新冠疫情下儿童呼吸道感染病毒病原学的变迁及诊断策略

doi:10.12372/jcp.2022.22e0195

Abstract

Abstract:

Respiratory tract infection is the commonest infectious disease in childhood, and virus is the main pathogen. Since the outbreak of coronavirus disease 2019 (COVID-2019), the epidemiological characteristics and spectrum of respiratory tract pathogens in children have changed. Etiological detection and continuous monitoring are of great significance and can provide evidence for clinical diagnosis, treatment and prevention and control.

Key words: respiratory tract infection, virus, coronavirus disease 2019, child

WANG Yuqing, JIANG Wujun, GU Wenjing. Changes in viral etiology of children with respiratory tract infection and diagnostic strategy during the COVID-19 pandemic[J].Journal of Clinical Pediatrics, 2022, 40(4): 241-246.

References 44

[1]	Klavinskis LS, Liu MA, Lu S. A timely update of global COVID-19 vaccine development[J]. Emerg Microbes Infect, 2020, 9(1):2379-2380. doi: 10.1080/22221751.2020.1838246
[2]	Liu L, Oza S, Hogan D, et al. Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the Sustainable Development Goals[J]. Lancet, 2016, 388:3027-3035. doi: S0140-6736(16)31593-8 pmid: 27839855
[3]	Zhong-Jie Li, Hai-Yang Zhang, Li-Li Ren, et al. Etiological and epidemiological features of acute respiratory infections in China[J]. Nat Commun, 2021, 12(1):5026. doi: 10.1038/s41467-021-25120-6 pmid: 34408158
[4]	Pneumonia Etiology Research for Child Health(PERCH) Study Group. Causes of severe pneumonia requiring hospital admission in children without HIV infection from Africa and Asia: the PERCH multi-country case-control study[J]. Lancet, 2019, 394(10200):757-779. doi: 10.1016/S0140-6736(19)30721-4
[5]	Baker RE, Park SW, Yang W, et al. The impact of COVID-19 nonpharmaceutical interventions on the future dynamics of endemic infections[J]. Proc Natl Acad Sci U S A, 2020, 117:30547-30553. doi: 10.1073/pnas.2013182117
[6]	European Centre for Disease Prevention and Control(ECDC). Influenza virus characterisation, summary Europe, December 2020[EB/OL]. (2022-02-10) https://www.ecdc.europa.eu/sites/default/files/documents/Influenza-characterisation-report-December-2020.pdf.
[7]	Olsen SJ, Azziz-Baumgartner E, Budd AP, et al. Decreased infuenza activity during the COVID-19 pandemic-United States, Australia, Chile, and South Africa, 2020[J]. MMWR Morb Mortal Wkly Rep, 2020, 69:1305-1309. doi: 10.15585/mmwr.mm6937a6
[8]	Minney-Smith C, Smith D, Stocks N, et al. Where has all the influenza gone? The impact of COVID-19 on the circulation of influenza and other respiratory viruses, Australia, March to September 2020[J]. Euro Surveill, 2020, 25(47):2001847.
[9]	中国疾病预防控制中心, 病毒病预防控制所. 中国流感流行情况概要. 2021年1月11日周报[EB/OL]. (2022-02-10) https://ivdc.chinacdc.cn/cnic/zyzx/lgzb/202101/P020210111510404437185.pdf.
[10]	Zhang RX, Chen DM, Qian Y, et al. Surges of hospital-based rhinovirus infection during the 2020 coronavirus disease-19 (COVID-19) pandemic in Beijing, China[J]. World J Pediatr, 2021, 17(6):590-596. doi: 10.1007/s12519-021-00477-2
[11]	闫芍药, 原伟莉, 黎巧玲. 2016-2020年西安地区急性呼吸道感染患者病毒病原学特征分析[J]. 华南预防医学, 2021, 47(11):1417-1419.
[12]	花盛浩, 邵雪君, 徐俊. 新型冠状病毒肺炎常态化防控下儿童常见呼吸道病毒感染谱的变化[J]. 中华传染病杂志, 2021, 39(10):621-625.
