ArticleHeliyon2024
Alterations of pathogen transmission patterns and attenuated immune stimulation might be the cause of increased adult respiratory infections cases in 2023, results from a multi-center study in mainland China.
Article in Heliyon, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Emergence of the novel PA-D27G mutation conferring reduced baloxavir susceptibility in influenza A viruses circulating in China, 2018-2025.Emerging microbes & infections · 2026Article
- Artificial intelligence risk prediction model for common respiratory pathogens in China based on heterogeneous multi-source clinical and geographic data: A modeling study.PLOS digital health · 2026Article
- Etiological landscape and co-infection dynamics in Acute Respiratory Infections (ARIs): insights from a multicenter outpatient study in Yunnan, China.BMC infectious diseases · 2026Article
- Article
- Enhancing upper respiratory tract infection detection: exploring qPCR negative respiratory samples using targeted next-generation sequencing.Infection · 2025Article
- Changing patterns of respiratory pathogens in hospitalized children with community-acquired pneumonia in northern China following the lifting of non-pharmaceutical interventions.Microbiology spectrum · 2025Observational
- Epidemiological characteristics of six common respiratory pathogen infections in children.Microbiology spectrum · 2025Article
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Authors and funding
30 authors.
Funding
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Abstract
Background: Several respiratory infections outbreaks have been observed in mainland China after reduction of non-pharmaceutical interventions. Other countries have seen increases in respiratory infections outside typical seasons post-COVID-19, warranting investigation into underlying causes. Methods: We established monitoring networks for suspected respiratory infection in 14 tertiary hospitals nationwide. PCR for SARS-CoV-2, influenza A and B were performed on 3708 respiratory specimens and deep sequencing were conducted to identify co-infections or newly emerging microbes in 2023. Viral evolutionary analysis was completed. We retrospectively detected serum antibody level for various respiratory pathogens from 4324 adults without respiratory infections over 7 years to observe its dynamic curves. Findings: SARS-CoV-2 and influenza A were the main pathogens during outbreaks in 2023, bacterial-virus and bacterial-bacterial co-infections were most detected, but community co-infections didn't significantly increase pneumonia incidence. Different SARS-CoV-2 and influenza variants were present in different outbreaks, and no novel pathogens were found. The epidemiological patterns of influenza A, COVID-19 and etc. were altered, exhibiting characteristics of being "staggered" compared to most global regions, and potentially led to "overlapping prevalence". Binding antibody testing showed regular fluctuation, without significant decrease against common respiratory pathogens in adults. Influenza A antibody stimulation was attenuated during the 2023 outbreak. Conclusions: "Misaligned" alteration in seasonal respiratory disease patterns possibly caused combined epidemics, leading to cases spike in China, 2023. In adults, antibody levels didn't show significant decline, but reduced immune response to influenza during 2020-2023 emphasizes the need for consistent vaccination during pandemics.
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