AI Summary & Key Takeaways
AI InsightAlthough RSV remained the predominant pathogen and independently increased odds of severe disease, overall invasive ventilation requirements declined during and after the pandemic.
📌 3 Key Takeaways
Abstract
Aims: To evaluate the impact of the COVID-19 pandemic on the epidemiology and clinical characteristics of viral lower respiratory tract infections (LRTIs) in young infants admitted to a neonatal intensive care unit (NICU). Methods: This single-center retrospective cohort study included 235 young infants hospitalized with viral LRTI between January 2018 and January 2024. Patients were categorized into pre-pandemic (n=54), during the pandemic (n=64), and post-pandemic (n=117) periods. Demographic characteristics, viral pathogen distribution, respiratory support requirements, length of stay, and clinical morbidities were compared. Multivariate logistic regression was performed to identify predictors of invasive mechanical ventilation (IMV). Results: RSV was the most frequently identified pathogen (49.8%), followed by SARS-CoV-2 (8.5%), influenza (6.4%), and rhinovirus (3.0%); no pathogen was detected in 24.7% of cases. Viral distribution differed significantly across pandemic periods (χ² test, p=0.017; Cramer’s V=0.35). RSV proportion increased from 40.7% (pre-pandemic) to 53.0% (post-pandemic), while SARS-CoV-2 emerged during the pandemic (20.3%). Respiratory support requirements differed significantly (p=0.002; Cramer’s V=0.22), with invasive ventilation decreasing from 50.0% (pre-pandemic) to 20.5% (post-pandemic). Length of NICU stay did not differ significantly among periods (p=0.354). Clinical morbidities were comparable across periods (all p>0.05). In multivariate analysis, RSV-related infection independently predicted IMV (OR 4.36, 95% CI 2.15-8.84, p<0.001). Compared with the pre-pandemic period, the odds of IMV was significantly lower during the pandemic (OR 0.38, 95% CI 0.17-0.87, p=0.022) and post-pandemic (OR 0.17, 95% CI 0.07-0.38, p<0.001). Conclusion: The COVID-19 pandemic was associated with significant changes in viral pathogen distribution in young infants viral LRTIs. Although RSV remained the predominant pathogen and independently increased odds of severe disease, overall invasive ventilation requirements declined during and after the pandemic. Ongoing young infants-specific viral surveillance and updated RSV preventive strategies are warranted.