WAS THE ACTIVITY OF THE RESPIRATORY SYNCYTIAL VIRUS REDUCED DURING THE COVID-19 PANDEMIC?
Keywords:respiratory syncytial virus, bronchiolitis, epidemiology, COVID-19 pandemic
Introduction. Respiratory syncytial virus (RSV) is the most significant cause of acute respiratory diseases, such as bronchiolitis, in children at the earliest age. The COVID-19 pandemic has significantly changed the epidemiology of other viral respiratory diseases, including RSV infections.
Aim. The aim of our study was to examine whether there was a statistically significant decrease in the number of infants and young children affected by viral bronchiolitis during the COVID-19 pandemic.
Methods. The criteria for participation in this retrospective study included subjects aged 1-24 months who, due to respiratory problems, were examined by the pediatrician in the period from 01.01.2019. until 31.12.2022. We classified the subjects into four groups by calendar year: 2019, 2020, 2021 and 2022, and in each year we separated children with symptoms of bronchiolitis from the total number of children with respiratory problems. The diagnosis of bronchiolitis was made clinically. The obtained data were processed by a computer program for statistical analysis of data (SPSS, version 20), and we used the Chi-square test for the significance level p≤0,001.
Results. The total number of subjects for four years was 3,645, and 687 infants were diagnosed with acute bronchiolitis. According to calendar years, in 2019 there were 214 cases, in 2020 there were 172 cases, in 2021 there were 45 cases, and in 2022 there were 256 cases. Using the Chi-square test for the level of significance p≤0,001, we compared the distribution of bronchiolitis patients in the investigated calendar years and found that during the year 2021 there was a statistically significant decrease in the number of patients compared to other years.
Conclusion. The COVID-19 pandemic has significantly changed the epidemiology of other viral respiratory diseases, including RSV infections. In the absence of successful and licensed vaccines, the only ways to reduce the number of children with RSV infection are early detection of patients and implementation of general hygiene measures with epidemiological surveillance and this happened during the COVID-19 pandemic.
Salimi V, Viegas M, Trento A, Agoti CN, Anderson LJ, Avadhanula V, et al. Proposal for Human Respiratory Syncytial Virus Nomenclature below the Species Level. Emerg Infect Dis. 2021 Jun;27(6):1-9. doi: 10.3201/eid2706.204608. PMID: 34013862; PMCID: PMC8153853.
Nenna R, Evangelisti M, Frassanito A, Scagnolari C, Pierangeli A, Antonelli G, et al. Respiratory syncytial virus bronchiolitis, weather conditions and air pollution in an Italian urban area: An observational study. Environ Res. 2017 Oct;158:188-193. doi: 10.1016/j.envres.2017.06.014. Epub 2017 Jul 3. PMID: 28647513; PMCID: PMC7125886.
Piedimonte G, Perez MK. Respiratory syncytial virus infection and bronchiolitis. Pediatr Rev. 2014;35:519-530.
Smith DK, Seales S, Budzik C. Respiratory Syncytial Virus Bronchiolitis in Children. Am Fam Physician. 2017 Jan 15;95(2):94-99. PMID: 28084708.
Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM, et al. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics. 2014 Nov;134(5):e1474-502. doi: 10.1542/peds.2014-2742. Erratum in: Pediatrics. 2015 Oct;136(4):782. PMID: 25349312.
Farley R, Spurling GK, Eriksson L, Del Mar CB. Antibiotics for bronchiolitis in children under two years of age. Cochrane Database Syst Rev. 2014(10):CD005189.
American Academy of Pediatrics Committee on Infectious Diseases; American Academy of Pediatrics Bronchiolitis Guidelines Committee. Updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for respiratory syncytial virus infection. Pediatrics. 2014;134(2):e620-e638.
Yeoh DK, Foley DA, Minney-Smith CA, Martin AC, Mace AO, Sikazwe CT, et al. Impact of Coronavirus Disease 2019 Public Health Measures on Detections of Influenza and Respiratory Syncytial Virus in Children During the 2020 Australian Winter. Clin Infect Dis. 2021 Jun 15;72(12):2199-2202. doi: 10.1093/cid/ciaa1475. PMID: 32986804; PMCID: PMC7543326.
Sullivan S.G., Carlson S., Cheng A.C., Chilver M.B., Dwyer D.E., Irwin M., et al. Where has all the influenza gone? The impact of COVID-19 on the circulation of influenza and other respiratory viruses, Australia, March to September 2020. Euro Surveill. 2020;25:2001847. doi: 10.2807/1560-7917.ES.20202547.2001847.
