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Influenza Other Respir Viruses . Comparative Analysis of Influenza Epidemiology Before and After the COVID-19 Pandemic in Argentina (2018-2019 vs. 2

tetano

Editor, Senior Moderator
Influenza Other Respir Viruses


. 2025 Feb;19(2):e70078.
doi: 10.1111/irv.70078. Comparative Analysis of Influenza Epidemiology Before and After the COVID-19 Pandemic in Argentina (2018-2019 vs. 2022-2023)

Angela Gentile[SUP] 1 [/SUP], María Del Valle Juárez[SUP] 1 [/SUP], Gabriela Ensinck[SUP] 2 [/SUP], Oscar Lopez[SUP] 3 [/SUP], Pablo Melonari[SUP] 4 [/SUP], Tatiana Fernández[SUP] 5 [/SUP], Andrés Gioiosa[SUP] 5 [/SUP], Gustavo Lazarte[SUP] 2 [/SUP], Silvina Lobertti[SUP] 2 [/SUP], María Florencia Lucion[SUP] 1 [/SUP], Natalia Pejito[SUP] 1 [/SUP], Camila Racana[SUP] 1 [/SUP], Leandro López[SUP] 3 [/SUP], Gabriela Gregorio[SUP] 5 [/SUP]



Affiliations
Abstract

Introduction: The COVID-19 pandemic altered the epidemiology of respiratory viruses other than SARS-CoV-2. This study investigated the clinical-epidemiological pattern of hospitalized pediatric patients with acute lower respiratory tract infections (ALRI) and influenza in Argentina, comparing prepandemic and postpandemic periods.
Materials and methods: This multicenter, cross-sectional study included patients under 18 years old admitted for ALRIs in five tertiary centers of Argentina before (2018 and 2019) and after (2022 and 2023) COVID-19. Changes in viral detection rates, seasonality, and case fatality rate (CFR), along with epidemiological and clinical characteristics, were analyzed. Indirect immunofluorescence assay (IFA) or RT-PCR was used for virological diagnosis pre-pandemic, and only RT-PCR in post-pandemic. Epi Info 7 and SPSS 15.0 was used for data analysis.
Results: A total of 5838 cases of ALRI were included (mean age: 9.5 months; IQR: 4-22 months); 96.6% were tested for viral detection, and 66.4% were positive (3877 cases). Respiratory syncytial virus (RSV) was the most prevalent. Influenza showed typical winter seasonality in 2018, 2019, and 2023. However, 2022 exhibited a bimodal pattern: late summer and spring, with co-circulation of influenza A and B in the second peak. CFR varied by viral diagnosis; influenza showed the highest CFR, all deaths related to influenza A. Among 354 influenza cases, 81% were < 5 years old, 53% were male, 63% had comorbidities, and 14.1% required intensive care. Mean of influenza vaccine coverage (6-24 months) was 21.4%. In both periods, patients with influenza were more likely to have pneumonia. Additionally, in the postpandemic period, malnourishment or being 3 years of age or older was also associated with a higher likelihood of influenza infection compared with infection with other respiratory viruses.
Conclusions: Influenza primarily affected children under 5 years old. Postpandemic cases involved older individuals, and increased circulation of influenza A H3N2 was observed. Vaccination coverage was notably low. Influenza returned to its usual seasonal pattern in 2023.

Keywords: ALRI; case fatality rate; influenza; influenza vaccine coverage.

 
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