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Eur J Clin Microbiol Infect Dis . Common respiratory virus spectrum and epidemiological trends among children in Northwest China during the post-COV

tetano

Editor, Senior Moderator
Eur J Clin Microbiol Infect Dis


. 2026 Feb 16.
doi: 10.1007/s10096-026-05437-0. Online ahead of print.
Common respiratory virus spectrum and epidemiological trends among children in Northwest China during the post-COVID-19 era

You Wu[SUP] #[/SUP][SUP] 1 [/SUP], Weina Yang[SUP] #[/SUP][SUP] 2 [/SUP], Congcong Chen[SUP] #[/SUP][SUP] 2 [/SUP], Jianfei Shi[SUP] 2 [/SUP], Peiwen Ning[SUP] 2 [/SUP], Jiahua Liu[SUP] 2 [/SUP], Rui Wu[SUP] 2 [/SUP], Zengguo Wang[SUP] 3 4 [/SUP], Jianyong Tang[SUP] 5 6 [/SUP]


Affiliations
Abstract

Objective: To explore the epidemiology of common pediatric respiratory viruses among children in the post-COVID-19 era.
Methods: Retrospective analysis of children with respiratory symptoms who visited our hospital between March 2023 and May 2025 was conducted. Influenza A/B (IAV/IBV) antigen testing was performed for 151,809 children; nucleic acid testing for respiratory syncytial virus (RSV), adenovirus (ADV), human metapneumovirus (HMPV), and parainfluenza viruses (PIV) I-III was performed for 35,326 children. Demographic and laboratory data were analyzed.
Results: Across two post-pandemic seasons, most viruses resurged; HMPV and PIV II peaked more prominently in season 2. RSV showed the highest positivity, whereas IAV had the most positive cases. RSV and PIV III predominated in infants; IAV, HMPV, and PIV I/II predominated in preschoolers; and IBV and ADV predominated in school-aged children. IAV, IBV, and the RSV shared a winter peak and summer trough, whereas the PIV subtypes displayed distinct seasonality. Clinically, IAV and IBV were associated mainly with acute upper respiratory infections; non-severe pneumonia was associated predominantly with RSV, ADV, HMPV, and PIVs. Coinfections were most frequent with ADV and HMPV and least frequent with IAV and IBV; the most common dual and triple coinfections were "RSV + ADV" and "RSV + ADV + IBV".
Conclusion: In the post-COVID-19 era, the age distribution, seasonality, and coinfection patterns of pediatric respiratory viruses shifted. Viruses with high detection and coinfection propensities warrant strengthened surveillance and tailored control strategies.

Keywords: China; Coinfection; Epidemiological; Pediatrics; Respiratory virus; post-COVID-19.

 
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