Impact of Public Health Interventions on Seasonal Influenza Activity During the COVID-19 Outbreak in Korea

Changes in seasonal respiratory viral infections among pediatric population around the COVID-19 pandemic; 2019-2023

PURPOSE

This study aims to describe the prevalence and the fluctuations of respiratory viral infections among the pediatric population in a tertiary care center during 2019-2023, parallel with the COVID-19 pandemic, and the specific preventative measures applied in the region during this time.

METHODS

In this observational study, we extracted all respiratory virus PCR tests collected from pediatric patients (< 15 years old) between January 2019 and March 2023. Data on the positivity rate and prevalence of 18 respiratory viruses were presented over the study period.

RESULTS

The lowest rate for the studied respiratory viruses was observed in 2020/2021 (during the COVID-19 pandemic), followed by a gradual increase in positive cases in the 2021/2022 season. Timing (seasonality) was altered during 2022/2023 with an early circulation of respiratory viruses in May-June followed by an early start of the usual respiratory viruses' season in September, leading to prolonged respiratory virus activity. Most respiratory viruses were circulating at unprecedented levels during the 2022/2023 season, with rhinovirus/enterovirus being the most commonly detected virus in all seasons. Other viruses that had atypical activity after the COVID-19 pandemic were influenza A(H3) virus, adenovirus, and parainfluenza 3 virus.

CONCLUSION

Our study demonstrates the extended influence of the COVID-19 pandemic and its associated community restriction measures on the timing and distribution of other respiratory viruses. Continuous monitoring of changes in the circulation of respiratory viruses is crucial for the success of related public health measures such as vaccination distributions and epidemic preparedness.

Social distancing during the COVID-19 pandemic: Potential impact and correlation with asthma

BACKGROUND

Non-pharmaceutical interventions have been implemented globally to control the COVID-19 pandemic and have been shown to alleviate both allergies and respiratory infections. Although mask-wearing is an accepted non-pharmaceutical intervention, the effects of social distancing have not been thoroughly evaluated.

OBJECTIVES

To evaluate the effects of social distancing on asthma trends in Seoul, South Korea.

METHODS

This study included data from the National Health Insurance Service of South Korea, covering approximately 10 million people in Seoul. Daily and monthly data of patients with asthma from 2018 to 2021 were examined, and the degree of social distancing performance was measured using the number of subway users as an index. Pearson's correlation coefficient was used to determine the relationship between the two indices. The change-point detection technique, cross-correlation, and Granger causality method were used to assess the temporal causality between social distancing and asthma.

RESULTS

The number of patients with asthma decreased by 42.4 % from 2019 to 2020, while that of subway users decreased by 26.3 % during this period. Pearson's correlation analysis revealed significant positive correlations. Asthma and subway users showed a significant change in incidence following the implementation of social distancing; subway users showed a causal relationship with patients with asthma.

CONCLUSION

Our results showed that the number of subway users decreased after the implementation of strict social distancing, coinciding with a decrease in the number of patients with asthma. These findings suggest that social distancing measures implemented to control COVID-19 may reduce the incidence and exacerbation of asthma.

Effusion Prevalence at Tympanostomy During COVID-19: Follow-Up

OBJECTIVE

We previously reported pandemic year (2020) intraoperative middle ear effusion (MEE) rate at time of bilateral myringotomy tube (BMT) placement was 18% lower compared to pre-pandemic year (2019). After mandatory stay at home orders (MSHO) and pandemic social distancing precautions were relaxed, we aimed to assess the impact of a persistent pandemic with new COVID-19 variants on MEE presence during BMT.

METHODS

This study is a retrospective chart summary exempted by Nemours institutional review board at a single tertiary children's hospital. Children < 18 years who underwent BMT during March 1, 2019-June 31, 2019 (pre-COVID), March 1, 2020-June 31, 2020 (PY1), and March 1, 2021-June 31, 2021 (PY2) were included. Statistical analysis included chi-squared and KruskalWallis.

RESULTS

A total of 1069 BMTs were reviewed: 551 (52%) during pre-COVID, 227 (21%) during PY1, and 291 (27%) during PY2. There were no significant differences in age, sex, or BMI across comparison groups. Intraoperative MEE was significantly higher pre-COVID (83%) compared to PY1 (65%) and PY2 (69%) (P < .001) despite a small rebound in PY2.

CONCLUSION

Intraoperative MEE remains lower in subsequent pandemic years despite relaxed public health measures and may be impacted by persistent public health measures like masking, lower return to daycare, variable social distancing, and/or change to access to health care.

Trends in Nationally Notifiable Infectious Diseases in Humans and Animals during COVID-19 Pandemic, South Korea

We investigated trends in notifiable infectious diseases in both humans and animals during the COVID-19 pandemic in South Korea and compared those data against expected trends had nonpharmaceutical interventions (NPIs) not been implemented. We found that human respiratory infectious diseases other than COVID-19 decreased by an average of 54.7% after NPIs were introduced. On the basis of that trend, we estimated that annual medical expenses associated with respiratory infections other than COVID-19 also decreased by 3.8% in 2020 and 18.9% in 2021. However, human gastrointestinal infectious diseases and livestock diseases exhibited similar or even higher incidence rates after NPIs were instituted. Our investigation revealed that the preventive effect of NPIs varied among diseases and that NPIs might have had limited effectiveness in reducing the spread of certain types of infectious diseases. These findings suggest the need for future, novel public health interventions to compensate for such limitations.

Changes in respiratory infection trends during the COVID-19 pandemic in patients with haematologic malignancy

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has changed respiratory infection patterns globally. However, its impact on community-acquired pneumonia (CAP) in high-risk patients with haematological malignancies (HM) is uncertain. We aimed to examine how community-acquired pneumonia aetiology in patients with haematological malignancies changed during the COVID-19 pandemic.

METHODS

This was a retrospective study that included 524 patients with haematological malignancies hospitalised with community-acquired pneumonia between March 2018 and February 2022. Patients who underwent bronchoscopy within 24 h of admission to identify community-acquired pneumonia aetiology were included. Data on patient characteristics, laboratory findings, and results of bronchioalveolar lavage fluid cultures and polymerase chain reaction tests were analysed and compared to identify changes and in-hospital mortality risk factors.

RESULTS

Patients were divided into the 'pre-COVID-19 era' (44.5%) and 'COVID-19 era' (55.5%) groups. The incidence of viral community-acquired pneumonia significantly decreased in the COVID-19 era, particularly for influenza A, parainfluenza, adenovirus, and rhinovirus (pre-COVID-19 era vs. COVID-19 era: 3.0% vs. 0.3%, P = 0.036; 6.5% vs. 0.7%, P = 0.001; 5.6% vs. 1.4%, P = 0.015; and 9.5% vs. 1.7%, P < 0.001, respectively), whereas that of bacterial, fungal, and unknown community-acquired pneumonia aetiologies remain unchanged. Higher Sequential Organ Failure Assessment scores and lower platelet counts correlated with in-hospital mortality after adjusting for potential confounding factors.

CONCLUSIONS

In the COVID-19 era, the incidence of community-acquired pneumonia with viral aetiologies markedly decreased among patients with haematological malignancies, with no changes in the incidence of bacterial and fungal pneumonia. Further studies are required to evaluate the impact of COVID-19 on the prognosis of patients with haematological malignancies and community-acquired pneumonia.

Managing risk of infectious disease transmission at religious mass gatherings: Insights from survey, COVID-19 PCR, and antibody tests from Arbaeen walkers in 2020

BACKGROUND

Arbaeen in Iraq has been one of the largest mass gatherings during the COVID-19 pandemic with 14.5 million attendees in 2020. We set out to assess the prevalence of current or past COVID-19 among 2020 Arbaeen participants, and establish associations between COVID-19 test results, symptoms, and known recent exposure.

METHODS

This was a cross-sectional study involving participants who joined Arbaeen walk in Iraq in October 2020. COVID-19 PCR and/or rapid antibody test were conducted among consented participants. A short questionnaire was administered. Rapid antibody testing was done onsite. Nasal and throat swab samples were transferred to the laboratory for PCR testing.

RESULTS

A total of 835 (88.3% male; 11.7% female) participants were recruited. The most common symptom overall was cough (9.6%) followed by sore throat, fever, and loss of taste/smell (6.6%, 5.5%, and 5.0%, respectively). One in five (20.3%) participants reported close contact with a confirmed COVID-19 case in the past 14 days. Of the 237 participants with a PCR test, 18 (7.6%) were positive. Of the 765 participants with rapid antibody test, 19.3% tested positive for IgM, 39.3% for IgG, and 16.4% for both. Approximately 40% of the participants had evidence of current or past COVID-19 infection based on antibody and PCR.

CONCLUSIONS

The almost 1 in 10 COVID-19 cases within such a multimillion person gathering, illustrates the difficulty in limiting the participation of infectious individuals in religious mass gatherings. There is a pressing need to explore measures to reduce the risk of transmission of infectious diseases at major mass gathering events.

Impact of the coronavirus disease 2019 pandemic on the incidence of other infectious diseases in the hematology hospital in Korea

BACKGROUND/AIMS

Since the coronavirus disease 2019 (COVID-19) outbreak, hospitals have implemented infection control measures to minimize the spread of the virus within facilities. This study aimed to investigate the impact of COVID-19 on the incidence of healthcare-associated infections (HCAIs) and common respiratory virus (cRV) infections in hematology units.

METHODS

This retrospective study included all patients hospitalized in Catholic Hematology Hospital between 2019 and 2020. Patients infected with vancomycin-resistant Enterococci (VRE), carbapenemase-producing Enterobacterales (CPE), Clostridium difficile infection (CDI), and cRV were analyzed. The incidence rate ratio (IRR) methods and interrupted time series analyses were performed to compare the incidence rates before and after the pandemic.

