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First page of Impact of COVID-19 and Non-Pharmaceutical Interventions on Common Respiratory Viruses in Children: A Five-Year Study in Hangzhou, China

Background: Non-Pharmaceutical Interventions (NPIs) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) not only curbed the spread of novel coronavirus (COVID-19) but also affected common respiratory viruses infected by children. Methods: Samples of children diagnosed with respiratory tract infection in Children's Hospital affiliated with Zhejiang University from January 2019 to December 2023 were collected, and ADV, Flu A, Flu B and RSV were detected. Statistical analysis was carried out with R software. Results: From January 2019 to December 2023, a total of 684413 samples were tested, including 369620 males, accounting for 54.01%, and 314793 females, accounting for 45.99%. Among them, there were 213443 positive samples (31.19%), of which 40484 ADV-positive samples (18.97%), 106423 Flu A-positive samples (49.86%), 32379 Flu B-positive samples (15.17%) and 30776 RSV-positive samples (14.42%), 3381 mixed infection samples (1.58%). Among children of different ages in Hangzhou before, during and after COVID-19, the highest total detection rate of respiratory virus was 4-6 years old (accounting for 36.69%), followed by >7 years old (accounting for 35.10%). The distribution in different seasons shows that the number of children infected with respiratory viruses reaches a peak in winter and spring. Compared with 2019 (33.20%) before the COVID-19 epidemic, the total detection rate of common respiratory viruses in children was lower during the COVID-19 pandemic (24.54% in 2020-2022), and it was increased in 2023 while after NPIs were cancelled (accounting for 35.20%). Conclusion: NPI measures can effectively reduce the spread of common respiratory viruses, Lifting of NPIs can lead children to an increase viral infection rate, particularly in Flu A.

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2025
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