Respiratory Syncytial Virus in Xiamen, China: Epidemiological and
Clinical Shifts Across COVID-19 Pandemic Phases
Abstract
Objective To analyzed epidemiology and clinical feature of
respiratory syncytial virus(RSV) in Xiamen, China, and to compare RSV
infections before, during and after the COVID-19 pandemic.
Methods From January 2017 to December 2023, medical records of
inpatients aged under 5 years with lower respiratory infection with RSV
infections were reviewed. The epidemiology and clinical features were
analyzed. Results The peak of RSV epidemiology was shifted from
September (pre-COVID-19) to June-September (during and post-COVID-19).
The proportion of patients aged over 2 years increased during and
post-COVID-19 period (29.5% and 35.2% vs 14.9%, P<0.01).
Compared with pre-COVID-19 period, fever was more prevalent during and
post-COVID-19 period (70.5% and 76.0% vs 51.6%, P<0.01). The
incidence of oxygen supplement and ventilator usage was higher in the
post-COVID-19 period compared with pre-COVID-19 period (43.2% vs 28.8%
and 10.4% vs 2.3%, P<0.01). Clinical characteristics across
the three period by age stratified noted increased disease severity in
children aged under 6 months, with higher incidence of ventilator usage
and ICU admissions during the COVID-19 pandemic and post-COVID-19
period(P<0.015), while disease severity was similar in children
aged over 2years across three phases. Binary logistic regression
analyses for risk factors of ICU admission showed that younger age
(adjusted OR 2.7,95% CI 1.9-3.8, P <0.001), tachypnea (adjusted
OR 3.4,95% CI 2.2-5.4, P <0.001) were the significant
independent risk factors associated with ICU admissions in RSV
infection. Conclusion The COVID-19 pandemic has altered RSV
epidemiology and clinical characteristics, increased severity was
observed in children aged under 6 months during these periods. These
findings underscore the need for continued surveillance of RSV patterns
in the post-COVID-19 era and adaptive prevention strategies.