RESULTS

The incidence rates of CPE and VRE did not differ between the two periods. However, the incidence of CDI increased significantly (IRR: 1.41 [p = 0.002]) after the COVID-19 pandemic. The incidence of cRV infection decreased by 76% after the COVID-19 outbreak (IRR: 0.240 [p < 0.001]). The incidence of adenovirus, parainfluenza virus, and rhinovirus infection significantly decreased in the COVID-19 period (IRRs: 0.087 [p = 0.003], 0.031 [p < 0.001], and 0.149 [p < 0.001], respectively).

CONCLUSION

The implementation of COVID-19 infection control measures reduced the incidence of cRV infection. However, CDI increased significantly and incidence rates of CPE and VRE remained unchanged in hematological patients after the pandemic. Infection control measures suitable for each type of HCAI, such as stringent hand washing for CDI and enough isolation capacities, should be implemented and maintained in future pandemics, especially in immunocompromised patients.

Changes in Prevalence and Seasonality of Pathogens Identified in Acute Respiratory Tract Infections in Hospitalised Individuals in Rural and Urban Settings in South Africa; 2018-2022

Severe acute respiratory tract infections (SARIs) has been well described in South Africa with seasonal patterns described for influenza and respiratory syncytial virus (RSV), while others occur year-round (rhinovirus and adenovirus). This prospective syndromic hospital-based surveillance study describes the prevalence and impact of public interventions on the seasonality of other respiratory pathogens during the coronavirus disease-19 (COVID-19) pandemic. This occurred from August 2018 to April 2022, with 2595 patients who met the SARS case definition and 442 controls, from three sentinel urban and rural hospital sites in South Africa. Naso/oro-pharyngeal (NP/OP) swabs were tested using the FastTrack Diagnostics® Respiratory pathogens 33 (RUO) kit. Descriptive statistics, odds ratios, and univariate/multivariate analyses were used. Rhinovirus (14.80%, 228/1540) and Streptococcus pneumoniae (28.50%, 439/1540) were most frequently detected in NP/OP swabs and in children <1 years old (35%, 648/1876). Among others, pathogens associated with SARI cases causing disease were influenza A&B, HRV, RSV, hCoV 229e, Haemophilus influenzae, Staphylococcus aureus, and Streptococcus pneumoniae. Pre-COVID-19, seasonal trends of these pathogens correlated with previous years, with RSV and influenza A seasons only resuming after the national lockdown (2021). It is evident that stringent lockdown conditions have severe impacts on the prevalence of respiratory tract infections.

Evaluating the Effectiveness of Public Health Measures During Infectious Disease Outbreaks: A Systematic Review

Over the previous three decades, the incidence of infectious disease outbreaks has considerably increased and the trend is expected to increase further. Public health measures are essential for controlling and preventing emerging outbreaks of infectious illnesses. This study is aimed at evaluating the effectiveness of public health measures during infectious disease outbreaks by summarizing the outcomes from the available evidence in the literature. A systematic review was carried out through a detailed search strategy using specific keywords applied across different electronic databases, including the Science Direct, PubMed, and EMBASE databases. Studies published between 2015 and 2024 were included with a focus on cohorts, clinical trials, longitudinal studies, case-control, and quasi-experimental studies. Low-quality studies and those published before 2015 along with incorrect findings or measures were excluded. A standardized form was used for data extraction. The quality of included studies and the risk of bias were assessed through relevant techniques. The obtained data was narrative synthesized and findings were organized systematically. The reviewed studies revealed that public health measures are considerably effective against infectious disease outbreaks. The success of various measures such as social isolation, confinement measures, and public education on hygiene against different outbreaks of respiratory infectious diseases has been well-established in the literature. Moreover, the timing of intervention application plays a vital role in their success. The implementation in the early phase of an outbreak is highly effective, as it protects more people from infection and controls the overall burden of the disease. The systematic review provided valuable insights into the efficiency of public health measures in monitoring outbreaks of infectious illnesses. The main findings suggest that appropriate public health interventions are effective in controlling the incidence of contagious disease outbreaks. Ongoing research strives to investigate measures that are most effective from the perspective of public health against various transmittable diseases to prevent future outbreaks.

Assessment of quality of care for hospitalized non-COVID-19 older adult patients with pneumonia before and after the COVID-19 pandemic

BACKGROUND

There is limited research into the clinical implications of the coronavirus disease 2019 (COVID-19) pandemic for non-COVID-19 pneumonia in older adults, as well as their quality of care or outcomes. This study aims to assess the process and outcome quality of care for hospitalized older adult patients with pneumonia before and after the pandemic.

METHODS

A retrospective cohort of older adult patients (age ≥ 65) hospitalized for non-COVID pneumonia were recruited from five Korean hospitals (January 20, 2019, to January 19, 2021). The quality of care before and after the COVID-19 pandemic was evaluated.

RESULTS

A total of 7356 hospitalization episodes of older adult pneumonia were identified, and 978 cases (552 pre-pandemic and 426 during the pandemic) were analyzed. The pneumonia severity score was higher during the pandemic, and the waiting time from the emergency room to admission was also longer. Furthermore, the pneumonia mortality rate during the pandemic was higher than that in the pre-pandemic period (in-hospital mortality: 10.1% vs. 18.1%; 90-day mortality: 11.6% vs. 22.3%). A significantly higher mortality risk was observed during the pandemic than in the period prior (adjusted odds ratio: 1.74, 95% confidence interval: 1.14-2.63).

CONCLUSIONS

While the quality of care for hospitalized pneumonia has been maintained during the pandemic, there has been an increase in mortality rates. Further investigations are needed to understand the underlying causes of this increase.

Influenza viral infection is a risk factor for severe illness in COVID-19 patients: a nationwide population-based cohort study

In order to prepare for the twindemic of influenza and SARS-CoV-2 infection, we investigated the association between influenza infection and subsequent severity of SARS-CoV-2 infection. A population-based nationwide cohort study was performed using data from the National Health Insurance Service (NHIS) in the Republic of Korea. This study included 274,126 individuals who underwent SARS-CoV-2 PCR testing between 20 January 2020 and 1 October 2020. Among these patients, 28,338 tested positive for SARS-CoV-2, and 4,003 of these individuals had a history of influenza. The control group was selected through 1:1 propensity score matching. In the group of 4,003 COVID-19-positive individuals with no history of influenza, 192 (4.8%) experienced severe illness from COVID-19 infection. In the group of 4,003 COVID-19-positive individuals with a history of influenza, 260 (6.5%) had severe illness from COVID-19, and the overall adjusted odds ratio (aOR) was 1.29 (95% confidence interval 1.04-1.59). Among the 4,003 COVID-19-positive individuals with a history of influenza, severe COVID-19 infection was experienced by 143 of 1,760 (8.1%) with an influenza history within 1 year before the onset of COVID-19, 48 of 1,129 (4.3%) between 1 and 2 years, and 69 of 1,114 (6.2%) between 2 and 3 years before COVID-19 onset, and the aORs were 1.54 (1.20-1.98), 1.19 (0.84-1.70), and 1.00 (0.73-1.37), respectively. In conclusion, individuals who had an influenza infection less than 1 year before COVID-19 infection were at an increased risk of experiencing severe illness from the SARS-CoV-2 infection. To control the public health burden, it is essential that effective public health control measures, which include influenza vaccination, hand washing, cough etiquette, and mask use are in place.

Impact of the SARS-CoV-2 pandemic on the overall respiratory viruses' transmission in a cancer care setting

INTRODUCTION AND OBJECTIVE

The emergence of the COVID-19 pandemic raised questions about the interaction between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory viruses. The objective of this study is to validate the impact of the SARS-CoV-2 pandemic and its interventional measures on the respiratory viruses' transmission/infection rates.

METHODS

A retrospective chart review was conducted for cancer patients who underwent laboratory-confirmed respiratory virus polymerase chain reaction (PCR) testing from January 2018 to June 2022. COVID-19 PCR tests from March 2020 to June 2022 were also included. Joinpoint regression analysis was applied to evaluate trends in respiratory virus rates. Statistical analysis was performed using Statistical Package for Social Science software.

RESULTS

A total of 6298 respiratory virus PCRs and 40,000 COVID-19 PCRs were performed. Data showed a significant decrease in respiratory viruses' positive cases, total respiratory tests, and respiratory viruses' activity during the pandemic period compared with the pre-pandemic period (p = .0209, .026, and .028, respectively). The joinpoint regression analysis showed a significant decrease of 13.85% in the tested positive cases of respiratory viruses between the years 2018 and 2022. Monthly, the analysis indicated a significant decrease in the positive cases by 13.46% from December 2019 to May 2021. Weekly analysis following lockdown initiation showed a reduction in respiratory virus cases.

CONCLUSION

This study provides valuable insights into the interplay between COVID-19 and other respiratory viruses, suggesting that the measures taken for COVID-19 were effective in reducing the spread of viral respiratory infections, aiding future infection control strategies to protect vulnerable populations, including cancer patients, from seasonal respiratory infections.

Perceptions of Healthcare Safety Nets among Tertiary Hospital and Long-Term Care Hospital Nurses during the COVID-19 Pandemic: A Q-Methodological Approach

This study was conducted to identify the types of perceptions toward healthcare safety nets. This study applied a Q-methodology. From a Q-population of 91 samples that included a review of the related literature and interviews with five tertiary hospital nurses and five long-term care (LTC) hospital nurses, 33 Q-samples were selected. The data were analyzed with the PC-QUANL program. We recruited 32 nurses in a tertiary hospital and 33 nurses in an LTC hospital. The perceptions of the healthcare safety net of tertiary hospital nurses were categorized into four types: (1) systematic system request; (2) realistic work support; (3) government support; and (4) emotional support. The perceived subjectivity of the healthcare safety net of LTC hospital nurses were categorized into four types: (1) reward system and facility environmental support; (2) realistic work support; (3) social prevention infrastructure support; and (4) government support. This study provides basic data for these different hospital settings, as well as to inform future government policy and system improvements in an era characterized by infectious diseases. Specifically, this study presents the types of perceptions of healthcare safety nets of nurses in two hospital settings that deliver care for patients.

