Are we ready to face the next wave of RSV surge after the COVID-19 Omicron pandemic in China?

Front Cell Infect Microbiol. 2023 Dec 12:13:1216536. doi: 10.3389/fcimb.2023.1216536. eCollection 2023.

Abstract

Background: China had its first wave of COVID-19 in 2020 and second wave of COVID-19 Omicron in 2022. The number of RSV cases decreased sharply in 2020 and 2022. Investigation of the resurge of RSV infections after the first wave of COVID-19 will guide us to take preventive actions before the resurge of RSV infections after the second wave of COVID-19 Omicron.

Methods: We analysed epidemiological and clinical data of 59934 patients with lower respiratory tract infections (LRTI) from a prospective long-term cohort surveillance programme in Suzhou, China, collected from February 2016 to January 2022. The annual incidence of RSV infection in children aged<16 years in 2020 and 2021 was compared with the pre-pandemic years 2016 to 2019. We also compared the clinical characteristics, and RSV-related ICU admissions between pre-pandemic years and 2021.

Results: Among children with LRTI, the positive rate of RSV increased by 70.7% in 2021 compared to the average level in the pre-pandemic years. The RSV resurge in 2021 was most prominently in children aged 2-4 years (a significant rise compared with the expected value 149.1%; 95%CI, 67.7% to 378%, P<.01). The percentage of RSV-related ICU admissions decreased in 2021 (3.2% vs 6.7%, P<0.01). The death rate of RSV infections in 2021 was 0.2%, while that in pre-pandemic years was only 0.02%. RSV-associated death in immunocompetent children (complicated by necrotizing encephalitis) was firstly occurred in 2021.

Conclusions: Our findings raise concerns for RSV control in Southeast China after the COVID-19 pandemic especially for children aged 2-4 years. Although ICU admissions were significantly reduced in this resurgence, we could not ignore the increase of RSV-associated death.

Keywords: COVID-19 pandemic; children; intensive care unit; respiratory syncytial virus infection; surveillance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19* / complications
  • COVID-19* / epidemiology
  • Child
  • China / epidemiology
  • Humans
  • Infant
  • Pandemics
  • Prospective Studies
  • Respiratory Syncytial Virus Infections* / epidemiology
  • Respiratory Syncytial Virus, Human*
  • Respiratory Tract Infections* / epidemiology

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by a grant from the National Natural Science Foundation of China (Grant No.81573167), Science and Technology Program of Jiangsu (SBK2021042695), Science and Technology Projects of Suzhou (SKY2021009), Zhongnanshan Medical Foudation Of Guangdong Province (ZNSA-2021017), Special Project on Diagnosis and Treatment of Key Clinical Diseases in Suzhou (LCZX202206), Suzhou Youth Science and Technology Project of “Revitalizing Health through Science and Education” (KJXW2021021). The funding body had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.