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Background <p>This study analyzed the results of seven respiratory pathogen tests to investigate their epidemiological characteristics in children and provide clinical evidence for the prevention and control of acute respiratory infections (ARIs) in the pediatric population of Shanghai.</p> Methods <p>The test results for the seven pathogens (influenza A virus (FLUA), influenza B virus (FLUB), parainfluenza virus (PIV), adenovirus (ADV), respiratory syncytial virus (RSV), <i>Mycoplasma pneumoniae</i> (MP) and <i>Chlamydia pneumoniae</i> (CP)) were collected from 40,606 pediatric patients exhibiting clear ARI symptoms at Shanghai Children’s Medical Center, affiliated with Shanghai Jiao Tong University School of Medicine from January 2018 to December 2023 and retrospectively analyzed. Statistical analyses were conducted on positive detection rates, infection patterns, epidemic periods and variations based on sex and age.</p> Results <p>The overall positive detection rate for the seven respiratory pathogens was 22.57%. Compared with those in 2018, 2019 (pre-COVID-19) and 2023 (post-COVID-19), the rate significantly decreased during the pandemic period (2020–2022) (<i>P</i>*&lt;0.05), with mono-infections (mostly due to RSV, MP and PIV) being predominant. The epidemic periods of several pathogens shifted significantly after the pandemic. ADV (2.33%) and MP (14.52%) showed the highest positive detection rates among children aged 3 to &lt; 6 years and 6 to &lt; 12 years, respectively. Additionally, FLUA (1.46%) and FLUB (0.59%) exhibited the lowest rates in children aged 0 to &lt; 3 years, while PIV (5.11%) and RSV (9.88%) showing the highest rates in the same age range. Finally, the positive detection rate of MP was significantly higher in girls (6.93%) than in boys (6.18%) (<i>P</i>*&lt;0.05).</p> Conclusions <p>The overall positive detection rate for the seven respiratory pathogens decreased significantly during the pandemic (2020–2022), with several pathogens showing notable shifts in their pre- and post-pandemic epidemic periods. MP, RSV and PIV were identified as the primary ARI-causing pathogens in children, and age- or sex-related differences also observed. This study enhances current understanding of the epidemiological characteristics of respiratory pathogen infections among children spanning the pre-, during, and post-COVID-19 periods, and provides critical insights for developing more effective prevention and control strategies in Pudong, Shanghai.</p>

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Epidemiology of acute respiratory infections in children in Pudong, Shanghai: analysis of seven respiratory test results from 2018 to 2023

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  • 发表日期：

    2026年1月2日

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  • Ying Wu,
  • Xin Zhang,
  • Lin Yang,
  • Ji Ma,
  • Qiuhui Pan,
  • Li Liu

摘要

Background

This study analyzed the results of seven respiratory pathogen tests to investigate their epidemiological characteristics in children and provide clinical evidence for the prevention and control of acute respiratory infections (ARIs) in the pediatric population of Shanghai.

Methods

The test results for the seven pathogens (influenza A virus (FLUA), influenza B virus (FLUB), parainfluenza virus (PIV), adenovirus (ADV), respiratory syncytial virus (RSV), Mycoplasma pneumoniae (MP) and Chlamydia pneumoniae (CP)) were collected from 40,606 pediatric patients exhibiting clear ARI symptoms at Shanghai Children’s Medical Center, affiliated with Shanghai Jiao Tong University School of Medicine from January 2018 to December 2023 and retrospectively analyzed. Statistical analyses were conducted on positive detection rates, infection patterns, epidemic periods and variations based on sex and age.

Results

The overall positive detection rate for the seven respiratory pathogens was 22.57%. Compared with those in 2018, 2019 (pre-COVID-19) and 2023 (post-COVID-19), the rate significantly decreased during the pandemic period (2020–2022) (P*<0.05), with mono-infections (mostly due to RSV, MP and PIV) being predominant. The epidemic periods of several pathogens shifted significantly after the pandemic. ADV (2.33%) and MP (14.52%) showed the highest positive detection rates among children aged 3 to < 6 years and 6 to < 12 years, respectively. Additionally, FLUA (1.46%) and FLUB (0.59%) exhibited the lowest rates in children aged 0 to < 3 years, while PIV (5.11%) and RSV (9.88%) showing the highest rates in the same age range. Finally, the positive detection rate of MP was significantly higher in girls (6.93%) than in boys (6.18%) (P*<0.05).

Conclusions

The overall positive detection rate for the seven respiratory pathogens decreased significantly during the pandemic (2020–2022), with several pathogens showing notable shifts in their pre- and post-pandemic epidemic periods. MP, RSV and PIV were identified as the primary ARI-causing pathogens in children, and age- or sex-related differences also observed. This study enhances current understanding of the epidemiological characteristics of respiratory pathogen infections among children spanning the pre-, during, and post-COVID-19 periods, and provides critical insights for developing more effective prevention and control strategies in Pudong, Shanghai.