Impact of COVID-19 Pandemic on the Incidence of Pediatric Acute Otitis Media in Seoul, South Korea

OBJECTIVE

The implementation of nonpharmaceutical interventions (NPIs) for coronavirus disease 2019 (COVID-19) may affect the incidence of infectious diseases. This study aimed to evaluate the changes in the incidence of pediatric acute otitis media (AOM) after the COVID-19 outbreak in Seoul, South Korea.

STUDY DESIGN

Retrospective cohort.

SETTING

Tertiary referral center.

PATIENTS

We ascertained the daily number of COVID-19 and pediatric AOM patients between January 20, 2020, and June 19, 2020. During the same period, the number of children using public transportation was used as an index for implementing NPIs. The same period 1 year ago was set as the control period.

INTERVENTION

Diagnostic.

MAIN OUTCOME MEASURE

The differences in the incidence of AOM and implementation of NPIs between the COVID-19 pandemic and control period were analyzed using segmented regression analyses. Negative values of difference meant that the number in the COVID-19 pandemic period declined compared with the control period.

RESULTS

The study period was divided into two sections based on the change point of the COVID-19 cases. In the first period, the increased number of COVID-19 cases decreased, and in the second period, the number of COVID-19 cases increased again. Similar trends were observed in the incidence of AOM and NPI implementation. Before the change point, the study found a significant decreasing trend in the differences in pediatric AOM cases and children using public transportation. However, these trends changed after the change point, with a significant increase in both indices.

CONCLUSION

Our findings indicate that NPIs for COVID-19 may influence the incidence of pediatric AOM.

Alterations in Patients' Clinical Outcomes and Respiratory Viral Pathogen Activity following the COVID-19 Pandemic

BACKGROUND

Before the COVID-19 pandemic, respiratory pathogens such as influenza, parainfluenza, and respiratory syncytial virus were the most commonly detected viruses among hospitalized patients with respiratory tract infections.

METHODS

This was a retrospective observational study of inpatients and outpatients who attended Jordan University Hospital and underwent Nasopharyngeal Aspiration (NPA) in the periods from December 2017 to December 2018 and from December 2021 to December 2022. The results of multiplex respiratory pathogen real-time PCR tests for nasopharyngeal swab specimens were extracted from the electronic-based molecular diagnostic laboratory record of JUH. We compared the prevalence of the detected viruses as well as the patients' characteristics and outcomes between the two periods.

RESULTS

The total number of included patients was 695. Our analysis showed that a higher percentage of patients with hypertension and diabetes presented before the pandemic compared to the same period after it (p-value < 0.001). The need for O2 devices, white blood cell counts, diastolic blood pressure, and the length of hospital stay were significantly higher among patients who presented before the pandemic (p-value < 0.050). Influenza H1N1 (8.70% vs. 4.03%), influenza B (1.67% vs. 0.25%), parainfluenza (1.00% vs. 0.00%), human metapneumovirus (5.35% vs. 0.76%), adenoviruses (6.35% vs. 3.02%), and coronaviruses (8.70% vs. 3.53%) were detected with higher frequency in the period before the pandemic (p-value = 0.011, 0.045, 0.045, 0.000, 0.035, 0.004). These results were similar in terms of changes in the detection rates of viruses after matching the number of tested patients between the periods before and after the pandemic.

CONCLUSIONS

We have demonstrated a reduction in the detection of several viruses, which might be due to the increase in public awareness toward infection protection measures after the COVID-19 pandemic.

Changes in Influenza Activities Impacted by NPI Based on 4-Year Surveillance in China: Epidemic Patterns and Trends

BACKGROUND

Since the Non-pharmaceutical Intervention (NPI) by COVID-19 emerged, influenza activity has been somewhat altered.

OBJECTIVES

The aim of this study was to explore changes in influenza activities in the context of COVID-19 based on the sentinel hospitals/units in Guangdong, southern China.

METHODS

The surveillance data in influenza-like illness (ILI) were collected from 21 cities in Guangdong between September 2017 and August 2021, while 43 hospitals/units were selected to analyze the predominant types of influenza, population characteristics, and seasonal features by three methods (the concentration ratio, the seasonal index, and the circulation distribution), based on a descriptive epidemiological approach.

RESULTS

During the four consecutive influenza seasons, a total of 157345 ILIs were tested, of which 9.05% were positive for influenza virus (n = 14238), with the highest positive rates for both IAV (13.20%) and IBV (5.41%) in the 2018-2019 season. After the emergence of COVID-19, influenza cases decreased near to zero from March 2020 till March 2021, and the dominant type of influenza virus changed from IAV to IBV. The highest positive rate of influenza existed in the age-group of 5 ~  < 15 years in each season for IAV (P < 0.001), which was consistent with that for IBV (P < 0.001). The highest annual positive rates for IBV emerged in eastern Guangdong, while the highest annual positive rates of IAV in different seasons existed in different regions. Furthermore, compared with the epidemic period (ranged from December to June) during 2017-2019, the period ended three months early (March 2020) in 2019-2020, and started by five months behind (April 2021) during 2020-2021.

CONCLUSION

The highest positive rates in 5 ~  < 15 age-group suggested the susceptible in this age-group mostly had infected with infected B/Victoria. Influenced by the emergence of COVID-19 and NPI responses, the epidemic patterns and trends of influenza activities have changed in Guangdong, 2017-2021.

Impact of SARS-CoV-2-Related Hygiene Measures on Community-Acquired Respiratory Virus Infections in Lung Transplant Recipients in Switzerland

Background and Objectives: Community-acquired respiratory virus (CARV) infections pose a serious risk for lung transplant recipients (LTR) as they are prone to severe complications. When the COVID-19 pandemic hit Switzerland in 2020, the government implemented hygiene measures for the general population. We investigated the impact of these measures on the transmission of CARV in lung transplant recipients in Switzerland. Materials and Methods: In this multicenter, retrospective study of lung transplant recipients, we investigated two time periods: the year before the COVID-19 pandemic (1 March 2019-29 February 2020) and the first year of the pandemic (1 March 2020-28 February 2021). Data were mainly collected from the Swiss Transplant Cohort Study (STCS) database. Descriptive statistics were used to analyze the results. Results: Data from 221 Swiss lung transplant cohort patients were evaluated. In the year before the COVID-19 pandemic, 157 infections were diagnosed compared to 71 infections in the first year of the pandemic (decline of 54%, p < 0.001). Influenza virus infections alone showed a remarkable decrease from 17 infections before COVID-19 to 2 infections after the beginning of the pandemic. No significant difference was found in testing behavior; 803 vs. 925 tests were obtained by two of the three centers during the respective periods. Conclusions: We observed a significant decline in CARV infections in the Swiss lung transplant cohort during the first year of the COVID-19 pandemic. These results suggest a relevant impact of hygiene measures when implemented in the population due to the COVID-19 pandemic on the incidence of CARV infections.

Reduced incidence of respiratory, gastrointestinal and malaria infections among children during the COVID-19 pandemic in Western Kenya: An analysis of facility-based and weekly diaries data

Background

Epidemics can cause significant disruptions of essential health care services. This was evident in West-Africa during the 2014-2016 Ebola outbreak, raising concerns that COVID-19 would have similar devastating consequences for the continent. Indeed, official facility-based records show a reduction in health care visits after the onset of COVID-19 in Kenya. Our question is whether this observed reduction was caused by lower access to health care or by reduced incidence of communicable diseases resulting from reduced mobility and social contacts.

Methods

We analysed monthly facility-based data from 2018 to 2020, and weekly health diaries data digitally collected by trained fieldworkers between February and November 2020 from 342 households, including 1974 individuals, in Kisumu and Kakamega Counties, Kenya. Diaries data was collected as part of an ongoing longitudinal study of a digital health insurance scheme (Kakamega), and universal health coverage implementation (Kisumu). We assessed the weekly incidence of self-reported medical symptoms, formal and informal health-seeking behaviour, and foregone care in the diaries and compared it with facility-based records. Linear probability regressions with household fixed-effects were performed to compare the weekly incidence of health outcomes before and after COVID-19.

Results

Facility-based data showed a decrease in health care utilization for respiratory infections, enteric illnesses, and malaria, after start of COVID-19 measures in Kenya in March 2020. The weekly diaries confirmed this decrease in respiratory and enteric symptoms, and malaria / fever, mainly in the paediatric population. In terms of health care seeking behaviour, our diaries data find a temporary shift in consultations from health care centres to pharmacists / chemists / medicine vendors for a few weeks during the pandemic, but no increase in foregone care. According to the diaries, for adults the incidence of communicable diseases/symptoms rebounded after COVID-19 mobility restrictions were lifted, while for children the effects persisted.

Conclusions

COVID-19-related containment measures in Western Kenya were accompanied by a decline in respiratory infections, enteric illnesses, and malaria / fever mainly in children. Data from a population-based survey and facility-based records aligned regarding this finding despite the temporary shift to non-facility-based consultations and confirmed that the drop in utilization of health care services was not due to decreased accessibility, but rather to a lower incidence of these infections.

