Changes in the epidemic patterns of respiratory pathogens of children in guangzhou, China during the COVID-19 pandemic

Abstract Objective To investigate the epidemiological characteristics of pediatric respiratory pathogens in Guangzhou, China, from 2018 to 2023 in the context of the COVID-19 Pandemic and to evaluate the impact of non-pharmaceutical interventions (NPIs) on the transmission dynamics and seasonal patt...

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Main Authors: De-Feng Liang, Wen-Lin Guo, Dan-Ping Zhu, Su-Yun Li, Wei-Dong Zhu, Ying Li, Li Huang, Jun Shen, Pei-Qing Li
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-025-11215-8
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author De-Feng Liang
Wen-Lin Guo
Dan-Ping Zhu
Su-Yun Li
Wei-Dong Zhu
Ying Li
Li Huang
Jun Shen
Pei-Qing Li
author_facet De-Feng Liang
Wen-Lin Guo
Dan-Ping Zhu
Su-Yun Li
Wei-Dong Zhu
Ying Li
Li Huang
Jun Shen
Pei-Qing Li
author_sort De-Feng Liang
collection DOAJ
description Abstract Objective To investigate the epidemiological characteristics of pediatric respiratory pathogens in Guangzhou, China, from 2018 to 2023 in the context of the COVID-19 Pandemic and to evaluate the impact of non-pharmaceutical interventions (NPIs) on the transmission dynamics and seasonal patterns of respiratory pathogens. Methods A retrospective analysis was conducted at Guangzhou Women and Children’s Medical Center between January 2018 and December 2023. Pediatric patients who underwent the respiratory pathogens tests were enrolled in the study and divided into four groups by age: Infant group, Toddler group, Preschool group, and School-age group. The nasopharyngeal swab or bronchoalveolar lavage fluid (BALF) samples were collected for real-time fluorescence quantitative polymerase chain reaction (qPCR) test of respiratory pathogens. Ten common respiratory pathogens, including respiratory syncytial virus (RSV), Mycoplasma pneumoniae (MP) and Influenza A virus (FluA), were detected. In addition, the study period was divided into three phases: Pre-COVID-19 (2018–2019), COVID-19 (2020–2022), and Post-COVID-19 (2023). Detection rates, distribution patterns, and seasonal variations of respiratory pathogens were analyzed between different phases and different age groups. Results This study included 317,828 pediatric patients (median age: 3.4 years, IQR: 1.3-6.0), from whom 1,160,764 respiratory pathogen tests were conducted. The overall pathogen detection rate was 8.02% (93,108/1,160,764). The positive rate during the COVID-19 phase (18.44%, 95% CI 14.89-22.00%) was significantly lower than that of the Pre-COVID-19 (27.55%, 95% CI 23.95–31.16%) and Post-COVID-19 (27.15, 95% CI 21.47–32.84%) phases (P < 0.001). No significant difference was observed between Pre-COVID-19 and Post-COVID-19 phases (P = 0.948). Different pathogens exhibited varying levels of suppression and recovery patterns, with some demonstrating altered seasonal patterns. The primary affected age groups shifted from infants and toddlers during the Pre-COVID-19 and COVID-19 phases to preschool and school-age children in the Post-COVID-19 phase. Co-infections were identified in 2,515 cases, with the highest rate observed during the Pre-COVID-19 phase (3.40%), followed by the COVID-19 (2.26%) and Post-COVID-19 (2.46%) phases. Conclusions NPIs implemented during the early COVID-19 pandemic effectively suppressed the transmission of respiratory pathogens and disrupted their seasonal patterns. However, some pathogens gradually resumed activity during the mid-to-late COVID-19 phase, leading to atypical outbreaks. Following NPI relaxation, multiple pathogens rebounded during the Post-COVID-19 phase, posing significant challenges for the healthcare system. These findings offer valuable insights for guiding public health strategies and optimizing the prevention and control of respiratory infections. Clinical trial number Not applicable.