[13]	European Centre for Disease Prevention and Control(ECDC). Influenza virus characterisation-Summary Europe, December 2021[EB/OL].(2022-02-10) https://www.ecdc.europa.eu/en/publications-data/influenza-virus-characterisation-summary-europe-december-2021.
[14]	中国疾病预防控制中心, 病毒病预防控制所. 中国流感流行情况概要. 12月17日周报[EB/OL]. (2022-02-10) http://ivdc.chinacdc.cn/cnic/zyzx/lgzb/202112/P020211217607106751971.pdf.
[15]	Gastaldi A, Donà D, Barbieri E, et al. COVID-19 lesson for respiratory syncytial virus (RSV): hygiene works[J]. Children (Basel), 2021, 8(12):1144.
[16]	ECDC. Surveillance atlas of infectious diseases[EB/OL]. (2022-02-10) https://atlas.ecdc.europa.eu/public/index.aspx.
[17]	王莉莉, 刘志, 彭虹艳, 等. 新型冠状病毒肺炎疫情暴发前后儿童呼吸道合胞病毒感染流行特征分析[J]. 实用预防医学, 2021, 28(12):1487-1489.
[18]	黄瑶, 张秀玲, 王艳, 等. 2017-2020年扬州地区住院肺炎患者呼吸道病毒监测结果分析[J]. 检验医学, 2021, 36(11):1135-1139.
[19]	Foley DA, Yeoh DK, Minney-Smith CA, et al. The interseasonal resurgence of respiratory syncytial virus in australian children following the reduction of coronavirus disease 2019-related public health measures[J]. Clin Infect Dis, 2021, 73(9):e2829-e2830. doi: 10.1093/cid/ciaa1906
[20]	Agha R, Avner JR. Delayed seasonal RSV surge observed during the COVID-19 pandemic[J]. Pediatrics, 2021, 148(3):e2021052089.
[21]	Sullivan SG, Carlson S, Cheng AC, et al. Where has all the infuenza gone? The impact of COVID-19 on the circulation of infuenza and other respiratory viruses, Australia, March to September 2020[J]. Euro Surveill, 2020, 25:2001847.
[22]	Takashita E, Kawakami C, Momoki T, et al. Increased risk of rhinovirus infection in children during the coronavirus disease-19 pandemic[J]. Influenza Other Respir Viruses, 2021, 15(4):488-494. doi: 10.1111/irv.v15.4
[23]	王宇清, 季伟, 陈正荣, 等. 2006-2009年苏州地区儿童急性呼吸道感染人类偏肺病毒感染的流行特点及与气候因素的相关性研究[J]. 中华儿科杂志, 2011, 49(3):214-217.
[24]	Chen Z, Zhu Y, Wang Y, et al. Association of meteorological factors with childhood viral acute respiratory infections in subtropical China: an analysis over 11 years[J]. Arch Virol, 2014, 159(4):631-639. doi: 10.1007/s00705-013-1863-8
[25]	Wu A, Mihaylova VT, Landry ML, et al. Interference between rhinovirus and infuenza A virus: a clinical data analysis and experimental infection study[J]. Lancet Microbe, 2020, 1:e254-e262. doi: 10.1016/S2666-5247(20)30114-2
[26]	Casalegno JS, Ottmann M, Duchamp MB, et al. Rhinoviruses delayed the circulation of the pandemic influenza A (H1N1) 2009 virus in France[J]. Clin Microbiol Infect, 2010, 16:326-629. doi: 10.1111/j.1469-0691.2010.03167.x
[27]	Achten NB, Wu P, Bont L, et al. Interference between respiratory syncytial virus and human rhinovirus infection in infancy[J]. J Infect Dis, 2017, 215:1102-1106. doi: 10.1093/infdis/jix031 pmid: 28368456
[28]	Agrawal B. Heterologous immunity: role in natural and vaccineinduced resistance to infections[J]. Front Immunol, 2019, 10:2631. doi: 10.3389/fimmu.2019.02631 pmid: 31781118
[29]	Schneider WM, Chevillotte MD, Rice CM. Interferon-stimulated genes: a complex web of host defenses[J]. Annu Rev Immunol, 2014, 32:513-545. doi: 10.1146/annurev-immunol-032713-120231 pmid: 24555472
[30]	Price OH, Sullivan SG, Sutterby C, et al. Using routine testing data to understand circulation patterns of influenza A, respiratory syncytial virus and other respiratory viruses in Victoria, Australia[J]. Epidemiol Infect, 2019, 147:e221. doi: 10.1017/S0950268819001055