[Distribution characteristics and results of allergens in patients with allergic rhinitis in Ningxia area]

Objective:To investigate the distribution of allergens in patients with allergic rhinitis （AR） in Ningxia, and provide theoretical data for the prevention and treatment of AR in this region. Methods:A total of 1664 patients diagnosed with AR in the Otorhinolaryngology Head and Neck Surgery Department of Yinchuan First People's Hospital Outpatient Clinic from January 2018 to December 2021 were retrospectively collected. Use the allergen sIgE antibody detection kit （immunoblotting method） to detect inhalation and ingestion allergens in patients.Results: ①Among all AR patients, 1 158 cases were detected positive, resulting in the detection rate was 69.59%; ②The detection rate of inhalation allergen was 65.87%, and the detection rate of ingestion allergen was 19.83%; ③Mugwort was the most sensitive allergen, and 76.32% of the patients having a positive grade ≥3; ④Out of the patients, 294 cases （25.39%） were allergic to only one allergen, 244 cases （21.07%） were allergic to two allergens, and 620 cases （53.54%） were allergic to three or more allergens; ⑤During different seasons, the highest number of positive allergens detected was in the summer, with 968 cases （83.59%）. Mugwort was the main allergen during this season （69.01%）. After the COVID-19 epidemic, the total positive rate of sIgE tests in AR patients decreased compared to before, and the difference was statistically significant （P<0.001）; ⑥Mugwort, dog epithelium, mold combination, egg, peanut, soybean, Marine fish combination and fruit combination all showed statistically significant differences between different gender groups （P<0.05）; ⑦Common ragweed, mugwort, dust mite combination, cockroach, egg, milk, Marine fish combination, shrimp, fruit combination and nut combination all showed statistically significant differences among different age groups （P<0.05）; ⑧There were statistically significant differences in hay dust among different ethnic groups （P<0.05）. Conclusion:Artemisia argyi is the main allergen in Ningxia, and the distribution characteristics of different allergens are influenced by treatment season, the COVID-19 epidemic, gender, age, ethnicity, and other factors, showing certain distribution patterns and rules.

Global variability of influenza activity and virus subtype circulation from 2011 to 2023

BACKGROUND

Although decreased influenza activity has been reported in many countries during the COVID-19 pandemic, it remains unknown how global influenza activity has changed. We described the global variability of influenza activity and virus subtype circulation from 2011 to 2023 to prepare for the potential influenza outbreak with the control of the COVID-19 pandemic.

METHODS

Influenza virological surveillance data between 2011 and 2023 were obtained from the WHO-FluNet database. We first calculated and compared the influenza activity before and during the COVID-19 pandemic. For countries whose influenza activity has recovered, we also described changes in the duration of influenza epidemics. We then determined the proportion of influenza cases caused by the different influenza virus types.

RESULTS

In total, 73 countries with 2.17 million influenza cases were included. In the early stage of the COVID-19 pandemic, decreased influenza activity was observed in all WHO regions. In 2022 and 2023, rebound in influenza activity was observed in all WHO regions, especially in Western Pacific Region. At the same time, a change in the duration of the influenza epidemic was observed in several Southern Hemisphere countries. Moreover, in all WHO regions, few B/Yamagata viruses were detected during the COVID-19 pandemic.

CONCLUSIONS

Lack of exposure to influenza will diminish population immunity and increase the severity of large epidemics on a future global resurgence. Ongoing monitoring of the changes in the duration of the influenza epidemic and circulation subtypes should be the focus of future work.

Transient Decrease in Incidence Rate of Maternal Primary Cytomegalovirus Infection during the COVID-19 Pandemic in Japan

This study evaluated the impact of the coronavirus disease 2019 (COVID-19) pandemic on the occurrence of maternal primary cytomegalovirus (CMV) infection in Japan. We performed a nested case-control study using data from maternal CMV antibody screening under the Cytomegalovirus in Mother and infant-engaged Virus serology (CMieV) program in Mie, Japan. Pregnant women with negative IgG antibodies at ≤20 weeks of gestation who were retested at ≥28 weeks were enrolled. The study period was divided into 2015-2019 as the pre-pandemic and 2020-2022 as the pandemic period, and the study site included 26 institutions conducting the CMieV program. The incidence rate of maternal IgG seroconversion was compared between the pre-pandemic (7008 women enrolled) and pandemic (2020, 1283 women enrolled; 2021, 1100 women; and 2022, 398 women) periods. Sixty-one women in the pre-pandemic period and five, four, and five women during 2020, 2021, and 2022, respectively, showed IgG seroconversion. The incidence rates in 2020 and 2021 were lower (p < 0.05) than that in the pre-pandemic period. Our data suggest a transient decrease in the incidence of maternal primary CMV infection in Japan during the COVID-19 pandemic, which could be due to prevention and hygiene measures taken at the population level.

Pediatric respiratory admissions and related viral infections during the COVID-19 pandemic

INTRODUCTION

The COVID-19 pandemic has affected the incidence of respiratory viral infections. Our aim was to assess changes in pediatric admissions due to respiratory diseases and associated respiratory viral infections.

METHODS

An observational study including all respiratory admissions to the pediatric departments from January 2015 to August 2021. We compared respiratory admission percentage, respiratory viral panel results and clinical characteristics of these admissions between two study periods, January 2015 to February 2020 (pre-COVID-19 era) and March 2020 to August 2021 (COVID-19 era).

RESULTS

A total of 8774 respiratory admissions were included, 7157 pre-COVID-19 era and 1617 COVID-19 era. Relative to all pediatric admissions, there was a 17% decrease in respiratory admission percentage during the COVID-19 era (p < 0.001) and a 31% and 22% decreased in the admission percentages due to bronchiolitis (p < 0.001) and pneumonia (p < 0.001), respectively. However, admission percentages for asthma, wheezing illness, complicated pneumonia, and stridor remained the same. There was a significant decrease in the detection of a respiratory viral pathogen associated with these respiratory admissions (p < 0.001). This was related to a significant decrease in the detection of respiratory syncytial virus (RSV) (37% vs. 27%, p < 0.001) and influenza (5% vs. 0.3%, p < 0.001), but not other respiratory viruses. An alteration in the circulation pattern of most respiratory viruses, was observed.

CONCLUSIONS

During the COVID-19 pandemic, a decrease in the prevalence of RSV and influenza was associated with a significant decrease in admissions for bronchiolitis and pediatric pneumonia. This may allow us to estimate the significance of preventive measures for RSV and influenza on pediatric respiratory admissions.

Twenty-Five Year Trend Change in the Etiology of Pediatric Invasive Bacterial Infections in Korea, 1996-2020

BACKGROUND

The coronavirus disease-2019 (COVID-19) pandemic has contributed to the change in the epidemiology of many infectious diseases. This study aimed to establish the pre-pandemic epidemiology of pediatric invasive bacterial infection (IBI).

METHODS

A retrospective multicenter-based surveillance for pediatric IBIs has been maintained from 1996 to 2020 in Korea. IBIs caused by eight bacteria (Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pyogenes, Listeria monocytogenes, and Salmonella species) in immunocompetent children > 3 months of age were collected at 29 centers. The annual trend in the proportion of IBIs by each pathogen was analyzed.

RESULTS

A total of 2,195 episodes were identified during the 25-year period between 1996 and 2020. S. pneumoniae (42.4%), S. aureus (22.1%), and Salmonella species (21.0%) were common in children 3 to 59 months of age. In children ≥ 5 years of age, S. aureus (58.1%), followed by Salmonella species (14.8%) and S. pneumoniae (12.2%) were common. Excluding the year 2020, there was a trend toward a decrease in the relative proportions of S. pneumoniae (r_s = -0.430, P = 0.036), H. influenzae (r_s = -0.922, P < 0.001), while trend toward an increase in the relative proportion of S. aureus (r_s = 0.850, P < 0.001), S. agalactiae (r_s = 0.615, P = 0.001), and S. pyogenes (r_s = 0.554, P = 0.005).

CONCLUSION

In the proportion of IBIs over a 24-year period between 1996 and 2019, we observed a decreasing trend for S. pneumoniae and H. influenzae and an increasing trend for S. aureus, S. agalactiae, and S. pyogenes in children > 3 months of age. These findings can be used as the baseline data to navigate the trend in the epidemiology of pediatric IBI in the post COVID-19 era.

Why is Success of South Korea's Covid-19 Response Fading?

South Korea demonstrated its ability to respond effectively with rapid policy measures and implementation in the early stages of the pandemic. However, at the end of second year of the pandemic, South Korea reached a peak in its number of daily new cases. Why didn't South Korea maintain the initial successful performance? To answer the question, this study examined South Korea's pandemic response process through Complex Adaptive Systems (CAS), focusing on actors' behavior according to the phase transition. We found that the South Korean government failed to interact with the rapidly evolving public due to the different evolving pace. Dissonance between the government and the public resulted in distrust, fatigue, and resistance to the government's policy among people. From the case study of South Korea, this study emphasizes that not only individual governments, but also the international community, should anticipate and interact with the rapidly evolving public to prepare for the pandemic and post-pandemic era.

Whole-Genome Analysis of Influenza A(H3N2) and B/Victoria Viruses Detected in Myanmar during the COVID-19 Pandemic in 2021

An influenza circulation was observed in Myanmar between October and November in 2021. Patients with symptoms of influenza-like illness were screened using rapid diagnostic test (RDT) kits, and 147/414 (35.5%) upper respiratory tract specimens presented positive results. All RDT-positive samples were screened by a commercial multiplex real-time polymerase chain reaction (RT-PCR) assay, and 30 samples positive for influenza A(H3N2) or B underwent further typing/subtyping for cycle threshold (Ct) value determination based on cycling probe RT-PCR. The majority of subtyped samples (n = 13) were influenza A(H3N2), while only three were B/Victoria. Clinical samples with low Ct values obtained by RT-PCR were used for whole-genome sequencing via next-generation sequencing technology. All collected viruses were distinct from the Southern Hemisphere vaccine strains of the corresponding season but matched with vaccines of the following season. Influenza A(H3N2) strains from Myanmar belonged to clade 2a.3 and shared the highest genetic proximity with Bahraini strains. B/Victoria viruses belonged to clade V1A.3a.2 and were genetically similar to Bangladeshi strains. This study highlights the importance of performing influenza virus surveillance with genetic characterization of the influenza virus in Myanmar, to contribute to global influenza surveillance during the COVID-19 pandemic.

