A retrospective study of respiratory infections in children following the COVID-19 pandemic in Wuhan, China.

INTRODUCTION Acute respiratory infections cause over 4 million deaths annually worldwide, half of which occur in children under 5 years, primarily in developing countries. This study investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic on the epidemiological and clinical characteristics of pediatric patients with respiratory infections. METHODOLOGY This study retrospectively analyzed 8,815 pediatric cases (0-18 years) with laboratory-confirmed respiratory infections at Wuhan Children's Hospital in pre-pandemic (November 2019-February 2020) and post-pandemic (November 2020-February 2021) periods. Included cases were symptomatic and tested positive for at least one pathogen: influenza A (FluA), influenza B (FluB), respiratory syncytial virus (RSV), Chlamydia pneumoniae (CP), Mycoplasma pneumoniae (MP), adenovirus (ADV), or coxsackievirus (CV). The pathogen distribution spectrum between periods was compared. Routine blood parameters - platelet count, white blood cell count, red blood cell count, lymphocyte percentage, neutrophil percentage, monocyte percentage, C-reactive protein, and hemoglobin - were also compared across groups and periods.

Results

The post-pandemic pathogen spectrum shifted significantly. MP detection increased across all age groups (28 days-2 years, 2-8 years, 8-18 years), while other pathogens (RSV, ADV, CV, CP) decreased, with patterns varying by age. Post-pandemic platelet count and lymphocyte percentage increased, while neutrophil percentage decreased in the CP group.

Conclusions

COVID-19 control measures were temporally associated with marked changes in respiratory pathogen detection; notably a rise in MP. However, changes in healthcare-seeking behavior and testing intensity are important confounders. The observed shift in pathogen spectrum requires careful interpretation within this complex context.