Evidence map›Paper›PMID 42522402›Full record

SynthesisInfluenza and other respiratory viruses2026

Impact of Non-Pharmaceutical Interventions Targeted at COVID-19 Pandemic on Influenza Burden-A Systematic Review and Meta-Analysis.

Laura-Inés Böhler, Lisa Koeppel, Stefan Fabian Weber, Mary Gaeddert, Katharina Thielemann, Kerstin Glaser, Horeya M Ismail, Ulrich Reinacher, Veronika K Jaeger, Julia Böhnke and 15 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Influenza and other respiratory viruses, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

25 authors.

Laura-Inés BöhlerDepartment of Infectious Disease and Tropical Medicine, Heidelberg University Medical Faculty, Heidelberg University Hospital, Heidelberg, Germany.
Lisa KoeppelDepartment of Infectious Disease and Tropical Medicine, Heidelberg University Medical Faculty, Heidelberg University Hospital, Heidelberg, Germany.ORCID https://orcid.org/0000-0003-4445-7881
Stefan Fabian WeberDepartment of Infectious Disease and Tropical Medicine, Heidelberg University Medical Faculty, Heidelberg University Hospital, Heidelberg, Germany.
Mary GaeddertDepartment of Infectious Disease and Tropical Medicine, Heidelberg University Medical Faculty, Heidelberg University Hospital, Heidelberg, Germany.
Katharina ThielemannDepartment of Infectious Disease and Tropical Medicine, Heidelberg University Medical Faculty, Heidelberg University Hospital, Heidelberg, Germany.
Kerstin GlaserDepartment of Infectious Disease and Tropical Medicine, Heidelberg University Medical Faculty, Heidelberg University Hospital, Heidelberg, Germany.
Horeya M IsmailDepartment of Infectious Disease and Tropical Medicine, Heidelberg University Medical Faculty, Heidelberg University Hospital, Heidelberg, Germany.
Ulrich ReinacherRobert Koch-Institut, Berlin, Germany.
Veronika K JaegerInstitute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
Julia BöhnkeInstitute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
Antonia BartzInstitute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
Maja PavicInstitute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
Manuela HarriesHelmholtz Centre for Infection Research, Department of Epidemiology, Braunschweig, Germany.
Christina KuczewskiHelmholtz Centre for Infection Research, Department of Epidemiology, Braunschweig, Germany.
Torben HeinsohnHelmholtz Centre for Infection Research, Department of Epidemiology, Braunschweig, Germany.
Olga HovardovskaHelmholtz Centre for Infection Research, Department of Epidemiology, Braunschweig, Germany.
Sin-Yin HueiHelmholtz Centre for Infection Research, Department of Epidemiology, Braunschweig, Germany.
Chao XuInstitute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
Cornelia GottschickInstitute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
Seba ContrerasInstitute for the Dynamics of Complex Systems, University of Göttingen, Göttingen, Germany.
Maciej FilinskiFaculty of Information and Communication Technology, Wrocław University of Science and Technology, Wrocław, Poland.
Maurizio GrilliMedical Faculty Mannheim, Heidelberg University, Heidelberg, Germany.
Berit LangeHelmholtz Centre for Infection Research, Department of Epidemiology, Braunschweig, Germany.
RESPINOW Study Group
Claudia M DenkingerDepartment of Infectious Disease and Tropical Medicine, Heidelberg University Medical Faculty, Heidelberg University Hospital, Heidelberg, Germany.

Funding

Federal Ministry of Education and Research (BMBF) 031L0298CFederal Ministry of Education and Research (BMBF) 031L0298FFederal Ministry of Education and Research (BMBF) 031L0298GFederal Ministry of Education and Research (BMBF) FKZ031L0298BFederal Ministry of Education and Research (BMBF) MV2021-012
6 · The paper itself

Abstract

Seasonal influenza imposes a substantial global health burden. The COVID-19 pandemic, accompanied by widespread non-pharmaceutical interventions (NPIs), profoundly disrupted respiratory virus circulation, offering a unique opportunity to assess their broader epidemiological impact. This study aimed to quantify changes in influenza burden between the pre-pandemic and intra-pandemic periods. Within the RESPINOW project, we conducted a systematic review following PRISMA guidelines. Studies reporting absolute influenza case counts before and during the pandemic were included. Data extraction and quality assessment were performed using a modified NHLBI tool for before-after studies. Influenza cases were normalized by reporting period length, and relative changes were estimated using incidence rate ratios. Subgroup analyses explored age, setting, hemisphere, human development index, influenza transmission zones, WHO regions, and viral strains. Of 20,676 screened records, 115 studies from 98 countries were included. Globally, influenza incidence declined by -92% (95% CI: -94 to -90) following the onset of the pandemic. Reductions varied geographically, ranging from near-elimination in several countries to more modest declines (e.g., South Korea: -61%, 95% CI: -79 to -26). Decreases were observed across all transmission zones and WHO regions, with descriptively larger reductions observed in high-income countries (-96%, 95% CI: -98 to -94) than in low-income settings (-82%, 95% CI: -88 to -73). Age-specific declines appeared smaller among young children (< 6 years: -66%, 95% CI: -79 to -45) compared with adults aged 18-64 years (-80%, 95% CI: -90 to -63). Influenza A appeared to decline more strongly than influenza B. The COVID-19 pandemic was associated with an unprecedented global reduction in influenza incidence. Data limitations and the need for robust epidemiological indicators highlight the importance of strengthened, integrated global surveillance to inform future pandemic responses.

Indexed as

COVID-19Influenza, HumanPandemicsGlobal HealthHumansIncidence

Identifiers

PMID42522402
PMCPMC13416394

What OpenQuestion holds

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LicenceCC BY
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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.