Influence of COVID-19-Related Interventions on the Number of Inpatients with Acute Viral Respiratory Infections: Using Interrupted Time Series Analysis

After the first COVID-19 patient was diagnosed, non-pharmaceutical interventions such as social distancing and behavior change campaigns were implemented in South Korea. The social distancing policy restricted unnecessary gatherings and activities to prevent local transmission. This study aims to evaluate the effect of social distancing, a strategy for COVID-19 prevention, on the number of acute respiratory infection inpatients. This study used the number of hospitalized patients with acute respiratory infection from the Infectious Disease Portal of the Korea Centers for Disease Control and Prevention (KCDC) between the first week of January 2018, to the last week of January 2021. Intervention 1t represents the first patient occurrence of COVID-19, Intervention 2t represents the relaxing of the social distancing policy. We used acute respiratory infection statistics from Korea and segmented regression analysis was used. The analysis showed that the trend of the number of acute respiratory infection inpatients decreased after the implementation of the first patient incidence of COVID-19 due to prevention activities. After the relaxing of the social distancing policy, the number of inpatients with acute respiratory infections significantly increased. This study verified the effect of social distancing on the reduction in hospital admissions for acute respiratory viral infections.

Low prevalence of influenza viruses and predominance of A(H3N2) virus with respect to SARS-CoV-2 during the 2021-2022 season in Bulgaria

Social distancing, mask-wearing, and travel restrictions during the COVID-19 pandemic have significantly impacted the spread of influenza viruses. The objectives of this study were to analyze the pattern of influenza virus circulation with respect to that of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Bulgaria during the 2021-2022 season and to perform a phylogenetic/molecular analysis of the hemagglutinin (HA) and neuraminidase (NA) sequences of representative influenza strains. Influenza infection was confirmed using real-time reverse transcription polymerase chain reaction in 93 (4.2%) of the 2193 patients with acute respiratory illness tested wherein all detected viruses were subtyped as A(H3N2). SARS-CoV-2 was identified in 377 (24.3%) of the 1552 patients tested. Significant differences in the incidence of influenza viruses and SARS-CoV-2 were found between individual age groups, outpatients/inpatients, and in the seasonal distribution of cases. Two cases of coinfections were identified. In hospitalized patients, the C_t values of influenza viruses at admission were lower in adults aged ≥65 years (indicating higher viral load) than in children aged 0-14 years (p < 0.05). In SARS-CoV-2-positive inpatients, this association was not statistically significant. HA genes of all A(H3N2) viruses analyzed belonged to subclade 3C.2a1b.2a. The sequenced viruses carried 11 substitutions in HA and 5 in NA, in comparison to the vaccine virus A/Cambodia/e0826360/2020, including several substitutions in the HA antigenic sites B and C. This study revealed extensive changes in the typical epidemiology of influenza infection, including a dramatic reduction in the number of cases, diminished genetic diversity of circulating viruses, changes in age, and seasonal distribution of cases.

Impact of air pollutants on influenza-like illness outpatient visits under COVID-19 pandemic in the subcenter of Beijing, China

This study aimed to explore the association between air pollutants and outpatient visits for influenza-like illnesses (ILI) under the coronavirus disease 2019 (COVID-19) stage in the subcenter of Beijing. The data on ILI in the subcenter of Beijing from January 1, 2018 to December 31, 2020 were obtained from the Beijing Influenza Surveillance Network. A generalized additive Poisson model was applied to examine the associations between the concentrations of air pollutants and daily outpatient visits for ILI when controlling meteorological factors and temporal trend. A total of 171 943 ILI patients were included. In the pre-coronavirus disease 2019 (COVID-19) stage, an increased risk of ILI outpatient visits was associated to a high air quality index (AQI) and the high concentrations of particulate matter less than 2.5 (PM_2.5 ), particulate matter 10 (PM₁₀ ), sulphur dioxide (SO₂ ), nitrogen dioxide (NO₂ ), and carbon monoxide (CO), and a low concentration of ozone (O₃ ) on lag0 day and lag1 day, while a higher increased risk of ILI outpatient visits was observed by the air pollutants in the COVID-19 stage on lag0 day. Except for PM₁₀ , the concentrations of other air pollutants on lag1 day were not significantly associated with an increased risk of ILI outpatient visits during the COVID-19 stage. The findings that air pollutants had enhanced immediate effects and diminished lag-effects on the risk of ILI outpatient visits during the COVID-19 pandemic, which is important for the development of public health and environmental governance strategies.

Real-Time Monitoring of Infectious Disease Outbreaks with a Combination of Google Trends Search Results and the Moving Epidemic Method: A Respiratory Syncytial Virus Case Study

The COVID-19 pandemic has disrupted the seasonal patterns of several infectious diseases. Understanding when and where an outbreak may occur is vital for public health planning and response. We usually rely on well-functioning surveillance systems to monitor epidemic outbreaks. However, not all countries have a well-functioning surveillance system in place, or at least not for the pathogen in question. We utilized Google Trends search results for RSV-related keywords to identify outbreaks. We evaluated the strength of the Pearson correlation coefficient between clinical surveillance data and online search data and applied the Moving Epidemic Method (MEM) to identify country-specific epidemic thresholds. Additionally, we established pseudo-RSV surveillance systems, enabling internal stakeholders to obtain insights on the speed and risk of any emerging RSV outbreaks in countries with imprecise disease surveillance systems but with Google Trends data. Strong correlations between RSV clinical surveillance data and Google Trends search results from several countries were observed. In monitoring an upcoming RSV outbreak with MEM, data collected from both systems yielded similar estimates of country-specific epidemic thresholds, starting time, and duration. We demonstrate in this study the potential of monitoring disease outbreaks in real time and complement classical disease surveillance systems by leveraging online search data.

Analysis of Changes in Antibiotic Use Patterns in Korean Hospitals during the COVID-19 Pandemic

With the onset of the coronavirus disease 2019 (COVID-19) pandemic, changes in patient care and antibiotic use have occurred in hospitals. The data of the National Health Insurance System's claims of inpatients from all hospitals in Korea between January 2019 and December 2020 were obtained from the Health Insurance Review & Assessment Service and analyzed. The trend in the use of all antibacterial agents in both hospitals declined for the total number of COVID-19 patients at the bottom 10% and those in the top 10%. Specifically, a decreasing trend in the use of broad-spectrum antibacterial agents predominantly prescribed for community-acquired cases and narrow-spectrum beta-lactam agents were observed in both hospitals. In the aftermath of the COVID-19 pandemic, the total use of antibacterial agents has gradually decreased among patients with pneumonia and those with severe COVID-19. In contrast, its use has increased gradually among those with mild to moderate COVID-19. A decreasing trend in overall antibiotic use was observed during the COVID-19 pandemic, and an increasing trend in antibiotic use was observed in patients with mild to moderate COVID-19 in Korean hospitals.

Viral and Bacterial Respiratory Pathogens during the COVID-19 Pandemic in Israel

BACKGROUND

previous worldwide reports indicated a substantial short-term reduction in various respiratory infections during the early phase of the SARS-CoV-2 pandemic.

AIMS

exploring the long-term impact of the COVID-19 pandemic on respiratory pathogens.

METHODS

retrospective analysis of bacterial and viral positivity rate in respiratory samples, between 1 January 2017-30 June 2022 in a tertiary hospital in Jerusalem, Israel.

RESULTS

A decline in overall respiratory tests and positivity rate was observed in the first months of the pandemic. Respiratory isolations of Hemophilus influenza and Streptococcus pneumoniae were insignificantly affected and returned to their monthly average by November 2020, despite a parallel surge in COVID-19 activity, while Mycoplasma pneumoniae was almost eliminated from the respiratory pathogens scene. Each viral pathogen acted differently, with adenovirus affected only for few months. Human-metapneumovirus and respiratory-syncytial-virus had reduced activity for approximately a year, and influenza A virus resurged in November 2021 with the elimination of Influenza-B.

CONCLUSIONS

After an immediate decline in non-SARS-CoV-2 respiratory infections, each pathogen has a different pattern during a 2-year follow-up. These patterns might be influenced by intrinsic factors of each pathogen and different risk reduction behaviors of the population. Since some of these measures will remain in the following years, we cannot predict the timing of return to pre-COVID-19 normalcy.

Changes in the Incidence of Immune Thrombocytopenia in the Coronavirus Disease 2019 Era: A Nationwide Observational Study in Korea

Purpose

We investigated whether nonpharmaceutical interventions (NPI) to reduce the spread of coronavirus disease 2019 (COVID-19) was associated with a change in the incidence of immune thrombocytopenia (ITP).

Patients and Methods

Using the Korean Health Insurance Review and Assessment Services (HIRA) database, individuals newly diagnosed with ITP between January 2015 and December 2020 were identified. The NPI period was defined as February 2020 to December 2020. The ITP incidence in the NPI period was compared with the mean annual incidence during the same months in the pre-NPI period and the incidence predicted by the autoregressive integrated moving average model.

