Evidence map›Paper›PMID 41081990›Full record

Observational studyEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2026

Shifts in epidemic patterns and age dynamics of RSV, IFV, and SARS-CoV-2 in Chinese children following COVID-19 non-pharmaceutical intervention relaxation, 2017 - 2024.

Yiguo Zhou, Jian-Bo Xia, Meimei Luo, Wan-Xue Zhang, Shan-Shan Zhang, Le Ao, Han Yang, Qin-Yi Ma, Juan Du, Yu-Ting Wang and 4 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Yiguo Zhou *Clinical Medical Research Center, The Second Affiliated Hospital, Army Medical University, Chongqing, 400037, P. R. China.
Jian-Bo Xia *Department of Clinical Laboratory, Maternal and Child Health Hospital of Hubei Province, 745th Wuluo Road, Hongshan District, Wuhan, 430070, P. R. China.
Meimei Luo *Department of Biostatistics, School of Public Health, Peking University, Beijing, 100191, P. R. China.
Wan-Xue ZhangDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, P. R. China.
Shan-Shan ZhangDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, P. R. China.
Le AoDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, P. R. China.
Han YangDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, P. R. China.
Qin-Yi MaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, P. R. China.
Juan DuDepartment of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, 38th Xueyuan Road, Haidian District, Beijing, 100191, P. R. China.
Yu-Ting WangDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, P. R. China.
Ninghua HuangDepartment of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, 38th Xueyuan Road, Haidian District, Beijing, 100191, P. R. China.
Xing-Wen HuDepartment of Clinical Laboratory, Maternal and Child Health Hospital of Hubei Province, 745th Wuluo Road, Hongshan District, Wuhan, 430070, P. R. China. xingwenhu0107@126.com.
Fuqiang CuiDepartment of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, 38th Xueyuan Road, Haidian District, Beijing, 100191, P. R. China. cuifuq@bjmu.edu.cn.
Qing-Bin LuDepartment of Laboratorial Science and Technology and Vaccine Research Center, School of Public Health, Peking University, 38th Xueyuan Road, Haidian District, Beijing, 100191, P. R. China. qingbinlu@bjmu.edu.cn.

Funding

the Joint Research Fund for Beijing Natural Science Foundation and Haidian Original Innovation L222029, L242050 and L222028
6 · The paper itself

Abstract

backgroundFollowing the nationwide relaxation of non-pharmaceutical interventions (NPIs) in December 2022 in China, there was considerable uncertainty regarding the resurgence and interaction patterns of major respiratory syncytial virus (RSV), influenza virus (IFV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We hypothesized that this post-NPI era would experience an unusual resurgence of traditional respiratory viruses with altered seasonality and age distribution, alongside distinct epidemic patterns of SARS-CoV-2.

methodsThis retrospective observational study analyzed comprehensive surveillance data of RSV, IFV, and SARS-CoV-2 from pediatric acute respiratory tract infection (ARTI) cases at a major maternal and child health hospital in Hubei Province, China, spanning September 2017 to August 2024. We examined temporal trends across pre-pandemic, pandemic, and post-NPI periods, age distribution shifts across four defined age groups, and coinfection patterns.

resultsA large dataset of 105,264 RSV, 177,754 IFV and 23,090 SARS-CoV-2 test records were analyzed. Following the lifting of NPIs, delayed RSV and IFV outbreaks occurred in 2022-2023 season with unusual seasonality (e.g., RSV peaking atypically in April). In the 2023-2024 season, a partial return to traditional seasonality was observed, though IFV exhibited an unprecedentedly high peak. Significant age distribution shifts occurred, with RSV infections increasing markedly in the 3 - 6 years age group and IFV infections surging in the 6 - 14 years age group during 2023, largely consistent with an immunity debt phenomenon. SARS-CoV-2 outbreaks consistently followed the peaks of IFV and RSV, showing distinct spring and summer epidemic patterns, particularly affecting young children. Coinfections of RSV and IFV remained consistently rare (about 1%).

conclusionsThe post-NPI era in China brought profound shifts in pediatric respiratory virus epidemiology, characterized by altered seasonality and age distribution for RSV and IFV, and a distinct sequential pattern for SARS-CoV-2. These findings underscore the impact of NPIs on viral dynamics and highlight the concept of immunity debt. Our study provides crucial insights for adaptive public health strategies, emphasizing the need for continued, integrated surveillance and tailored interventions to address the evolving characteristics of these key respiratory pathogens.

Indexed as

COVID-19Influenza, HumanRespiratory Syncytial Virus InfectionsAdolescentAge DistributionAge FactorsChildChild, PreschoolChinaCoinfectionEast Asian PeopleFemaleHumansInfantInfant, NewbornMaleAcute respiratory tract infectionEpidemiologyInfluenzaPost-pandemic seasonalityRespiratory syncytial virusSARS-CoV-2

Identifiers

PMID41081990

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.