[31]	Wu X, Cai Y, Huang X, et al. Co-infection with SARS-CoV-2 and influenza A virus in patient with pneumonia, China[J]. Emerg Infect Dis, 2020, 26(6):1324-1326. doi: 10.3201/eid2606.200299
[32]	Jiang W, Wu M, Zhou J, et al. Etiologic spectrum and occurrence of coinfections in children hospitalized with community-acquired pneumonia[J]. BMC Infectious Diseases, 2017, 17(1):787. doi: 10.1186/s12879-017-2891-x
[33]	中华人民共和国国家卫生健康委员会. 新型冠状病毒感染的肺炎诊疗方案(第八版)[EB/OL]. (2022-02-10) http://www.nhc.gov.cn/xcs/zhengcwj/202105/6f1e8ec6c4a540d99fafef52fc86d0f8.shtml.
[34]	Thavagnanam S, Christie SN, Doherty GM, et al. Respiratory viral infection in lower airways of asymp-tomatic children[J]. Acta Paediatr, 2010, 99(3):394-398. doi: 10.1111/apa.2010.99.issue-3
[35]	Lu AZ, Shi P, Wang LB, et al. Diagnostic value of nasopharyngeal aspirates in children with lower respiratory tract infections[J]. Chin Med J (Engl), 2017, 130(6):647-651.
[36]	Tan J, Wu J, Jiang W, et al. Etiology, clinical characteristics and coinfection status of bronchiolitis in Suzhou[J]. BMC Infect Dis, 2021, 21(1):135. doi: 10.1186/s12879-021-05772-x
[37]	Leung EC, Chow VC, Lee MK, et al. Evaluation of the xpert xpress SARS-CoV-2/Flu/RSV assay for simultaneous detection of SARS-CoV-2, influenza A and B viruses, and respiratory syncytial virus in nasopharyngeal specimens[J]. J Clin Microbiol, 2021, 59(4):e02965-20.
[38]	Chung HY, Jian MJ, Chang CK, et al. Multicenter study evaluating one multiplex RT-PCR assay to detect SARS-CoV-2, influenza A/B, and respiratory syncytia virus using the LabTurbo AIO open platform: epidemiological features, automated sample-to-result, and high-throughput testing[J]. Aging (Albany NY), 2021, 13(23):24931-24942.
[39]	Yun J, Park JH, Kim N, et al. Evaluation of three multiplex real-time reverse transcription PCR assays for simultaneous detection of SARS-CoV-2, influenza A/B, and respiratory syncytial virus in nasopharyngeal swabs[J]. J Korean Med Sci, 2021, 36(48):e328. doi: 10.3346/jkms.2021.36.e328
[40]	Nörz D, Hoffmann A, Aepfelbacher M, et al. Clinical evaluation of a fully automated, laboratory-developed multiplex RT-PCR assay integrating dual-target SARS-CoV-2 and influenza A/B detection on a high-throughput platform[J]. J Med Microbiol, 2021, 70(2):001295.
[41]	Nabti LZ, Sahli F, Olowo-Okere A, et al. Molecular characterization of clinical carbapenem-resistant enterobacteriaceae isolates from Sétif, Algeria[J]. Microb Drug Resist, 2021: 274-279.
[42]	Marí-Almirall M, Ferrando N, Fernández MJ, et al. Clonal spread and intra- and inter-species plasmid dissemination associated with Klebsiella pneumoniae carbapenemase-producing enterobacterales during a hospital outbreak in Barcelona, Spain[J]. Front Microbiol, 2021, 12:781127. doi: 10.3389/fmicb.2021.781127
[43]	Khanal M, Joshi PR, Paudel S, et al. Methicillin-resistant coagulase negative staphylococci and their antibiotic susceptibility pattern from healthy dogs and their owners from kathmandu valley[J]. Trop Med Infect Dis, 2021, 6(4):194.
[44]	Zhao F, Lu J, Lu B, et al. A novel strategy for the detection of SARS-CoV-2 Variants based on multiplex PCR-Mass spectrometry minisequencing technology[J]. Microbiol Spectr, 2021, 9(3): e0126721.