Results

In total, 25,723 patients were identified, and the overall annual incidence of ITP was 8.28 per 100,000 persons ([95% confidence interval (CI): 8.18-8.39]. The ITP incidence in the NPI period was 6.60 per 100,000 person-years (95% CI: 6.37-6.85), 0.77 times (95% CI: 0.74-0.80) lower than that during the pre-NPI period [8.62/100,000 (95% CI: 8.50-8.74)]. With the exception for patients aged ≥70 years, the ITP incidence was significantly lower in the NPI period than in the pre-NPI period. The most significant decline in the ITP incidence during the NPI period was observed in the 0-9 years age group [25.76/100,000 vs 14.01/100,000, P <0.001; incidence rate ratio (IRR): 0.54 (95% CI: 0.51-0.58)]. The intravenous immunoglobulin-treated ITP incidence in the NPI period was 1.69/100,000 (95% CI: 1.58-1.81), 0.79 times (95% CI: 0.73-0.85) lower than that in the pre-NPI period 2.15/100,000 (95% CI: 2.09-2.21)]. The incidence of steroid-treated ITP was lower in the NPI period than in the pre-NPI period (2.73/100,000 vs 2.2/100,000, P <0.001), with an IRR of 0.80 (95% CI: 0.76-0.83).

Conclusion

This nationwide study revealed a significant decrease in ITP incidence, particularly among children, after the implementation of NPI.

Sharp decline in rates of community respiratory viral detection among patients at the National Institutes of Health Clinical Center during the coronavirus disease 2019 (COVID-19) pandemic

OBJECTIVES

To analyze the frequency and rates of community respiratory virus infections detected in patients at the National Institutes of Health Clinical Center (NIHCC) between January 2015 and March 2021, comparing the trends before and during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

We conducted a retrospective study comparing frequency and rates of community respiratory viruses detected in NIHCC patients between January 2015 and March 2021. Test results from nasopharyngeal swabs and washes, bronchoalveolar lavages, and bronchial washes were included in this study. Results from viral-challenge studies and repeated positives were excluded. A quantitative data analysis was completed using cross tabulations. Comparisons were performed using mixed models, applying the Dunnett correction for multiplicity.

RESULTS

Frequency of all respiratory pathogens declined from an annual range of 0.88%-1.97% between January 2015 and March 2020 to 0.29% between April 2020 and March 2021. Individual viral pathogens declined sharply in frequency during the same period, with no cases of influenza A/B orparainfluenza and 1 case of respiratory syncytial virus (RSV). Rhino/enterovirusdetection continued, but with a substantially lower frequency of 4.27% between April 2020 and March 2021, compared with an annual range of 8.65%-18.28% between January 2015 and March 2020.

CONCLUSIONS

The decrease in viral respiratory infections detected in NIHCC patients during the pandemic was likely due to the layered COVID-19 prevention and mitigation measures implemented in the community and the hospital. Hospitals should consider continuing the use of nonpharmaceutical interventions in the future to prevent nosocomial transmission of respiratory viruses during times of high community viral load.

Study on the influence of meteorological factors on influenza in different regions and predictions based on an LSTM algorithm

BACKGROUND

Influenza epidemics pose a threat to human health. It has been reported that meteorological factors (MFs) are associated with influenza. This study aimed to explore the similarities and differences between the influences of more comprehensive MFs on influenza in cities with different economic, geographical and climatic characteristics in Fujian Province. Then, the information was used to predict the daily number of cases of influenza in various cities based on MFs to provide bases for early warning systems and outbreak prevention.

METHOD

Distributed lag nonlinear models (DLNMs) were used to analyse the influence of MFs on influenza in different regions of Fujian Province from 2010 to 2021. Long short-term memory (LSTM) was used to train and model daily cases of influenza in 2010-2018, 2010-2019, and 2010-2020 based on meteorological daily values. Daily cases of influenza in 2019, 2020 and 2021 were predicted. The root mean squared error (RMSE), mean absolute error (MAE), mean absolute percentage error (MAPE) and symmetric mean absolute percentage error (SMAPE) were used to quantify the accuracy of model predictions.

RESULTS

The cumulative effect of low and high values of air pressure (PRS), air temperature (TEM), air temperature difference (TEMD) and sunshine duration (SSD) on the risk of influenza was obvious. Low (< 979 hPa), medium (983 to 987 hPa) and high (> 112 hPa) PRS were associated with a higher risk of influenza in women, children aged 0 to 12 years, and rural populations. Low (< 9 °C) and high (> 23 °C) TEM were risk factors for influenza in four cities. Wind speed (WIN) had a more significant effect on the risk of influenza in the ≥ 60-year-old group. Low (< 40%) and high (> 80%) relative humidity (RHU) in Fuzhou and Xiamen had a significant effect on influenza. When PRS was between 1005-1015 hPa, RHU > 60%, PRE was low, TEM was between 10-20 °C, and WIN was low, the interaction between different MFs and influenza was most obvious. The RMSE, MAE, MAPE, and SMAPE evaluation indices of the predictions in 2019, 2020 and 2021 were low, and the prediction accuracy was high.

CONCLUSION

All eight MFs studied had an impact on influenza in four cities, but there were similarities and differences. The LSTM model, combined with these eight MFs, was highly accurate in predicting the daily cases of influenza. These MFs and prediction models could be incorporated into the influenza early warning and prediction system of each city and used as a reference to formulate prevention strategies for relevant departments.

Impact of non-pharmaceutical interventions targeted at the COVID-19 pandemic on the incidence of influenza-like illness in the UK Armed Forces

INTRODUCTION

Non-pharmaceutical interventions (NPIs) such as lockdown, social distancing and use of face coverings was adopted by the United Kingdom (UK) Armed Forces (AF) during the COVID-19 pandemic. This study assessed the impact of the use of NPIs on the incidence of influenza-like illness (ILI) in the UK AF.

METHODS

A longitudinal study design was adopted, and secondary data was analysed retrospectively. Clinical Read codes for ILI was used to generate data for flu seasons before and during the COVID-19 pandemic (September 2017 to April 2021).

RESULTS

Before the COVID-19 pandemic, the rate of reporting ILI was ~ 4% across all flu seasons. The count of ILI was 2.9%, 2.2% and 3.1% during 2017-18, 2018-19 and 2019-20 flu seasons respectively. During the COVID-19 pandemic, both the rate of reporting ILI (0.6%) and the count of ILI (0.5%) were significantly smaller (p < .001). The rate of reporting ILI was positively correlated with the count of ILI (r (2) = .97, p = .014). Influenza vaccination rate increased by 1.3% during the COVID-19 pandemic. Vaccination rate was negatively correlated with the rate of reporting ILI (r (2) = -.52, p = 0.24) and the count of ILI (r (2) = -.61, p = 0.19). However, this correlation was not significant. The use of NPIs was negatively correlated with the rate of reporting ILI (r (2) = -.99, p = < .001) and the count of ILI (r (2) = -.95, p = 0.026). The overall multiple regression performed was statistically significant (R2 = 0.94, F (1, 2) = 33.628, p = 0.028). The rate of reporting ILI significantly predicted the count of ILI (β = 0.609, p = 0.028) while vaccination rate did not significantly predict the count of ILI (β = -0.136, p = 0.677).

CONCLUSIONS

The incidence of ILI in the UK AF was significantly reduced during the COVID-19 pandemic. The use of NPIs and the rate of reporting ILI significantly reduced the count of ILI. Being vaccinated for influenza did not significantly reduce the count of ILI.

The epidemiological features of pediatric viral respiratory infection during the COVID-19 pandemic in Taiwan

BACKGROUND

Enhanced nonpharmaceutical interventions (NPIs) to prevent the Coronavirus Disease 2019 (COVID-19) have shown various levels of impact on common respiratory pathogens. We aimed to analyze the epidemiological changes seen in certain common respiratory viruses found in Taiwanese children (e.g., influenza virus, enterovirus, parainfluenza virus, adenovirus and respiratory syncytial virus (RSV)) after the implementation of public health measures, as well as interpret the possible meaning of these changes.

METHODS

This retrospective observational study examined the viral isolation from children younger than 18 years at a medical center in central Taiwan during the period January 2015-December 2020, a time frame of six years. Viral isolations prior to the COVID-19 pandemic (January 2015-December 2019), along with those during the post-COVID-19 period (January-December 2020) were analyzed and compared.

RESULTS

A total of 6899 throat swab samples were collected during the pre-pandemic period of 2015-2019, with 2681 of them having a positive result (38.86%). There were a total of 713 samples collected in 2020, with 142 of them showing positive results (19.92%). The overall positive rate of viral isolates significantly decreased in 2020 (p < 0.001). Declines in the isolation of the influenza virus, parainfluenza virus, adenovirus and enterovirus were observed. The RSV surprisingly became the leading isolate, with up to 47 (6.59%) instances in 2020, and showing an unusual peak in the winter of 2020. The rise began in September of 2020 and reached its plateau in November of that year.

CONCLUSIONS

Most respiratory viruses decreased under NPIs regarding SARS-CoV-2. However, the RSV outbreak in the winter of 2020 had shown the limitation of current NPIs. Possible explanations have been discussed in details and public preventive measures should be reinforced for RSV, particularly amongst people having young children both at home and in care centers.

Associations Between Conventional Healthy Behaviors and Social Distancing During the COVID-19 Pandemic: Evidence From the 2020 Community Health Survey in Korea

OBJECTIVES

Many studies have shown that social distancing, as a non-pharmaceutical intervention (NPI) that is one of the various measures against coronavirus disease 2019 (COVID-19), is an effective preventive measure to suppress the spread of infectious diseases. This study explored the relationships between traditional health-related behaviors in Korea and social distancing practices during the COVID-19 pandemic.

METHODS

Data were obtained from the 2020 Community Health Survey conducted by the Korea Disease Control and Prevention Agency (n=98 149). The dependent variable was the degree of social distancing practice to cope with the COVID-19 epidemic. Independent variables included health-risk behaviors and health-promoting behaviors. The moderators were vaccination and unmet medical needs. Predictors affecting the practice of social distancing were identified through hierarchical multiple logistic regression analysis.