Van Brusselen D, De Troeyer K, Ter Haar E, Vander Auwera A, Poschet K, Van Nuijs S, et al. Bronchiolitis in COVID-19 times: a nearly absent disease? Eur J Pediatr. 2021 Jun;180(6):1969-1973. doi: 10.1007/s00431-021-03968-6. Epub 2021 Jan 30. PMID: 33517482; PMCID: PMC7847293.
Calderaro A, De Conto F, Buttrini M, Piccolo G, Montecchini S, Maccari C, et al. Human respiratory viruses, including SARS-CoV-2, circulating in the winter season 2019-2020 in Parma, Northern Italy. Int J Infect Dis. 2021 Jan;102:79-84. doi: 10.1016/j.ijid.2020.09.1473. Epub 2020 Oct 2. PMID: 33017694; PMCID: PMC7530558.
Kuitunem I, Artama M, Mäkelä L, Backman K, Heiskanen‐Kosma T, Renko M. Effect of social distancing due to the COVID‐19 pandemic on the incidence of viral respiratory tract infections in children in Finland during early 2020. Pediatr Infect Dis J. 2020;39:e423‐e427.
Hernández-Rivas L, Pedraz T, Calvo C, Juan IS, José Mellado M, Robustillo A. Respiratory syncytial virus outbreak DURING THE COVID-19 PANDEMIC. How has it changed? Enferm Infecc Microbiol Clin. 2021 Dec 22. doi: 10.1016/j.eimc.2021.12.003. Epub ahead of print. PMID: 34955580; PMCID: PMC8692060.
Rodríguez-Fernández R, González-Martínez F, Perez-Moreno J, González-Sánchez MI, de la Mata Navazo S, Toledo Del Castillo B, et al. Clinical Phenotype of Respiratory Syncytial Virus Bronchiolitis before and during the Coronavirus Disease 2019 Pandemic. Am J Perinatol. 2022 Dec 21. doi: 10.1055/s-0042-1759602. Epub ahead of print. PMID: 36543242.
Ozeki S, Kawada JI, Yamashita D, Yasufuku C, Akano T, Kato M, Suzuki K, et al. Impact of the Coronavirus Disease 2019 Pandemic on the Clinical Features of Pediatric Respiratory Syncytial Virus Infection in Japan. Open Forum Infect Dis. 2022 Oct 22;9(11):ofac562. doi: 10.1093/ofid/ofac562. PMCID: PMC9620303.
Mohebi L, Karami H, Mirsalehi N, Ardestani NH, Yavarian J, Mard-Soltani M, et al. A delayed resurgence of respiratory syncytial virus (RSV) during the COVID-19 pandemic: An unpredictable outbreak in a small proportion of children in the Southwest of Iran, April 2022. J Med Virol. 2022 Dec;94(12):5802-5807. doi: 10.1002/jmv.28065. Epub 2022 Aug 23. PMID: 35961780; PMCID: PMC9538802.
Qiu W, Zheng C, Huang S, Zhang Y, Chen Z. Epidemiological Trend of RSV Infection Before and During COVID-19 Pandemic: A Three-Year Consecutive Study in China. Infect Drug Resist. 2022 Nov 28;15:6829-6837. doi: 10.2147/IDR.S388231. PMID: 36465809; PMCID: PMC9717604.
Bardsley M, Morbey RA, Hughes HE, Beck CR, Watson CH, Zhao H, Ellis J, et al. Epidemiology of respiratory syncytial virus in children younger than 5 years in England during the COVID-19 pandemic, measured by laboratory, clinical, and syndromic surveillance: a retrospective observational study. Lancet Infect Dis. 2023 Jan;23(1):56-66. doi: 10.1016/S1473-3099(22)00525-4. Epub 2022 Sep 2. PMID: 36063828; PMCID: PMC9762748.
Bozzola E, Barni S, Villani A. Respiratory Syncytial Virus Pediatric Hospitalization in the COVID-19 Era. Int J Environ Res Public Health. 2022 Nov 22;19(23):15455. doi: 10.3390/ijerph192315455. PMID: 36497528; PMCID: PMC9738890.
Tenenbaum T, Doenhardt M, Diffloth N, Berner R, Armann JP. High burden of RSV hospitalizations in Germany 2021-2022. Infection. 2022 Dec;50(6):1587-1590. doi: 10.1007/s15010-022-01889-6. Epub 2022 Jul 29. PMID: 35904753; PMCID: PMC9334552.
Mrcela D, Markic J, Zhao C, Viskovic DV, Milic P, Copac R, at al. Changes following the Onset of the COVID-19 Pandemic in the Burden of Hospitalization for Respiratory Syncytial Virus Acute Lower Respiratory Infection in Children under Two Years: A Retrospective Study from Croatia. Viruses. 2022 Dec 9;14(12):2746. doi: 10.3390/v14122746. PMID: 36560751; PMCID: PMC9785187.