DYNAMICS OF CHILDHOOD RESPIRATORY INFECTIONS DURING THE COVID-19 PANDEMIC: THE EFFECT OF QUARANTINE АND BEYOND

  • Snezhina Lazova Pediatric Department, University Multiprofile Hospital for Active Treatment and Emergency Medicine named after N. I. Pirogov, Sofia, Bulgaria; Healthcare Department, Faculty of Public Health, Medical University Sofia, Bulgaria https://orcid.org/0000-0002-5884-7760
  • Tsvetelina Velikova Department of Clinical Immunology, University Hospital Lozenetz, Sofia University St. Kliment Ohridski, Sofia, Bulgaria https://orcid.org/0000-0002-0593-1272
Keywords: COVID-19, SARS-CoV-2, Hypothesis, Respiratory viral infections, Influenza, RSV, Rhinovirus, Children

Abstract

Monitoring epidemic processes and the dynamics of the spread of infectious diseases is essential for predicting their distribution and effective planning in healthcare. The importance of studying seasonal trends in the spread of respiratory viral infections and the specific effects of non-pharmaceutical interventions in nationwide scales and the use of available vaccines stand out even more in the context of the coronavirus disease-19 (COVID-19) pandemic. Even if the dynamics of pediatric respiratory viral infections show some variation at the national and local levels, depending on health regulation, respiratory viral pathogens follow a typical pattern of incidence. Therefore, we hypothesize that anticipated reduction of the incidence of common respiratory viral infections would undoubtedly exert positive effects, such as ease of burdening healthcare that combates the COVID-19 pandemic. However, we suspect a shift in familiar seasonal characteristics of common respiratory viral infections. We also speculate that strict long-term limitations of the natural spread of respiratory viral infections can lead to the development of hard-to-predict epidemiological outliers. Additionally, the tricky balance between humanity’s natural impulse to return to normalcy and control the new and still dynamically evolving infection could lead to new threats from old and well-known pathogens. Finally, we hypothesize that the absence of regular influenza virus circulation may lead to a high mismatch rate and a significant reduction in flu vaccine efficacy.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Naghavi M, Abajobir AA, Abbafati C, Abbas KM, Abd-Allah F, Abera SF et al. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: A systematic analysis for the global burden of disease study 2016. Lancet 2017;390(10100):1151–1210.

Noyola DE. Neuraminidase inhibitors in pediatric patients. Pediatr Drugs 2003;5(2): 125–131.

Tripp RA, Stambas J. Intervention strategies for seasonal and emerging respiratory viruses with drugs and vaccines targeting viral surface glycoproteins. Viruses 2021;13(4):625.

Yang Q, Xiao X, Gu X, Liang D, Cao T, Mou J, et al. Surveillance of common respiratory infections during the COVID-19 pandemic demonstrates the preventive efficacy of non-pharmaceutical interventions. Int J Infect Dis 2021;105:442–447.

Meissner HC, Rennels MB. Unpredictable patterns of viral respiratory disease in children. Pediatrics 2004;113(6):1814–1816.

Toelen J, Ritz N, de Winter JP. Changes in pediatric infections during the COVID-19 pandemic: 'A quarantrend for coronials'? Eur J Pediatr 2021;180(6):1965–1967.

Sperotto F, Wolfler A, Biban P, Montagnini L, Ocagli H, Comoretto R, et al. Unplanned and medical admissions to pediatric intensive care units significantly decreased during COVID-19 outbreak in Northern Italy. Eur J Pediat. 2021;180(2):643–648.

McDonnell T, Nicholson E, Conlon C, Barrett M, Cummins F, Hensey C et al. Assessing the impact of COVID-19 public health stages on paediatric emergency attendance. Int J Environ Res Public Health 2020;17(18):6719.

Torretta S, Capaccio P, Coro I, Bosis S, Pace ME, Bosi P, et al. Incidental lowering of otitis-media complaints in otitis-prone children during COVID-19 pandemic: Not all evil Comes to hurt. Eur J Pediatr 2021;180(2):649–652.

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;72(12),2199–2202.

