Epidemiology of respiratory viruses in pediatric acute otitis media during the COVID-19 pandemic: a cross-sectional study

Background To examine the epidemiology of respiratory viruses in children admitted for respiratory tract infection (RTI) and acute otitis media (AOM) during the 3 years before and the first 2 years of the COVID-19 pandemic. A period in which public health infection control measures were implemented to limit viral spread. Methods A cross-sectional study of children <= 6 years admitted with RTI and concurrent uncomplicated AOM was performed. Viruses were identified from nasopharyngeal swabs taken 3 years before the pandemic (January 2017-February 2020) and during the first two pandemic years (March 2020-February 2021 and March 2021-March 2022). Results376 children (median age, 17.6 months; males, 61.2%) were included. Before the pandemic, an average of 78 children were admitted annually, while in the first pandemic year, the number decreased to 20, and during the second year, it increased to 121 (p < 0.001). Before the pandemic, respiratory syncytial virus (RSV) was detected in 12.5-28.8%, adenovirus in 18.5-28.3%, and influenza in 7.7-24.7% of cases. In the first pandemic year, RSV and influenza were not detected, while adenovirus was detected in 15.0% of cases. In the second pandemic year, RSV detection increased to 33.1%, adenovirus to 29.4%, and influenza to 5.8% (p = 0.001, p = 0.281, p < 0.001, respectively). Enterovirus was the most commonly detected virus during the first pandemic year. Conclusions During the first 2 years of the COVID-19 pandemic, the number of children admitted for RTI and AOM significantly decreased, along with a notable shift in the epidemiology of respiratory viruses associated with AOM. These findings confirm the importance of infection control measures in children.