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spelling doaj-art-5d4fb73e90794b2f93b47cdd89d5428e2025-08-20T03:03:27ZengBMCBMC Infectious Diseases1471-23342025-07-0125111210.1186/s12879-025-11215-8Changes in the epidemic patterns of respiratory pathogens of children in guangzhou, China during the COVID-19 pandemicDe-Feng Liang0Wen-Lin Guo1Dan-Ping Zhu2Su-Yun Li3Wei-Dong Zhu4Ying Li5Li Huang6Jun Shen7Pei-Qing Li8Department of Emergency, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Hematology and Oncology, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Emergency, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Emergency, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Emergency, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Gastroenterology, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Emergency, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Emergency, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Emergency, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityAbstract Objective To investigate the epidemiological characteristics of pediatric respiratory pathogens in Guangzhou, China, from 2018 to 2023 in the context of the COVID-19 Pandemic and to evaluate the impact of non-pharmaceutical interventions (NPIs) on the transmission dynamics and seasonal patterns of respiratory pathogens. Methods A retrospective analysis was conducted at Guangzhou Women and Children’s Medical Center between January 2018 and December 2023. Pediatric patients who underwent the respiratory pathogens tests were enrolled in the study and divided into four groups by age: Infant group, Toddler group, Preschool group, and School-age group. The nasopharyngeal swab or bronchoalveolar lavage fluid (BALF) samples were collected for real-time fluorescence quantitative polymerase chain reaction (qPCR) test of respiratory pathogens. Ten common respiratory pathogens, including respiratory syncytial virus (RSV), Mycoplasma pneumoniae (MP) and Influenza A virus (FluA), were detected. In addition, the study period was divided into three phases: Pre-COVID-19 (2018–2019), COVID-19 (2020–2022), and Post-COVID-19 (2023). Detection rates, distribution patterns, and seasonal variations of respiratory pathogens were analyzed between different phases and different age groups. Results This study included 317,828 pediatric patients (median age: 3.4 years, IQR: 1.3-6.0), from whom 1,160,764 respiratory pathogen tests were conducted. The overall pathogen detection rate was 8.02% (93,108/1,160,764). The positive rate during the COVID-19 phase (18.44%, 95% CI 14.89-22.00%) was significantly lower than that of the Pre-COVID-19 (27.55%, 95% CI 23.95–31.16%) and Post-COVID-19 (27.15, 95% CI 21.47–32.84%) phases (P < 0.001). No significant difference was observed between Pre-COVID-19 and Post-COVID-19 phases (P = 0.948). Different pathogens exhibited varying levels of suppression and recovery patterns, with some demonstrating altered seasonal patterns. The primary affected age groups shifted from infants and toddlers during the Pre-COVID-19 and COVID-19 phases to preschool and school-age children in the Post-COVID-19 phase. Co-infections were identified in 2,515 cases, with the highest rate observed during the Pre-COVID-19 phase (3.40%), followed by the COVID-19 (2.26%) and Post-COVID-19 (2.46%) phases. Conclusions NPIs implemented during the early COVID-19 pandemic effectively suppressed the transmission of respiratory pathogens and disrupted their seasonal patterns. However, some pathogens gradually resumed activity during the mid-to-late COVID-19 phase, leading to atypical outbreaks. Following NPI relaxation, multiple pathogens rebounded during the Post-COVID-19 phase, posing significant challenges for the healthcare system. These findings offer valuable insights for guiding public health strategies and optimizing the prevention and control of respiratory infections. Clinical trial number Not applicable.https://doi.org/10.1186/s12879-025-11215-8ChildrenRespiratory pathogensCOVID-19Non-Pharmaceutical interventionsEpidemiological characteristics
spellingShingle De-Feng Liang
Wen-Lin Guo
Dan-Ping Zhu
Su-Yun Li
Wei-Dong Zhu
Ying Li
Li Huang
Jun Shen
Pei-Qing Li
Changes in the epidemic patterns of respiratory pathogens of children in guangzhou, China during the COVID-19 pandemic
BMC Infectious Diseases
Children
Respiratory pathogens
COVID-19
Non-Pharmaceutical interventions
Epidemiological characteristics
title Changes in the epidemic patterns of respiratory pathogens of children in guangzhou, China during the COVID-19 pandemic
title_full Changes in the epidemic patterns of respiratory pathogens of children in guangzhou, China during the COVID-19 pandemic
title_fullStr Changes in the epidemic patterns of respiratory pathogens of children in guangzhou, China during the COVID-19 pandemic
title_full_unstemmed Changes in the epidemic patterns of respiratory pathogens of children in guangzhou, China during the COVID-19 pandemic
title_short Changes in the epidemic patterns of respiratory pathogens of children in guangzhou, China during the COVID-19 pandemic
title_sort changes in the epidemic patterns of respiratory pathogens of children in guangzhou china during the covid 19 pandemic
topic Children
Respiratory pathogens
COVID-19
Non-Pharmaceutical interventions
Epidemiological characteristics
url https://doi.org/10.1186/s12879-025-11215-8
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