Changes in viral etiology of children with respiratory tract infection and diagnostic strategy during the COVID-19 pandemic

RichHTML

PDF (PC)

Like

Knowledge

Cited

Abstract

Cite this article

share this article

References 44

Related Articles 15

Metrics

Comments

Recommended 0

[1]	LIN Jinfeng, CHEN Yi, DENG Yan, FENG Ai, HUANG Juan, CHEN Lizhu, XIE Jingqi, NIE Xiaojing. A comparative study on the detection of anti-Nephrin antibodies in children's nephrotic syndrome by chemiluminescence method and cell-based assay [J]. Journal of Clinical Pediatrics, 2026, 44(8): 682-689.
[2]	ZHENG Fangyuan, WANG Miao, DING Mingming, LU Aidong, JIA Yueping, ZENG Huimin, ZHANG Leping. Next-generation sequencing identified gene variants and their prognostic impact in pediatric Philadelphia chromosome positive acute lymphoblastic leukemia [J]. Journal of Clinical Pediatrics, 2026, 44(8): 690-697.
[3]	ZHANG Xiao, FANG Hongjun, KUANG Xiaojun, WANG Lijuan, WU Zhao, JIANG Sha, LI Pei, WU Liwen. Analysis of the clinical and electrophysiological characteristics of atonic seizures in children [J]. Journal of Clinical Pediatrics, 2026, 44(8): 698-704.
[4]	WANG Mengqian, YANG Hui. Case series analysis of 13 intestinal Behcet’s syndrome in children [J]. Journal of Clinical Pediatrics, 2026, 44(8): 705-711.
[5]	WU Xirong, GAO Qi, GUO Siyuan, YIN Qingqin, QIN Qiang, YIN Ju, JIAO Anxia, CHEN Chenghao, WU Di, WANG Bei, DUAN Xiaomin, PENG Yun, XU Baoping, GAO Liwei. Clinical characteristics and prognosis of pulmonary mucormycosis in children with diabetes mellitus [J]. Journal of Clinical Pediatrics, 2026, 44(8): 712-720.
[6]	HAN Yanan, GE Lanlan, CUI Jieyuan. A case report of branchio-oto-renal syndrome caused by EYA1 gene variant with a 6-year follow-up [J]. Journal of Clinical Pediatrics, 2026, 44(8): 721-726.
[7]	SHI Jiayi, GAO Chunlin, JIA Lili, LU Yunyun, SUN Tao, ZHU Xiaodong, XIA Zhengkun, ZHANG Pei. Phenotypic characteristics and prognostic analysis of a pedigree with childhood isolated nephrotic syndrome caused by compound heterozygous mutations in the COQ2 gene [J]. Journal of Clinical Pediatrics, 2026, 44(8): 727-732.
[8]	LIN Luona, LIU Juanjuan, WANG Hongyu, HU Bofei, XU Yi, HUANG Lisu. Pathogenesis, clinical features, and management of pediatric influenza-associated extrapulmonary syndrome: from ectopic infection to immune-mediated injury [J]. Journal of Clinical Pediatrics, 2026, 44(8): 733-739.
[9]	Rachel Rosen, Osvaldo Borrelli, Christophe Faure, Katja Karrento, Usha Krishnan, Samuel Nurko, Nathalie Rommel, Alan Silverman, Michiel van Wijk, Marc Benninga (Author), Chinese Medical Association Parenteral and Enteral Nutrition Branch Pediatrics Group, The Subspecialty Group of Gastroenterology, The Society of Pediatric, Chinese Medical Association, Gastroenterology Group, Pediatrician Branch, Chinese Medical Doctor Association (Translator). Core interpretation and explanation of Rome Ⅴ diagnostic criteria: upper gastrointestinal disorders of gut-brain interaction in children and adolescents [J]. Journal of Clinical Pediatrics, 2026, 44(7): 595-608.
[10]	Carlo Di Lorenzo, Miguel Saps, Bruno P. Chumpitazi, Shaman Rajindrajith, Annamaria Staiano, Nikhil Thapar, Miranda van Tilburg, Carlos Velasco-Benítez, Arine Vlieger (Author), Chinese Medical Association Parenteral and Enteral Nutrition Branch Pediatrics Group, The Subspecialty Group of Gastroenterology, The Society of Pediatric, Chinese Medical Association, Gastroenterology Group, Pediatrician Branch, Chinese Medical Doctor Association (Translator). Core interpretation and explanation of Rome Ⅴ diagnostic criteria: lower and biliary disorders of gut-brain interaction in children and adolescents [J]. Journal of Clinical Pediatrics, 2026, 44(7): 609-621.
[11]	LI Xufeng, TANG Haoxun, LI Xingjun, ZHANG Lize, GAO Chenqing, ZHAO Shunying, LIU Jianhua. Clinical characteristics, chest CT imaging phenotypes, and their correlation with prognosis in 76 children with Chlamydia pneumoniae pneumonia [J]. Journal of Clinical Pediatrics, 2026, 44(7): 622-627.
[12]	WANG Zhen, SHAO Jingbo, ZHANG Na, XIA Min, ZHU Jiashi, DU Chengkan, LI Hong. Factors influencing long-term recurrence in pediatric acute lymphoblastic leukemia patients with low-risk disease at initial diagnosis: a five-year follow-up analysis of 254 cases from a single center [J]. Journal of Clinical Pediatrics, 2026, 44(7): 628-635.
[13]	GUO Xuemei, XUE Yao, WANG Yongren, RONG Liucheng, FANG Yongjun, LIN Rufeng. Clinical features and prognosis of childhood acute myeloid leukemia with CBFA2T3::GLIS2 fusion [J]. Journal of Clinical Pediatrics, 2026, 44(7): 636-643.
[14]	YANG Lijun, FU Dongxia, CUI Yan, YANG Junmei, ZHANG Liming. Clinical manifestation and genetic analysis of CHARGE syndrome caused by CHD7 gene variation [J]. Journal of Clinical Pediatrics, 2026, 44(7): 644-650.
[15]	HU Yan, YANG Fan, LIANG Aimin, MAO Meng. Identification and management of faltering growth in children: insights from the 13th International Conference on Nutrition and Growth [J]. Journal of Clinical Pediatrics, 2026, 44(6): 485-488.