Epidemiology of Pediatric Respiratory Viruses in Hangzhou (2019–2023) 🦠📊

 

INTRODUCTION 🧬

Respiratory tract infections (RTIs) are a significant cause of morbidity among children, especially in densely populated urban centers like Hangzhou. From 2019 to 2023, a comprehensive retrospective study involving 302,680 pediatric patients with acute respiratory infections was conducted to understand the epidemiological dynamics of respiratory viruses before, during, and after the COVID-19 pandemic. Using colloidal gold-based assays, key respiratory pathogens—adenovirus (ADV), influenza A (FluA), influenza B (FluB), and respiratory syncytial virus (RSV)—were identified and analyzed. The overall positivity rate for respiratory viruses was 21.64%, revealing dynamic changes in infection patterns over time. This large-scale study provides valuable insight into how public health events such as the COVID-19 pandemic influence the prevalence and spread of common respiratory viruses, with implications for both prevention and clinical management strategies.

VIRAL DETECTION TRENDS ACROSS PANDEMIC PERIODS 📊

This study highlights significant changes in viral detection rates before (2019), during (2020–2022), and after (2023) the COVID-19 pandemic. The data showed a marked shift in virus prevalence, as indicated by statistically significant differences in detection rates (χ²=18,074.97, P < 0.001). FluA demonstrated the most notable variation (χ²=31,866.75, P < 0.001), followed by significant fluctuations in FluB, RSV, and ADV. These changes suggest that widespread public health measures—mask-wearing, lockdowns, and reduced mobility—may have disrupted normal transmission cycles. The resurgence of certain viruses post-2022 points to the potential rebound effect following the relaxation of containment measures, highlighting the need for adaptive surveillance frameworks in future pandemics.

MIXED INFECTIONS AND CLINICAL COMPLEXITY ⚠️

The phenomenon of mixed infections, particularly involving adenovirus in combination with other respiratory pathogens, adds complexity to the clinical presentation and management of pediatric RTIs. While single infections were most common for FluA, co-infections represent a critical concern due to potential implications for symptom severity, treatment outcomes, and viral evolution. This study underscores the importance of developing diagnostic protocols that consider co-infection scenarios to avoid underestimating pathogen interactions. Understanding these patterns can lead to more effective therapeutic decisions and may also inform vaccine development strategies that take co-infection risks into account.

SEASONAL PATTERNS IN VIRAL INCIDENCE 🌦️

A clear seasonal trend was observed for several viruses: FluA and FluB infections peaked during winter and spring, while RSV was predominantly active in winter. ADV, however, exhibited no distinct seasonal trend. These findings suggest that temperature, humidity, and human behavior during colder months likely contribute to the increased transmission of certain viruses. The disruption in seasonal cycles during the COVID-19 pandemic also indicates that public health interventions can significantly alter virus seasonality. These observations are vital for designing targeted surveillance and vaccination campaigns aligned with seasonal risk profiles.

AGE-SPECIFIC VULNERABILITIES TO RESPIRATORY VIRUSES 👶🧒👧

Age played a pivotal role in determining infection risk and virus type. The highest RSV positivity (4.37%) occurred in children under two years, while ADV was more common among the 2–5-year age group (4.33%). FluA infections peaked in children aged 5–15 years (17.15%), and FluB had the highest positivity in those over 15 (4.86%). These age-stratified patterns suggest the need for tailored prevention and intervention strategies. Pediatric healthcare providers should maintain high vigilance during peak seasons, especially for age groups most vulnerable to specific viruses, to ensure early diagnosis and timely treatment.

GENDER AND RESPIRATORY VIRUS PREVALENCE 🚻

Analysis revealed a statistically significant difference in infection rates between genders (χ²=87.317, P < 0.001), indicating possible biological or behavioral factors influencing susceptibility. Though the study does not delve into causative mechanisms, this finding highlights the importance of considering sex-based differences in epidemiological research. Future studies could explore hormonal, genetic, or environmental contributors to gender disparities in respiratory virus infections, with potential implications for personalized medicine and risk-based health education.

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