ArticleFrontiers in pediatrics2026
Ecological reshaping of pediatric respiratory pathogen profiles after COVID-19-related non-pharmaceutical interventions were lifted: a 5-year interrupted time-series study.
Article in Frontiers in pediatrics, 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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Abstract
Background: COVID-19-related non-pharmaceutical interventions (NPIs) disrupted the circulation of many respiratory pathogens. After these measures were lifted, pediatric respiratory pathogen activity may have changed in pathogen-specific ways. However, laboratory-based evidence using continuous multi-year data, interrupted time-series analysis, and contextual factors such as meteorology, air quality, and school calendars remains limited. Methods: We conducted a single-center retrospective laboratory study of pediatric and neonatal inpatients aged 0-14 years with clinically diagnosed lower respiratory tract infection from January 2021 to December 2025. After 7-day deduplication within the same child, 20,250 throat-swab testing records were included. The NPI period was January 2021-December 2022, and the post-NPI period was January 2023-December 2025. Thirteen pathogen categories were analyzed using period comparisons, interrupted time-series models, and multivariable logistic regression incorporating meteorological factors, air quality index, and school-term status. Results: Overall positivity was higher in the post-NPI period than in the NPI period (75.4% vs. 58.8%), and co-detection was also higher in the post-NPI period (15.2% vs. 6.0%). Pathogen-specific interrupted time-series analysis showed heterogeneous patterns: human adenovirus showed a robust immediate level decrease (-13.00 percentage points; 95% CI, -20.13 to -5.87; FDR-adjusted Conclusion: The NPI and post-NPI periods showed distinct and heterogeneous temporal patterns in pediatric respiratory pathogen detection. These findings support integrated hospital-based laboratory surveillance centered on pathogen-specific temporal trends and interpreted alongside demographic, multi-pathogen, environmental, school-calendar, and longer-term temporal context.
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