2018—2022年河南省某三甲医院56472例儿童急性呼吸道感染常见病毒谱分析

Analysis of common viral profiles in 56472 cases of acute respiratory tract infections in children in a level-A tertiary hospital in Henan,2018-2022

目的分析新型冠状病毒感染(新冠感染)疫情前后儿童急性呼吸道感染(acute respiratory tract infections,ARTI)常见病毒谱及流行特征,为ARTI病原学防控及预判提供参考。方法分析2018—2022年56472例儿童ARTI的甲型流感病毒、乙型流感病毒、呼吸道合胞病毒、腺病毒检测结果,对比新冠感染疫情前(2018—2019年)、新冠感染疫情后(2020—2022年)不同性别、年龄和季节病毒感染总检出率差异。结果共检测56472例病例,检出甲型流感病毒、乙型流感病毒、呼吸道合胞病毒、腺病毒等4种病毒感染15028例,总检出率为26.61%;其中新冠感染疫情前总检出率为33.62%,各病毒检出率分别为20.53%、5.42%、3.16%、4.50%;新冠感染疫情后总检出率为15.47%,各病毒检出率分别为4.46%、2.73%、5.03%、3.25%,4种病毒总检出率及各病毒检出率在新冠感染疫情前后差异均有统计学意义(P均<0.05)。男、女呼吸道合胞病毒检出率新冠感染疫情后(5.27%、4.68%)较疫情前(3.23%、3.08%)升高(P均<0.05)。0~<1岁组、1~<3岁组、3~<6岁组呼吸道合胞病毒检出率新冠感染疫情后(8.46%、6.47%、2.77%)较疫情前(6.66%、4.62%、1.84%)升高(P均<0.05)。夏季甲型流感病毒检出率新冠感染疫情后(1.02%)较疫情前(0.15%)升高(P<0.05),秋、冬季乙型流感病毒检出率新冠感染疫情后(0.35%、4.88%)较疫情前(0.06%、0.55%)升高(P均<0.05),春、夏及冬季呼吸道合胞病毒检出率新冠感染疫情后(1.41%、1.31%、11.07%)较疫情前(0.54%、0.73%、4.51%)升高(P<均0.05)。结论4种常见病毒总检出率新冠感染疫情后较疫情前下降,除呼吸道合胞病毒外,甲型流感病毒、乙型流感病毒、腺病毒检出率疫情后较疫情前下降,佩戴口罩、注重手卫生等防控措施有助于降低呼吸道病毒的感染风险。

Objective To analyze the common viral profiles and epidemiological characteristics of acute respiratory tract infection(ARTI)in children before and after the epidemic of COVID-19,and provide a reference for the prevention,control,and prognosis of ARTI etiology.Methods Influenza A virus(IAV),Influenza B virus(IBV),Respiratory Syncytial Virus(RSV),and adenovirus(ADV)testing results in 56472 children with ARTI from 2018-2022 were analyzed;the differences in the total detection rate of viral infections by gender,age,and season before(2018-2019)and after(2020-2022)COVID-19 epidemic were compared.Results A total of 56472 cases were tested and 15028 cases with the four viruses,including IAV,IBV,RSV and ADV,were detected,with an overall detection rate of 26.61%;the overall detection rate before COVID-19 epidemic was 33.62%,with detection rates of 20.53%,5.42%,3.16%and 4.50%for the four kinds of viruses,respectively;the overall detection rate after COVID-19 epidemic was 15.47%,and the detection rates for the four kinds of viruses were 4.46%,2.73%,5.03%and 3.25%,respectively.The overall detection rate for the four kinds of viruses and detection rate for each kind of virus had significant differences before and after COVID-19 epidemic(P<0.05).The detection rates of RSV in males and females significantly increased after COVID-19 epidemic(5.27%,4.68%)compared to before COVID-19 epidemic(3.23%,3.08%)(P<0.05).The detection rates of RSV were all higher in the 0-<1 year-old group,1-<3 year-old group,and 3-<6 year-old group after the epidemic(8.46%,6.47%,2.77%)than those before the epidemic(6.66%,4.62%,1.84%)(all P<0.05).After the epidemic,the detection rate of IAV in summer(1.02%)was significantly higher than that before the epidemic(0.15%)(P<0.05),and the positive rates of IBV in autumn and winter(0.35%,4.88%)were significantly higher than those before the epidemic(0.06%,0.55%)(P<0.05),and the detection rates of RSV in spring,summer,and winter(1.41%,1.31%,11.07%)were significantly higher than those before the epidemic(0.54%,0.73%,4.51%)(P<0.05).Conclusions The overall detection rate of the four common viruses decreased after COVID-19 epidemic compared with that before the epidemic;except for RSV,the detection rates of IAV,IBV and ADV all decreased after the epidemic compared with those before the epidemic,and precautionary measures,such as wearing face masks and focusing on hand hygiene,helped to reduce the risk of respiratory virus infection.