■呼吸道合胞病毒(RSV)在全球范围内对幼儿和老年人造成了巨大的发病率和死亡率负担。据报道,2019年冠状病毒病(COVID-19)大流行改变了RSV流行病学,可能对RSV预防和控制策略具有重要意义。我们旨在通过利用流行病学来比较COVID-19大流行不同阶段与大流行前时期的RSV流行病学,分子,以及从前瞻性呼吸道病原体监测和血清学研究中收集的血清学数据。
■本研究基于2015年7月1日至2023年11月30日期间来自呼吸道病原体监测系统(RPSS)的数据,一个基于哨点医院的急性呼吸道感染监测系统,由35家医院组成,代表北京16个地区的所有年龄段的居民,中国。通过RT-PCR测试RSV感染状态,并在鉴定的RSV菌株中进行基因测序和系统发育分析。我们进一步补充了RPSS数据,在2017-2023年期间进行了三项血清学调查,测试了血清标本中的RSVIgG水平。按日历月计算RSV检出率,并在RSV季节(定义为第二年的7月1日至6月30日)进行比较。按一年中的季度计算RSVIgG阳性比例,并与季度汇总的RSV检出率相关,以了解感染与人群免疫之间的关系。
■总的来说,在研究期间,共收集并测试了52,931份呼吸道标本.RSV检出率从2017-2018赛季的1.24%(94/7594)到2018-2019赛季的2.80%(219/7824),从2022-2023年的1.06%(55/5165)到2021-2022年的2.98%(147/4938),在大流行前和大流行期间,分别。在大流行期间,ON1和BA9仍然是主要的基因型;没有发现新的RSV毒株。在大多数季节中,RSV循环遵循冬季季节模式。一个例外是2020-2021年季节,观察到全年广泛的循环,可能与非药物干预措施(NPI)的部分放松有关。另一个例外是2022-2023年季节,在通常的冬季月份观察到RSV活动非常低(可能是由于同时发生的当地COVID-19疫情),接着是春天反季节的复苏,RSV检测持续到研究期结束(2023年11月)。在以上两个季节,我们注意到RSV检出率与年龄组相关的不同步;幼儿的RSV检出率保持相似(甚至以临界显著性增加;43/594,7.24%,42/556,7.55%vs292/5293,5.52%;分别为P=0.10和P=0.06)与大流行前季节相比,而老年人的检出率显着下降(8/1779,0.45%,和3/2021,0.15%vs160/10,348,1.55%;两个比较中P<0.001)。血清学调查结果显示,与大流行前季节相比,2022-2023年季节的RSVIgG阳性显着下降(9.32%,29/311vs20.16%,100/496;P<0.001);在大流行前和大流行期间,老年人的RSVIgG阳性均明显高于幼儿(P值<0.001)。
■我们的研究记录了RSV检测的轨迹以及NPI严格性的变化,测量的IgG阳性,和当地的COVID-19流行病。研究结果表明,接触模式之间的相互作用,免疫动力学,和SARS-CoV-2感染对不同年龄人群RSV流行的影响。这些发现为RSV循环模式的潜在驱动因素提供了新的见解,并对RSV预防和控制策略具有重要意义。
■高素质公共卫生专业人员发展项目,资本用于健康改善和研究的基金,和公共卫生人员培训支持计划。
UNASSIGNED: Respiratory syncytial virus (RSV) has posed substantial morbidity and mortality burden to young children and older adults globally. The coronavirus disease 2019 (COVID-19) pandemic was reported to have altered RSV epidemiology and could have important implications for RSV prevention and control strategies. We aimed to compare RSV epidemiology in different phases of the COVID-19 pandemic with the pre-pandemic period by leveraging epidemiological, molecular, and serological data collected from a prospective respiratory pathogen surveillance and
serology study.
UNASSIGNED: This study was based on the data during July 1, 2015 to November 30, 2023 from the Respiratory Pathogen Surveillance System (RPSS), a sentinel-hospital based surveillance system of acute respiratory infections consisting of 35 hospitals that represent residents of all ages from all 16 districts in Beijing,
China. RSV infection status was tested by RT-PCR and gene sequencing and phylogenetic analysis was conducted among the identified RSV strains. We further supplemented RPSS data with three
serology surveys conducted during 2017-2023 that tested RSV IgG levels from serum specimens. RSV detection rate was calculated by calendar month and compared across RSV seasons (defined as the July 1 through June 30 of the following year). RSV IgG positivity proportion was calculated by quarter of the year and was correlated with quarterly aggregated RSV detection rate for understanding the relationship between infection and immunity at the population level.
UNASSIGNED: Overall, a total of 52,931 respiratory specimens were collected and tested over the study period. RSV detection rates ranged from 1.24% (94/7594) in the 2017-2018 season to 2.80% (219/7824) in the 2018-2019 season, and from 1.06% (55/5165) in the 2022-2023 season to 2.98% (147/4938) in the 2021-2022 season during the pre-pandemic and pandemic period, respectively. ON1 and BA9 remained the predominant genotypes during the pandemic period; no novel RSV strains were identified. RSV circulation followed a winter-months seasonal pattern in most seasons. One exception was the 2020-2021 season when an extensive year-round circulation was observed, possibly associated with partial relaxation of non-pharmaceutical interventions (NPIs). The other exception was the 2022-2023 season when very low RSV activity was observed during the usual winter months (possibly due to the concurrent local COVID-19 epidemic), and followed by an out-of-season resurgence in the spring, with RSV detection persisting to the end of the study period (November 2023). During the two seasons above, we noted an age-group related asynchrony in the RSV detection rate; the RSV detection rate in young children remained similar (or even increased with borderline significance; 43/594, 7.24%, and 42/556, 7.55% vs 292/5293, 5.52%; P = 0.10 and P = 0.06, respectively) compared with the pre-pandemic seasons whereas the detection rate in older adults decreased significantly (8/1779, 0.45%, and 3/2021, 0.15% vs 160/10,348, 1.55%; P < 0.001 in two comparisons). Results from
serology surveys showed significantly declined RSV IgG positivity in the 2022-2023 season compared to the pre-pandemic seasons (9.32%, 29/311 vs 20.16%, 100/496; P < 0.001); older adults had significantly higher RSV IgG positivity than young children in both pre-pandemic and pandemic periods (P values < 0.001).
UNASSIGNED: Our study documented the trajectory of RSV detection along with the changes in the stringency of NPIs, measured IgG positivity, and local COVID-19 epidemics. The findings suggest the interplay between contact patterns, immunity dynamics, and SARS-CoV-2 infection in shaping the RSV epidemics of population of different ages. These findings provide novel insights into the potential drivers of RSV circulating patterns and have important implications for RSV prevention and control strategies.
UNASSIGNED: The High-qualified Public Health Professionals Development Project, Capital\'s Funds for Health Improvement and Research, and the Public Health Personnel Training Support Program.