METHODS: We prospectively enrolled children aged < 18 years who were hospitalized in Soochow University Affiliated Children\'s Hospital with acute lower respiratory infection (ALRIs) from January 2018 to July 2022. Changes in epidemiological and clinical characteristics of RSV infections were analyzed.
RESULTS: Compared with the same period in 2018-2019, the difference in the overall positive rate of RSV was not statistically significant in 2020, while it increased significantly in 2021 (11.8% [662/5621] vs. 20.8% [356/1711], p < 0.001) and 2022 (9.0% [308/3406] vs. 18.9% [129/684], p < 0.001). Specifically, the positive rates declined considerably from October to December 2020 but sharply increased during the summer of 2021. Compared to prepandemic period, RSV infections were more frequently observed in older children during the pandemic. RSV-positive children exhibited milder clinical characteristics during the COVID-19 pandemic, including decreased proportion of patients with hospital stay ≥ 11 days (10.3% vs. 6.7%, p < 0.05), less requirement for oxygen therapy (13.7% vs. 6.9%, p < 0.001), and fewer cases of polypnea (12.2% vs. 9.7%, p < 0.05) and wheeze (50.1% vs. 42.9%, p < 0.001).
CONCLUSIONS: The implementation of multilayered NPIs targeted at COVID-19 has affected the activity of RSV. Ongoing monitoring of RSV is warranted as the changing RSV epidemiology can provide valuable insights for future healthcare system planning.
方法:前瞻性纳入2018年1月至2022年7月在苏州大学附属儿童医院住院的<18岁急性下呼吸道感染(ALRIs)患儿。分析RSV感染的流行病学变化和临床特征。
结果:与2018-2019年同期相比,RSV的总体阳性率在2020年差异无统计学意义,而在2021年则显着增加(11.8%[662/5621]vs.20.8%[356/1711],p<0.001)和2022年(9.0%[308/3406]与18.9%[129/684],p<0.001)。具体来说,2020年10月至12月,正利率大幅下降,但在2021年夏季大幅上升。与流行前期相比,大流行期间,年龄较大的儿童更频繁地观察到RSV感染。RSV阳性儿童在COVID-19大流行期间表现出更温和的临床特征,包括住院时间≥11天的患者比例下降(10.3%vs.6.7%,p<0.05),氧疗需求减少(13.7%vs.6.9%,p<0.001),和较少的病例呼吸息肉(12.2%vs.9.7%,p<0.05)和喘息(50.1%vs.42.9%,p<0.001)。
结论:针对COVID-19的多层NPI的实施影响了RSV的活性。RSV的持续监测是必要的,因为不断变化的RSV流行病学可以为未来的医疗保健系统规划提供有价值的见解。