Frontiers in pediatrics · 2026
Season-matched comparison of pediatric respiratory pathogen detection patterns before and after the lifting of COVID-19 restrictions in Guangzhou.
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Hua Liang, Liang Wanli, Li Wanling, Zhu Bing
Аннотация
INTRODUCTION: COVID-19-related non-pharmaceutical interventions and their subsequent relaxation may alter the epidemiology of pediatric respiratory pathogens. However, hospital-based data from subtropical southern China using a consistent multiplex PCR platform remain limited. This study described changes in pediatric respiratory pathogen detection patterns in Guangzhou, with emphasis on a season-matched comparison before and after the lifting of restrictions.
METHODOLOGY: We retrospectively analyzed 2,213 children 0 to <16 years who presented with fever or respiratory symptoms at Guangzhou Women and Children's Medical Center. Nasopharyngeal swabs collected during the pre-lifting period (November 2021-October 2022) and post-lifting period (February-May 2023) were tested using the same specimen type, nucleic-acid extraction system, PCR instrument, and 12-pathogen multiplex PCR panel. To reduce seasonal bias, the primary pathogen comparison was restricted to February-May 2022 vs. February-May 2023. Categorical variables were compared using the Chi-square test or Fisher's exact test, as appropriate.
RESULTS: Overall, 843 of 2,213 children (38.1%) tested positive for at least one pathogen. Compared with February-May 2022, February-May 2023 showed higher detection rates of Influenza A (0.64% vs. 16.60%), RSV (5.72% vs. 14.67%), and HRV (1.06% vs. 5.79%), and lower detection rates of Influenza B (7.84% vs. 0.39%) and HMPV (10.59% vs. 0.39%). The post-lifting cohort included a higher proportion of infants (<1 year: 14.29% vs. 8.50%) and higher proportions of fever, wheezing, and lower respiratory tract diagnoses; these clinical comparisons should be interpreted cautiously because health-care-seeking behavior and admission thresholds may have changed after lifting restrictions.
CONCLUSIONS: After the lifting of COVID-19 restrictions, pediatric respiratory pathogen detection in Guangzhou shifted toward increased Influenza A, RSV, and HRV activity in the season-matched comparison, with a younger patient composition and more lower-respiratory clinical diagnoses among tested children. These findings support continued multiplex surveillance and age-targeted prevention strategies, but causal attribution to the lifting of restrictions should be made cautiously because of residual confounding by seasonality, SARS-CoV-2 circulation, and health-care-seeking behavior.
METHODOLOGY: We retrospectively analyzed 2,213 children 0 to <16 years who presented with fever or respiratory symptoms at Guangzhou Women and Children's Medical Center. Nasopharyngeal swabs collected during the pre-lifting period (November 2021-October 2022) and post-lifting period (February-May 2023) were tested using the same specimen type, nucleic-acid extraction system, PCR instrument, and 12-pathogen multiplex PCR panel. To reduce seasonal bias, the primary pathogen comparison was restricted to February-May 2022 vs. February-May 2023. Categorical variables were compared using the Chi-square test or Fisher's exact test, as appropriate.
RESULTS: Overall, 843 of 2,213 children (38.1%) tested positive for at least one pathogen. Compared with February-May 2022, February-May 2023 showed higher detection rates of Influenza A (0.64% vs. 16.60%), RSV (5.72% vs. 14.67%), and HRV (1.06% vs. 5.79%), and lower detection rates of Influenza B (7.84% vs. 0.39%) and HMPV (10.59% vs. 0.39%). The post-lifting cohort included a higher proportion of infants (<1 year: 14.29% vs. 8.50%) and higher proportions of fever, wheezing, and lower respiratory tract diagnoses; these clinical comparisons should be interpreted cautiously because health-care-seeking behavior and admission thresholds may have changed after lifting restrictions.
CONCLUSIONS: After the lifting of COVID-19 restrictions, pediatric respiratory pathogen detection in Guangzhou shifted toward increased Influenza A, RSV, and HRV activity in the season-matched comparison, with a younger patient composition and more lower-respiratory clinical diagnoses among tested children. These findings support continued multiplex surveillance and age-targeted prevention strategies, but causal attribution to the lifting of restrictions should be made cautiously because of residual confounding by seasonality, SARS-CoV-2 circulation, and health-care-seeking behavior.