Friedrich F, Ongaratto R, Scotta MC, Veras TN, Stein RT, Lumertz MS, et al. Early impact of social distancing in response to coronavirus disease 2019 on hospitalizations for acute bronchiolitis in infants in Brazil. Clin Infect Dis 2021; 72 (12), 2071–2075.

Polcwiartek LB, Polcwiartek C, Andersen MP, Østergaard L, Broccia MD, Gislason GH, et al. Consequences of coronavirus disease-2019 (COVID-19) lockdown on infection-related hospitalizations among the pediatric population in Denmark. Eur J Pediatr 2021;180(6):1955–1963.

Van Brusselen D, De Troeyer K, Ter Haar E, Vander Auwera A, Poschet K, Van Nuijs, et al. Bronchiolitis in COVID-19 times: A nearly absent disease? Eur J Pediatr 2021;180(6):1969–1973.

Incidence of influenza and acute respiratory infections in Bulgaria [Updated 2021]. [Accessed September 16, 2021].

Leung NHL. Transmissibility and transmission of respiratory viruses. Nat Rev Microbiol 2021;19(8):528–545.

Covid-19: Preparing the future. Looking ahead to winter 2021-22 and beyond. [Updated 2021] [Accessed September 15, 2021.

Gasparyan AY, Ayvazyan L, Mukanova U, Yessirkepov M, Kitas GD. Scientific hypotheses: Writing, promoting, and predicting Implications. J Korean Med Sci 2019;34(45):e300.

Mahase E. Winter pressure: RSV, flu, and covid-19 could push NHS to breaking point, report warns. BMJ 2021; n1802.

Tricco AC, Chit A, Soobiah C, Hallett D, Meier G, Chen MH, et al. Comparing influenza vaccine efficacy against mismatched and matched strains: A systematic review and meta-analysis. BMC Med 2013;11(1):153.

Annual flu programme [Updated 2021] [Accessed August 9, 2021].

Louten J. Virus Structure and Classification. In Essential Human Virology; Elsevier, 2016; 19–29.

Brankston G, Gitterman L, Hirji Z, Lemieux C, Gardam M. Transmission of influenza A in human beings. Lancet Infect Dis 2007;7(4):257–265.

Scientific Brief: SARS-CoV-2 Transmission. [Updated 2021] [Accessed September 1, 2021].

Xiao F, Tang M, Zheng X, Liu Y, Li X, Shan H. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology 2020;158(6):1831-1833.e3.

Minodier L, Masse S, Capai L, Blanchon T, Ceccaldi PE, van der Werf S, et al. Clinical and virological factors associated with gastrointestinal symptoms in patients with acute respiratory infection: A two-year prospective study in general practice medicine. BMC Infect Dis 2017;17(1):729.

Colavita F, Lapa D, Carletti F, Lalle E, Bordi L, Marsella P, et al. SARS-CoV-2 isolation from ocular secretions of a patient with COVID-19 in Italy with prolonged viral RNA detection. Ann Intern Med 2020;173(3):242–243.

Bischoff WE, Reid T, Russell GB, Peters TR. Transocular entry of seasonal influenza-attenuated virus aerosols and the efficacy of N95 respirators, surgical masks, and eye protection in humans. J Infect Dis 2011;204(2):193–199.

Erratum for Euro Surveill. 2020;25(47) [Updated 2020] [Accessed September 2, 2021].

Zipfel CM, Colizza V, Bansal S. The missing season: The impacts of the COVID-19 pandemic on influenza. Vaccine 2021;39(28):3645–3648.

Wang J, Xiao T, Xiao F, Hong S, Wang S, Lin J, et al. Time distributions of common respiratory pathogens under the spread of SARS-CoV-2 among children in Xiamen, China. Front Pediatr 2021;9:584874.

Hills T, Kearns N, Kearns C, Beasley R. Influenza control during the COVID-19 pandemic. Lancet 2020;396(10263):1633–1634.

Angoulvant F, Ouldali N, Yang DD, Filser M, Gajdos V, Rybak A, et al. Coronavirus disease 2019 pandemic: Impact caused by school closure and national lockdown on pediatric visits and admissions for viral and nonviral infections—a time series analysis. Clin Infect Dis 2021;72(2):319–322.

