Broad Impacts of Coronavirus Disease 2019 (COVID-19) Pandemic on Acute Respiratory Infections in China: An Observational Study
Zhong Jie Li, Lin Yu, Xiao‐Ai Zhang, Chun Xi Shan, Qing Lü, Xiao Ai Zhang, Xiang Ren, Cui Hong Zhang, Yifei Wang, Sheng Hong Lin, Qiang Xu, Bao Gui Jiang, Tao Jiang, Chen Long Lv, Jin Jin Chen, George F. Gao, Wei Yang, Li Ping Wang, Yang Yang, Li Fang, Wei Liu, Wei Yang, George F. Gao, Zhong Jie Li, Li Ping Wang, Xiang Ren, Yifei Wang, Sheng Hong Lin, Cui Hong Zhang, Meng Jie Geng, Xin Wang, Huai Qi Jing, Wen Xu, Ai Li Cui, Yu Juan Shen, Yan Jiang, Qiao Sun, Li Peng Hao, Chu Chu Ye, Wei Liu, Xiao Ai Zhang, Liu Yu Huang, Yong Wang, Wen Yi Zhang, Ying Le Liu, Jian Wu, Qi Zhang, Wei Liu, Zi Yong Sun, Fa Xian Zhan, Ying Xiong, Lei Meng, De Shan Yu, Chun Xiang Wang, Sheng Cang Zhao, Wen Rui Wang, Xia Lei, Juan Sheng Li, Yuhong Wang, Yan Zhang, Jun Yang, Yan Bo Wang, Fu Cai Quan, Zhi Jun Xiong, Li Liang, Quan E Chang, Yun Wang, Ping Wang, Zuo Sen Yang, Ling Mao, Jia Meng Li, Li Kun Lv, Jun Xu, Chang Shu, Xiao Chen, Yu Chen, Yanjun Zhang, Lun Biao Cui, Kui Zheng, Xing Guo Zhang, Xi Zhang, Li Hong Tu, Zhi Yi, Wei Wang, Shi Zhao, Xiao Fang Zhou, Xiao Fang Pei, Tian Li Zheng, Xiao Ni Zhong, Qin Li, Hua Ling, Ding Ming Wang, Shi Jun Li, Shu Sen He, Meng Feng Li, Jun Li, Xun Zhu, Chang Wen Ke, Hong Xiao, Biao Di
Abstract
BACKGROUND: To combat the coronavirus disease 2019 (COVID-19) pandemic, nonpharmaceutical interventions (NPIs) were implemented worldwide, which impacted a broad spectrum of acute respiratory infections (ARIs). METHODS: Etiologically diagnostic data from 142 559 cases with ARIs, who were tested for 8 viral pathogens (influenza virus [IFV], respiratory syncytial virus [RSV], human parainfluenza virus [HPIV], human adenovirus [HAdV], human metapneumovirus [HMPV], human coronavirus [HCoV], human bocavirus [HBoV], and human rhinovirus [HRV]) between 2012 and 2021, were analyzed to assess the changes in respiratory infections in China during the first COVID-19 pandemic year compared with pre-pandemic years. RESULTS: Test-positive rates of all respiratory viruses decreased during 2020, compared to the average levels during 2012-2019, with changes ranging from -17.2% for RSV to -87.6% for IFV. Sharp decreases mostly occurred between February and August when massive NPIs remained active, although HRV rebounded to the historical level during the summer. While IFV and HMPV were consistently suppressed year-round, RSV, HPIV, HCoV, HRV, and HBoV resurged and went beyond historical levels during September 2020-January 2021, after NPIs were largely relaxed and schools reopened. Resurgence was more prominent among children <18 years and in northern China. These observations remain valid after accounting for seasonality and long-term trend of each virus. CONCLUSIONS: Activities of respiratory viral infections were reduced substantially in the early phases of the COVID-19 pandemic, and massive NPIs were likely the main driver. Lifting of NPIs can lead to resurgence of viral infections, particularly in children.