RESULTS

Smokers (adjusted odds ratio [aOR], 0.924) and frequent drinkers (aOR, 0.933) were more likely not to practice social distancing. A greater degree of physical activity was associated with a higher likelihood of practicing social distancing (aOR, 1.029). People who were vaccinated against influenza were more likely to practice social distancing than those who were not (aOR, 1.150). However, people with unmet medical needs were less likely to practice social distancing than those who did not experience unmet medical needs (aOR, 0.757).

CONCLUSIONS

Social distancing practices were related to traditional health behaviors such as smoking, drinking, and physical activity. Their patterns showed a clustering effect of health inequality. Therefore, when establishing a strategy to strengthen social distancing, a strategy to protect the vulnerable should be considered concomitantly.

Dearth of influenza among older adults admitted with respiratory symptoms in Malaysia during the coronavirus disease 2019 pandemic in 2021

Introduction

Influenza is a common respiratory virus which leads to over 400,000 annual deaths globally. Mortality from influenza is highest among those aged 75 years and over living in Africa and Southeast Asia.

Objective

To determine the burden of influenza among older adults presenting to public hospitals with severe acute respiratory infection (SARI) during the coronavirus disease 2019 (COVID-19) pandemic.

Methods

This multi-center, prospective, observational study recruited individuals aged 65 years and over who presented to four Malaysian hospitals with SARI from 1 January to 31 December 2021. Those with prior confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection were excluded. SARS-CoV-2 was detected through real-time polymerase chain reaction (PCR) with routine diagnostic kits. Influenza A, influenza B and respiratory syncytial virus (RSV) viruses were detected with Xpress Flu/RSV kits using the GeneXpert rapid real-time PCR system (Cepheid, USA).

Results

Samples were obtained from 512 participants, comprising 296 (57.8%) men and 216 (42.2%) women, with a mean age (SD) of 74.0 (7.1) years. Inpatient death occurred in 48 (9.6%) individuals. Significant differences existed in age, ethnicity, and comorbidities across study sites. One (0.2%) case of influenza A, two (0.4%) cases of RSV and 63 (12.5%) cases of SARS-CoV-2 infection were detected over the 1-year period. Cases of COVID-19 mirrored national trends derived from open source data, while the dearth of influenza cases mirrored national and global Flunet figures.

Conclusion

Our observational study conducted during the COVID-19 pandemic detected only one case of influenza, alongside a high SARS-CoV-2 positivity rate. The poor uptake of influenza vaccination nationally, worsened by the recent pandemic restrictions, could lead to waning immunity from the absence of seasonal exposure. Potentially deadly outbreaks may then occur when lockdown and infection control measures are eventually removed.

Impact of COVID-19 on viral respiratory infection epidemiology in young children: A single-center analysis

Background

The COVID-19 pandemic impacts different health aspects. Concomitant with the adoption of non-pharmaceutical interventions (NPIs) to reduce the spread of SARS-CoV-2, global surveillance studies reported a reduction in occurrence of respiratory pathogens like influenza A and B virus (IAV & IBV) and respiratory syncytial virus (RSV). We hypothesized to observe this collateral benefit on viral respiratory infection epidemiology in young children.

Methods

Respiratory samples of children aged below 6 years, presenting at the outpatient clinic, emergency department, or pediatric infectious diseases department of the University Hospitals Leuven, between April 2017 and April 2021 were retrospectively analyzed. The occurrence (positivity rate), and seasonal patterns of viral respiratory infections were described. Chi-squared or Fisher's exact test (and Bonferroni correction) were used to explore differences in occurrence between 2020-2021 and previous 12-month (April to April) periods.

Results

We included 3020 samples (453 respiratory panels, 2567 single SARS-CoV-2 PCR tests). IAV and IBV were not detected from March and January 2020, respectively. For IAV, positivity rate in 2020-2021 (0%, n = 0) was significantly different from 2018-2019 (12.4%, n = 17) (p < 0.001) and 2019-2020 (15.4%, n = 19) (p < 0.001). IBV positivity rate in 2020-2021 (0%, n = 0) was not significantly different from previous periods. RSV occurrence was significantly lower in 2020-2021 (3.2%, n = 3), compared to 2017-2018 (15.0%, n = 15) (p = 0.006), 2018-2019 (16.1%, n = 22) (p = 0.002) and 2019-2020 (22.8%, n = 28) (p < 0.001). The RSV (winter) peak was absent and presented later (March-April 2021). Positivity rate of parainfluenza virus 3 (PIV-3) was significantly higher in 2020-2021 (11.8%, n = 11) than 2017-2018 (1%, n = 1) (p = 0.002). PIV-3 was absent from April 2020 to January 2021, whereas no clear seasonal pattern was distinguished the other years. For the other viruses tested, no significant differences in occurrence were observed between 2020-2021 and previous periods. From March 2020 onwards, 20 cases (0.7%) of SARS-CoV-2 were identified.

Conclusion

These findings reinforce the hypothesis of NPIs impacting the epidemiology of influenza viruses and RSV in young children. Compared to previous periods, no IAV and IBV cases were observed in the 2020-2021 study period, and the RSV peak occurred later. Since the pandemic is still ongoing, continuation of epidemiological surveillance, even on a larger scale, is indicated.

A retrospective analysis of respiratory virus transmission before and during the COVID-19 pandemic in Pune the western region of India

Background

SARS-CoV-2 was first reported in China in December 2019 and quickly spread across the world. Non-pharmaceutical interventions (NPIs) are the key to control the transmission of respiratory viruses. To stop the spread, NPI is widely recommended and is still followed by most countries.

Methods

At the National Influenza Center of the Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), the surveillance of severe acute respiratory illness and acute respiratory illness cases for influenza and other respiratory viruses is in place. In this study, we analyzed surveillance data on respiratory viruses and/or SARS-CoV-2 testing from January 2017 to December 2021. Multiplex real-time PCR was used to detect the respiratory viruses.

Results

Our findings indicate that during the pandemic, the positivity for influenza A and B, metapneumovirus, parainfluenza virus, respiratory syncytial virus, and human coronavirus declined significantly.

Conclusion

The annual distinct seasonal outbreaks of influenza, RSV, and other respiratory viruses as observed during the pre-COVID-19 period were not observed during the COVID-19 pandemic in years 2020 and 21. Social distancing, lock-downs, and non-pharmaceutical interventions may play an important role in the reduction of respiratory viruses. Understanding the seasonal respiratory virus decline could help public health experts prepare for future respiratory virus pandemics.

Changing Epidemiology of Acute Viral Respiratory Infections in Hospitalized Children: The Post-Lockdown Effect

Several reports highlighted how public health measures aimed at limiting severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) circulation have likely contributed to reducing the circulation of other respiratory viruses, particularly during the first year of the COVID-19 pandemic. We evaluated the epidemiology of acute respiratory infections in a large cohort of hospitalized children during the third year of the pandemic (2021−2022). We retrospectively analyzed data from the health records of children (<14 years) hospitalized for acute respiratory infections between 1 July 2021 and 31 March 2022. A total of 1763 respiratory panels were collected. Overall, 1269 (72%) panels hadpositive results for at least one pathogen. Most positive panels (53.8%) belonged to patients aged 1−12 months. The most detected pathogen was respiratory syncytial virus (RSV) (57.8% of positive panels). The RSV peak occurred in November 2021. Nine hundred and forty-five (74.5%) panels were positive for one pathogen while three hundred and twenty-four (25.5%) showed multiple infections. Patients with multiple infections were significantly older than those with a single infection. The 2021−2022 peak of RSV infection in Italy occurred earlier than in the previous pre-pandemic seasons. A high number of children have been hospitalized because of acute viral infections also due to less aggressive viruses.

Global monitoring of public interest in preventive measures against COVID-19 via analysis of Google Trends: an infodemiology and infoveillance study

OBJECTIVES

The COVID-19 pandemic has influenced people's concerns regarding infectious diseases and their preventive measures. However, the magnitude of the impact and the difference between countries are unclear. This study aimed to assess the magnitude of the impact of COVID-19 on public interest and people's behaviours globally in preventing infectious diseases while comparing international trends and sustainability.

DESIGN

An infodemiology and infoveillance study.

SETTING

The study employed a web-based data collection to delineate public interest regarding COVID-19 preventive measures using Google Trends.

PRIMARY AND SECONDARY OUTCOME MEASURES

A relative search volume was assigned to a keyword, standardising it from 0 to 100, with 100 representing the highest share of the term searches. The search terms "coronavirus", "wash hand", "social distancing", "hand sanitizer" and "mask" were investigated across 196 different countries and regions from July 2018 to October 2021 and weekly reports of the relative search volume were obtained. Persistence of interest was assessed by comparing the first 20 weeks with the last 20 weeks of the study period.

RESULTS

Although the relative search volume of "coronavirus" increased and was sustained at a significantly higher level (p<0.05) than before the pandemic declaration, globally, the trends and sustainability of the interest in preventable measures against COVID-19 varied between countries and regions.

CONCLUSIONS

Sustained interest in preventive measures differed globally, with regional differences noted among Asia, Europe, Africa and the Americas. The global differences should be considered for implementing effective interventions against COVID-19. The increased interest in preventive behaviours against COVID-19 may be related to overall infectious disease prevention.

Collateral Impact of COVID-19 Prevention Measures on Re-Emergence of Scarlet Fever and Pertussis in Mainland China and Hong Kong China

The incidence of scarlet fever and pertussis has increased significantly in China in recent years. During the COVID-19 pandemic, stringent non-pharmaceutical intervention measures were widely adopted to contain the spread of the virus, which may also have essential collateral impacts on other infectious diseases, such as scarlet fever and pertussis. We compared the incidence data of scarlet fever and pertussis in Mainland China and Hong Kong from 2004 to 2021 before and after the COVID-19 pandemic. The results show that the incidence of both diseases decreased significantly in 2020-2021 compared to the after-re-emergence stage in these two locations. Specifically, in 2020, scarlet fever decreased by 73.13% and pertussis by 76.63% in Mainland China, and 83.70% and 76.10%, respectively, in Hong Kong. In the absence of COVID-19, the predicted incidence of both diseases was much higher than the actual incidence in Mainland China and Hong Kong in 2020-2021. This study demonstrates that non-pharmaceutical measures implemented during the COVID-19 pandemic can partially reduce scarlet fever and pertussis re-emergence in Mainland China and Hong Kong.

