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Changes in Pediatric Acute Respiratory Infections Before, During, and After the COVID-19 Pandemic: A Retrospective Study

Year: 2025

Type: article

Abstract: INTRODUCTION AND OBJECTIVES: Acute respiratory infections (ARIs) are a significant cause of morbidity in children and a common reason for emergency department (ED) visits. During the COVID-19 pandemic, governments adopted non-pharmacological interventions (NPIs) to limit SARS-CoV-2 transmission. These measures also reduced the circulation and seasonality of other respiratory pathogens, with little impact on infections in non-respiratory organ systems. This study aimed to quantify changes in the incidence and severity of pediatric ARIs before, during, and after the pandemic. MATERIALS AND METHODS: We conducted a retrospective observational time-series study of children aged 0-10 years presenting with ARIs to a level 2 pediatric ED in Covilhã, Portugal, from April 2019 to April 2023. To ensure representativeness while controlling data volume, admissions from the first five days of each month were analyzed. Three periods were defined: pre-COVID-19 (Pre-C), COVID-19 (C), and post-COVID-19 (Post-C). All statistical analyses were performed using SPSS Statistics version 28 (IBM Corp. Released 2021. IBM SPSS Statistics for Windows, Version 28.0. Armonk, NY: IBM Corp.). A significance level of p = 0.05 was applied. RESULTS: Among 7,448 sampled ED visits, 2,210 (29.7%) involved ARIs. Their proportion fell from Pre-C to C (p = 0.028) and rose sharply in Post-C (p < 0.001), exceeding Pre-C levels (p < 0.001). In C, atypical inter-seasonal peaks occurred. Hospitalization rates, length of stay, and oxygen requirements showed no significant variation. CONCLUSIONS: COVID-19 NPIs were associated with a marked reduction and altered timing of pediatric ARIs, whereas infections in other organ systems were largely unaffected. After restrictions were lifted, ARI incidence surpassed pre-pandemic levels, but disease severity remained stable. These findings highlight how public health measures and subsequent exposure shifts can reshape respiratory infection epidemiology in children.

Source: Cureus

DOI: 10.7759/cureus.92841

Authors: Ana Fradique, Marta Rodrigues, Laura Isabel Azevedo e Sousa, Arminda Jorge

Institutions: Unidade Local de Saúde de Coimbra, Hospital Center of Cova da Beira, University of Beira Interior

Language: English

Topic: Respiratory viral infections research

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4415507296