoV-2 respiratory viruses like respiratory syncytial virus (RSV) and influenza virus was remarkably influenced by the implementation of non-pharmacological interventions (NPIs) during the COVID-19 pandemic. Our study explored the epidemiological and clinical characteristics of pediatric patients hospitalized with RSV or influenza infection before and during the pandemic after relaxation of NPIs in central China. This hospital-based prospective case-series study screened pediatric inpatients (age ≤ 14 years) enrolled with acute respiratory infections (ARI) for RSV or influenza infection from 2018 to 2021. The changes in positivity rates of viral detection, epidemiological, and clinical characteristics were analyzed and compared. Median ages of all eligible ARI patients from 2018-2019 were younger than those from 2020-2021, so were ages of cases infected with RSV or influenza (RSV: 4.2 months vs. 7.2 months; influenza: 27.3months vs. 37.0 months). Where the positivity rate for influenza was considerably decreased in 2020-2021 (1.4%, 27/1964) as compared with 2018-2019 (2.9%, 94/3275, P < 0.05), it was increased for RSV (11.4% [372/3275] vs. 13.3% [262/1964], P < 0.05) in the same period. The number of severe cases for both RSV and influenza infection were also decreased in 2020-2021 compared with 2018-2019. The implemented NPIs have had varied impacts on common respiratory viruses. A more effective prevention strategy for RSV infections in childhood is needed.

Clinical features and viral etiology of acute respiratory infection in an outpatient fever clinic during COVID-19 pandemic in a tertiary hospital in Nanjing, China.

Clinical feature and viral etiology for acute respiratory infection (ARI) in the community was unknown during coronavirus disease 2019 (COVID-19) pandemic. In a retrospective study, we aimed to characterize the clinical feature and etiology for the ARI patients admitted to the outpatient fever clinic in Nanjing Drum Tower Hospital between November 2020 and March 2021. Fifteen common respiratory pathogens were tested using pharyngeal swabs by multiplex reverse transcriptase-polymerase chain reaction assays. Of the 242 patients, 56 (23%) were tested positive for at least one viral agent. The predominant viruses included human rhinovirus (HRV) (5.4%), parainfluenza virus type III (PIV-III) (5.0%), and human coronavirus-NL63 (HCoV-NL63) (3.7%). Cough, sputum, nasal obstruction, and rhinorrhea were the most prevalent symptoms in patients with viral infection. Elderly and the patients with underlying diseases were susceptible to pneumonia accompanied with sputum and chest oppression. Three (5.4%) patients in virus infection group, whereas 31 (16.7%) in non-viral infection group (p=0.033), were empirically prescribed with antiviral agents. Among 149 patients who received antibiotic therapy, 30 (20.1%) patients were later identified with viral infection. Our study indicated the importance of accurate diagnosis of ARI, especially during the COVID-19 pandemic, which might facilitate appropriate clinical treatment.