The Influence of COVID-19 Pandemic on Influenza Immunization in Saudi Arabia: Cross-Sectional Study

Introduction

Influenza vaccination is the primary control measure for severe complications caused by influenza viruses. Moreover, in the face of the COVID-19 pandemic, Saudi Arabia recommends vaccinating people at risk against influenza to minimise co-infection risk with SARS-CoV2. Therefore, this study aims to assess the Saudi population’s knowledge, attitude, and practice toward influenza vaccination during the COVID-19 pandemic. Moreover, we evaluate the impact of the COVID-19 pandemic on seasonal influenza vaccination.

Methods

This cross-sectional study was conducted using an online survey in Saudi Arabia between July to August 2021. Participants were invited to complete the questionnaire through a survey link sent to social media platforms.

Results

A total of 2410 participants were included in this study. Our data demonstrate a lack of practice, attitude, and knowledge, especially on the influenza virus’s symptoms, viral transmission, and vaccine efficacy. Moreover, this study showed that the COVID-19 pandemic significantly impacted seasonal influenza vaccination in the Saudi population by 1.5-times compared to the previous years.

Conclusion

COVID-19 pandemic has increased the hesitancy of Saudi participants in influenza vaccination due to the lack of knowledge. As the pandemic of COVID-19 is fading, awareness campaigns are needed to encourage the public about the importance of receiving the influenza vaccine, especially for those at high risk each year.

How Does the COVID-19 Pandemic Affect Pediatric Patients with Intussusception Treated by Ultrasound-Guided Hydrostatic Enema Reduction?

Background: The pandemic of COVID-19 has significantly influenced the epidemiology of intussusception. Nevertheless, the effects of the COVID-19 pandemic on the operation of ultrasound-guided hydrostatic enema reduction (USGHER) for intussusception have been largely unknown. Methods: The data of pediatric patients with intussusception who were treated by USGHER from January to March of 2019 (Control Group), 2020 (Study Group 1), and 2021 (Study Group 2) in a large Chinese medical institution were retrospectively collected and analyzed. Results: We enrolled 246 patients, including 90 cases in Control Group, 70 in Study Group 1, and 86 in Study Group 2 (p = 0.042). The time from the onset of symptoms to the hospital visit and the time from the hospital visit to performing the ultrasound in Study Group 1 was significantly longer than that in Control Group and Study Group 2 (p = 0.036, p = 0.031, respectively). The number of patients with bloody stool and the longest invaginated length of intussusception in Study Group 1 increased significantly compared with patients in the other two groups (p = 0.007, p = 0.042, respectively). Comparisons of neither the pressure of enema nor the time of duration when performing USGHER present statistical significance among the three groups (p = 0.091, p = 0.085, respectively). For all enrolled pediatric patients, there was no perforation case involved, and recurrence of intussusception occurred in few cases. Conclusions: Besides the negative impacts on the incidence of intussusception, the COVID-19 pandemic might have led to the diagnostic delay of intussusception and the deterioration of patients’ clinical manifestations, but it did not significantly affect the operation of USGHER and patients’ clinical outcome.

Shift in Clinical Epidemiology of Human Parainfluenza Virus Type 3 and Respiratory Syncytial Virus B Infections in Korean Children Before and During the COVID-19 Pandemic: A Multicenter Retrospective Study

BACKGROUND

Parainfluenza virus type 3 (PIV3) and respiratory syncytial virus (RSV) B epidemics occurred in South Korea in late 2021. We investigated epidemiological changes of PIV3 and RSV B infections in Korean children before and during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

In this multicenter retrospective study, we enrolled patients aged less than 19 years with PIV3 or RSV infection in four university hospitals from January 2018 to January 2022. Demographic and clinical data were extracted from the subject's medical records and analyzed for each virus.

RESULTS

A total of 652 children with PIV3 were identified including three epidemics: 216 in 2018, 260 in 2019, and 167 in 2021. Among 627 RSV B cases, 169 were identified in 2017/2018, 274 in 2019/2020, and 115 in 2021/2022. The peak circulation of PIV3 and RSV B epidemics were delayed by 6 and 2 months, respectively, in 2021, compared with those in the pre-COVID-19 period. The median age of PIV3 infections increased in 2021 (21.5 months in 2021 vs. 13.0-14.0 in 2018-2019; P < 0.001), whereas that of RSV B infections remained unchanged (3.6-4.0 months). During the COVID-19 pandemic, less frequent hospitalization rates were observed for both PIV3 and RSV B infections, but more children needed respiratory assistance for RSV B infection in 2021/2022 epidemic (32.5%) than before (14.7-19.4%, P = 0.014).

CONCLUSION

We observed changes in the epidemiology and clinical presentation of PIV3 and RSV B infections in Korean children during the COVID-19 pandemic.

Impact of COVID-19 on the social relationships and mental health of older adults living alone: A two-year prospective cohort study

Background

Owing to the COVID-19 outbreak, older adults living alone, who can only connect socially outside their homes, are at risk of social isolation and poor mental health. This study aimed to identify the changes, before and after COVID-19, by sex and age, in social relationships (social activity, social network, and social support) and mental health (depression and suicide ideation) among older adults living alone.

Methods

This is a prospective cohort study of community-dwelling older adults who were at least 65 years old and living alone in South Korea. The study was conducted during 2018–2020 with 2,291 participants (795, 771, and 725 for the 1st to 3rd waves, respectively). The data were collected via face-to-face interviews. A generalized linear mixed modeling framework was used to test for changes over three years.

Results

Social activity was reduced after the COVID-19, with an interaction effect of sex: older women (odds ratio [OR], 0.19; 95% confidence interval [CI], 0.15–0.23; p < .001) showed greater reduction than older men (OR, 0.50; 95% CI, 0.34–0.75; p < .001). Interaction with neighbors also reduced after the pandemic, but there was no significant evidence of interaction effects. Interaction with family members increased in both sexes during the pandemic, with the interaction effect of sex: older women (OR, 1.40; 95% CI, 1.11–1.76; p = .004) showed greater increase than men (OR, 1.55; 95% CI, 1.13–2.14; p = .007). Social support increased in both sexes during the pandemic, but there was no significant evidence of interaction effects. Depression and suicide ideation showed no significant differences before and after the pandemic.

Conclusions

The findings provide health administrators and health providers with explorative insights into the impact of the COVID-19 on social relationships and mental health among older adults living alone and can guide further studies of interventions considering specific properties of social relationships.

Impact of the COVID-19 Pandemic on the Diagnosis of Congenital Cytomegalovirus Infection in Spain

We conducted an observational study performed within the Spanish Registry of Children with congenital cytomegalovirus (cCMV) to evaluate the impact of the COVID-19 pandemic on the diagnosis of new cases of cCMV. Our study suggest a significant decrease in the monthly rate of new cCMV diagnoses during the COVID-19 pandemic.

First COVID-19 lockdown resulted in most respiratory viruses disappearing among hospitalised children, with the exception of rhinoviruses

Aim

Emergency room admissions have decreased globally during the COVID‐19 pandemic, particularly for respiratory diseases. We evaluated hospital admissions for respiratory diseases in the first year of the Italian pandemic and compared them with the corresponding period in 2016–2017.

Methods

The study was carried out at the Sapienza University in Rome, Italy, and covered 9 March to 28 February 2020–2021 and 2016–2017. We tested 85 hospitalised children who were negative for the virus that causes COVID‐19 in 2020–2021 and compared them with 476 hospitalised children from 2016–2017, as we had also tested nasal washing samples for 14 respiratory viruses during that period.

Results

Hospitalisations for acute respiratory tract infections were 82.2% lower in 2020–2021 than 2016–2017. The respiratory syncytial virus (RSV) and several other viruses were detected less frequently during the pandemic. An extraordinary finding was that rhinoviruses remained seasonal. In 2020–2021, we detected a virus in 54.1% of the hospitalised children: rhinoviruses in 41, RSV in 4 and other viruses in 1. This was significantly lower than the 71.6% in 2016–2017: RSV in 130, rhinoviruses in 128 and other viruses in 83.

Conclusion

Pandemic measures dramatically reduced childhood respiratory infections, particularly RSV, but were less effective at reducing rhinoviruses.

Changes in the pattern and disease burden of acute viral respiratory infections before and during the COVID-19 pandemic

Objectives

We conducted a comparative analysis of the differences in the incidence of 8 acute respiratory viruses and the changes in their patterns before and during the coronavirus disease 2019 (COVID-19) pandemic.

Methods

Three sentinel surveillance systems of the Korea Disease Control and Prevention Agency and data from the Health Insurance Review and Assessment Service were analyzed. The average numbers of reported cases and the related hospital admissions and outpatient data were compared between April 2018–2019 and 2020–2021. Changes in the disease burden and medical expenditures between these 2 time periods were evaluated.

Results

During the COVID-19 pandemic, the number of reported cases of all acute respiratory viral infections, except for human bocavirus, decreased significantly. Data from the Health Insurance Review and Assessment Service also showed decreases in the actual amount of medical service usage and a marked reduction in medical expenditures.

Conclusion

Non-pharmacological interventions in response to COVID-19 showed preventive effects on the transmission of other respiratory viruses, as well as COVID-19. Although COVID-19 had a tremendous impact on society as a whole, with high social costs, there were also positive effects, such as a reduction in the incidence of acute respiratory viral infections.