Coronavirus disease (COVID-19): How is it transmitted? [Updated 2021] [Accessed July 9, 2021].

World Health Organization. Transmission of SARS-CoV-2: implications for infection prevention precautions. [Updated 2020] [Accessed July 9, 2021].

Scientific Advisory Group for Emergencies (2021). Masks for Healthcare Workers to Mitigate Airborne Transmission of SARS-CoV-2. [Updated 2021] [Accessed August 31, 2021].

Nickbakhsh S, Mair C, Matthews L, Reeve R, Johnson PCD, Thorburn F, et al. Virus–virus interactions impact the population dynamics of influenza and the common cold. Proc Natl Acad Sci 2019;116(52):27142–27150.

Wu A, Mihaylova VT, Landry ML, Foxman EF. Interference between rhinovirus and influenza A virus: A clinical data analysis and experimental infection study. The Lancet Microbe 2020;1(6):e254–e262.

Takashita E, Kawakami C, Momoki T, Saikusa M, Shimizu K, Ozawa H, et al. Increased risk of rhinovirus infection in children during the coronavirus disease‐19 pandemic. Influenza Other Respi Viruses 2021;15(4):488–494.

Oh D-Y, Buda S, Biere B, Reiche J, Schlosser F, Duwe S, et al. Trends in respiratory virus circulation following COVID-19-targeted nonpharmaceutical interventions in Germany, January - September 2020.

Leung NHL, Chu DKW, Shiu EYC, Chan K-H, McDevitt JJ, Hau BJP, et al. Respiratory virus shedding in exhaled breath and efficacy of face masks. Nat Med 2020;26(5):676–680.

Linde A, Rotzén-Ostlund M, Zweygberg-Wirgart B, Rubinova S, Brytting M. Does viral interference affect spread of influenza? Euro Surveill 2009;14(40):19354.

Ånestad G, Nordbø SA. Virus Interference. Did rhinoviruses activity hamper the progress of the 2009 Influenza A (H1N1) pandemic in Norway? Med Hypotheses 2011;77(6):1132–1134.

Baker RE, Park SW, Yang W, Vecchi GA, Metcalf CJ, Grenfell BT. The impact of COVID-19 nonpharmaceutical interventions on the future dynamics of endemic infections. Proc Natl Acad Sci 2020;117(48):30547–30553.

Foley DA, Yeoh DK, Minney-Smith CA, Martin AC, Mace AO, Sikazwe CT, et al. The interseasonal resurgence of respiratory syncytial virus in Australian children following the reduction of coronavirus disease 2019–related public health measures. Clin Infect Dis. 2021;ciaa1906..

Agha R, Avner JR. Delayed seasonal RSV surge observed during the COVID-19 pandemic. Pediatrics 2021;e2021052089.

Australia's Notifiable Disease Status, 2016: Annual Report of the National Notifiable Diseases Surveillance System. Commun Dis Intell 2021,45.

Kissling E, Hooiveld M, Brytting M, Vilcu A, Lange M, Martínez‐Baz I, et al. Absence of association between 2019‐20 influenza vaccination and COVID‐19: Results of the European I‐MOVE‐COVID‐19 Primary Care Project, March‐August 2020. Influenza Other Respi. Viruses 2021;15(4):429–438.

Conlon A, Ashur C, Washer L, Eagle KA, Hofmann Bowman MA. Impact of the influenza vaccine on COVID-19 infection rates and severity. Am J Infect Control 2021;49(6):694–700.

Kucharski AJ, Lessler J, Cummings DAT, Riley, S. Timescales of influenza A/H3N2 antibody dynamics. PLOS Biol 2018;16(8):e2004974.

Hayward AC, Wang L, Goonetilleke N, Fragaszy EB, Bermingham A, Copas A, et al. Natural T cell–mediated protection against seasonal and pandemic influenza. Results of the Flu Watch Cohort Study. Am J Respir Crit Care Med 2015;191(12):1422–1431.

Sridhar S, Begom S, Bermingham A, Hoschler K, Adamson W, Carman W, et al. Cellular immune correlates of protection against symptomatic pandemic influenza. Nat Med 2013;19(10):1305–1312.

Published
2021-10-05