Prevalence of respiratory viruses in children with respiratory tract infections during the COVID-19 pandemic era: a systematic review and meta-analysis

Background and aimsThe evaluation of the spread of respiratory viruses in the context of the COVID-19 pandemic is required to understand how SARS-CoV-2 may have impacted the spectrum of respiratory viruses among children. Our study aimed to examine the viral etiology of respiratory infections other than SARS-CoV-2 in children during the COVID-19 pandemic.MethodsThree databases including PubMed, Scopus, and Web of Science were systematically searched from 2020 to 2023 to assess the pooled prevalence of respiratory viruses in different regions, types of patient care, and types of respiratory disease.ResultsA total of 68 studies were included in this systematic review and meta-analysis. Rhinovirus/Enterovirus (29.1%) and Respiratory syncytial virus (11.3%) were among the most common viruses among children with respiratory infections during the COVID-19 pandemic. In the case of patients younger than 5 years old, Rhinovirus/Enterovirus (36.2%) were the most prevalent viruses among all types of respiratory diseases. Also, Rhinovirus/Enterovirus were the most common viruses in the case of acute respiratory infection (26.1%), upper respiratory tract infection (21.0%), pneumonia (97.3%), and severe acute respiratory infection (54.7%). The most common viruses detected among inpatient cases were Rhinovirus/Enterovirus (47.4%) and Respiratory syncytial virus (14.9%). The prevalence of Influenza A + B viruses and Metapneumovirus among inpatients was also significantly higher than among outpatients.ConclusionThe high prevalence of viruses such as Rhinovirus/Enterovirus and Respiratory syncytial virus in various respiratory conditions, shows the requirement for enhanced surveillance, vaccination, and treatment strategies. The significance of Influenza viruses and metapneumovirus in inpatient settings delineates the importance of prioritizing them in future preventive measures such as vaccine development to minimize respiratory infection-associated hospitalization.