Reconstructing the post-pandemic landscape: a retrospective, hospital-based surveillance of respiratory pathogens in hospitalized children in Chenzhou, China, 2021-2025.

Xiaomei Lei, Xuemei Yan, Aoying Li, Ziting Tang, Tan Tan

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Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 authors.

Xiaomei Lei *The First People's Hospital of Chenzhou, The Affiliated ChenZhou Hospital, Hengyang Medical School, University of South China, No. 102 Luojiajing, Chenzhou, Hunan Province, China.

Xuemei Yan *The First People's Hospital of Chenzhou, The Affiliated ChenZhou Hospital, Hengyang Medical School, University of South China, No. 102 Luojiajing, Chenzhou, Hunan Province, China.

Aoying LiThe First People's Hospital of Chenzhou, The Affiliated ChenZhou Hospital, Hengyang Medical School, University of South China, No. 102 Luojiajing, Chenzhou, Hunan Province, China.

Ziting TangThe First People's Hospital of Chenzhou, The Affiliated ChenZhou Hospital, Hengyang Medical School, University of South China, No. 102 Luojiajing, Chenzhou, Hunan Province, China.

Tan TanThe First People's Hospital of Chenzhou, The Affiliated ChenZhou Hospital, Hengyang Medical School, University of South China, No. 102 Luojiajing, Chenzhou, Hunan Province, China. Tantan1413@xnu.edu.cn.

Funding

Hunan Provincial Natural Science Foundation Regional Joint Fund 2023JJ50378The scientific research project of the First People's Hospital of Chenzhou N2019-012

6 · The paper itself

Abstract

BACKGROUND &

objectivesThe COVID-19 pandemic significantly altered the global ecology of respiratory pathogens. This study aimed to characterize epidemiological shifts and explore determinants of infection risk among hospitalized children at a single center in Chenzhou, China, during the post-pandemic period.

methodsA retrospective analysis was conducted using hospital-based surveillance data of acute respiratory infections in children from January 1, 2021, to December 31, 2025. Nasopharyngeal swabs from 42,505 cases were tested via multiplex PCR for 13 common respiratory pathogens. Age-stratified positivity rates were calculated, and multivariable logistic regression models were employed to identify independent risk factors, adjusting for year, season, and sex.

resultsThe data revealed an altered pathogen landscape. Rhinovirus (RV) was consistently detected at a high frequency, becoming a persistently prevalent agent (annual average positivity: 33.65%). The seasonal peak of influenza A virus (FluA) approached pre-pandemic levels, co-circulating with respiratory syncytial virus (RSV) and parainfluenza virus (PIV) in autumn/winter. Mycoplasma pneumoniae (MP) exhibited a notable epidemic surge in 2023 (16.03%), followed by a rapid decline to 0.56% by 2025. Regression analysis, adjusted for multiple covariates, identified age as a significant independent risk factor and revealed three consistent age-related pathogen patterns: (1) RSV/PIV predominance in infants and toddlers; (2) peak incidence of RV, adenovirus (ADV), and human metapneumovirus (HMPV) in preschool children; and (3) increasing risk of MP and Chlamydia pneumoniae with age. Notably, RSV resurged earlier (2021) than reported in Western countries, and the elevated endemicity of RV was more evident..

conclusionThis retrospective analysis of large-scale surveillance data describes changes in respiratory pathogen ecology among hospitalized children in Chenzhou during the post-pandemic period, characterized by age-dependent patterns and region-specific rebound dynamics. These observed season-age risk patterns may help generate hypotheses for informing clinical stratification and could inform local surveillance efforts, though prospective validation is required before clinical implementation.

Indexed as

COVID-19Respiratory Tract InfectionsAdolescentChildChild, HospitalizedChild, PreschoolChinaFemaleHospitalizationHumansInfantInfant, NewbornMaleRetrospective StudiesRisk FactorsSeasonsAge distributionEpidemiological monitoringPost-COVID-19 periodRespiratory tract infectionsRhinovirus

Identifiers

PMID42363106

DOI10.1186/s12879-026-13865-8

PMCPMC13563753

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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.