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Seasonal respiratory virus trends in pediatric patients during the COVID-19 pandemic in Brazil

  • Clinical Microbiology - Research Paper
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Abstract

Acute respiratory infections are a constant public health problem causing childhood morbidity and mortality worldwide. Reported cases of major respiratory infections decreased in 2020 after restrictive measures were adopted to contain the COVID-19 pandemic, but there is little data on the impact after these measures were relaxed in the subsequent years. This study conducted molecular analysis to identify rhinovirus, respiratory syncytial virus, influenza A virus, and adenovirus in SARS-CoV-2-negative samples taken from symptomatic pediatric patients during 2021 and 2022 to ascertain the impact of pandemic response measures within the broader epidemiological scenario. The positivity rates found were 28.3% and 50.8%, in 2021 and 2022, respectively, representing a significant increase (1.8 times) in the circulation of non-SARS-CoV-2 viruses after the reduction of non-pharmacological measures to contain the COVID-19 pandemic. Within the positive samples, rhinovirus and respiratory syncytial virus were most frequent (44.4 and 18% in 2021; 44.5 and 22.5% in 2022), whereas influenza A and adenovirus were found in lower frequency (12.5 and 5.5% in 2021; 13.4 and 4.9% in 2022, respectively). Because these different respiratory virus diseases produce similar symptoms, diagnosis based on clinical condition alone can be inaccurate, and more reliable testing is required to select the best therapeutic approach for each case. The loosening of restrictive measures to contain the COVID-19 pandemic led to higher numbers of other respiratory infections in pediatric patients. Ongoing surveillance and differential diagnosis of respiratory viruses are required to better understand their seasonal patterns after the COVID-19 pandemic to guide prevention and control strategies.

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Funding

This work was supported by the Rede Corona-Ômica BR MCTI/FINEP, which is part of Rede Vírus/MCTI (FINEP 01.20.0029.000462/20, CNPq 404096/2020-4, CNPq fellowship 382032/2020-9 to C.A.B.). Funding support was also received from the FAPESP-COVID Program (Grant 2020/04836-0 to M.L.N.), from CNPq via the PIBIC fellowship (122597/2021-4) to A.K.S.L., and the Centers for Research in Emerging Infectious Diseases (CREID), “The Coordinating Research on Emerging Arboviral Threats Encompassing the Neotropics (CREATE-NEO)” grant 1U01AI151807 awarded to M.L.N. by the National Institutes of Health (NIH/USA). M.L.N. is a CNPq Research Fellow.

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Author notes

  1. Ana Karoline Sepedro Lima and Cecília Artico Banho contributed equally to this work.

Authors and Affiliations

  1. Laboratório de Pesquisas em Virologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, São Paulo, Brazil

    Ana Karoline Sepedro Lima, Cecília Artico Banho, Lívia Sacchetto, Beatriz de Carvalho Marques, Mariana Guedes dos Santos, Milene Rocha Ribeiro, Flora A. Gandolfi, Tatiana Pissolati Sakomura, Cássia Fernanda Estofolete & Maurício Lacerda Nogueira

  2. Hospital da Criança e Maternidade, São José do Rio Preto, São Paulo, Brazil

    Flora A. Gandolfi & Tatiana Pissolati Sakomura

  3. Hospital de Base, São José do Rio Preto, São Paulo, Brazil

    Cássia Fernanda Estofolete & Maurício Lacerda Nogueira

  4. Department of Pathology, The University of Texas Medical Branch, Galveston, TX, USA

    Maurício Lacerda Nogueira

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  1. Ana Karoline Sepedro Lima
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Contributions

A.K.L.S., C.A.B., and M.L.N. conceived and designed the study. A.K.L.S., C.A.B., M.G.S., and M.R.R. collected the samples. A.K.L.S., C.A.B., L.S., and B.C.M. carried out the respiratory infection diagnostics. C.A.B. and C.F.S. performed statistical analyses. A.K.S.L., C.A.B., F.A.G., T.P.S., and C.F.S. conducted the data analyses and interpretation. A.K.S.L. and C.A.B. wrote the first draft of the manuscript. C.A.B., C.F.S., L.S., and M.L.N. edited and revised the manuscript. M.L.N. provided the resources for the survey. All the authors approved the final version of the manuscript. All the authors had full access to all the data used in this study and had final responsibility for the decision to submit the text for publication.

Corresponding author

Correspondence to Maurício Lacerda Nogueira.

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Ethics approval and consent to participate

This study was approved by the Ethics Committee of the Faculdade de Medicina de São José do Rio Preto (FAMERP) (protocol number: CAAE 31588920.0.0000.5415, on November 29, 2021). Informed consent was not required, since all samples were collected for routine diagnosis and data were analyzed anonymously, ensuring total confidentiality for all participants.

Competing interests

The authors declare no competing interests.

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The funders had no role in the design of the study, collection, analyses, or interpretation of data, writing of the manuscript, or in the decision to publish the results.

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Lima, A.K.S., Banho, C.A., Sacchetto, L. et al. Seasonal respiratory virus trends in pediatric patients during the COVID-19 pandemic in Brazil. Braz J Microbiol 54, 1827–1834 (2023). https://doi.org/10.1007/s42770-023-01087-y

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