{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T07:15:22Z","timestamp":1763709322566,"version":"3.45.0"},"reference-count":59,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Immunity Inflam &amp;amp; Disease"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute respiratory infections (ARIs) are a significant global health concern, especially in children under five, causing approximately 4.3 million annual deaths. ARIs are mainly caused by respiratory viruses. The coronavirus disease 2019 (COVID\u201019) has altered the circulation of respiratory viruses. This study investigates the epidemiology and clinical features of respiratory viruses in hospitalized children during the COVID\u201019 pandemic in Gorgan, Iran.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 264 nasopharyngeal swab samples were collected from hospitalized children between October 2021 to March 2022 at Taleghani Children's Hospital, Gorgan, Iran. The frequency of various respiratory viruses, including human parainfluenza viruses (HPIV1\u20104), influenza viruses A and B (FLU\u2010A, B), human metapneumovirus (HMPV), human rhinovirus (HRV), respiratory syncytial virus (RSV), and severe acute respiratory syndrome\u2010associated coronavirus 2 (SARS\u2010CoV\u20102) was detected using a SYBR green\u2010based real\u2010time PCR assay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Out of the 264 hospitalized children, 88.2% (233) tested positive for at least one respiratory virus, with 60.2% (159) showing co\u2010infections and 28% (74) having single infections. The most frequently detected were HRV (56.4%), HMPV (53%), and RSV (18.2%). The proportions of HPIV\u20101, HPIV\u20102, HPIV\u20103, HPIV\u20104, FLU\u2010A, FLU\u2010B, and SARS\u2010CoV\u20102 were 8.7%, 12.9%, 8%, 7.6%, 1.9%, 0%, and 15.2%, respectively. There was a clear association between specific viruses and some clinical symptoms, such as RSV with pneumonia, and HPIV\u20101 with cyanosis. Co\u2010infections were linked to severe outcomes, including pneumonia and seizures. Among all 264 patients, 5 died, and 3 of them had underlying diseases. All fatal cases tested positive for at least one virus, with HMPV being the most frequently detected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study highlights the considerable impact of ARIs among children under five in Golestan Province, Iran, during the COVID\u201019 pandemic. The findings underscore the importance of early detection and ongoing surveillance, particularly in high\u2010risk pediatric populations and across diverse geographic areas.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/iid3.70275","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T07:36:37Z","timestamp":1759131397000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiology and Clinical Features of Respiratory Viruses in Hospitalized Iranian Children During the COVID\u201019 Pandemic"],"prefix":"10.1002","volume":"13","author":[{"given":"Ali","family":"Nateghi","sequence":"first","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine Golestan University of Medical Sciences Gorgan Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morvarid","family":"Hamrahjoo","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine Golestan University of Medical Sciences Gorgan Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Yasaghi","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine Golestan University of Medical Sciences Gorgan Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahnaz","family":"Ramzali","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine Golestan University of Medical Sciences Gorgan Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saeed","family":"Samadizadeh","sequence":"additional","affiliation":[{"name":"Wellcome\u2010Wolfson Institute for Experimental Medicine Queen's University Belfast Belfast Northern Ireland UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatemeh","family":"Fotouhi","sequence":"additional","affiliation":[{"name":"Influenza and Other Respiratory Viruses Pasteur Institute of Iran Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vahid","family":"Salimi","sequence":"additional","affiliation":[{"name":"Department of Virology Tehran University of Medical Sciences Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lobat","family":"Shahkar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine Golestan University of Medical Sciences Gorgan Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Britt","family":"Nakstad","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Health University of Botswana Gaborone Botswana"},{"name":"Division of Paediatric and Adolescent Medicine, Institute of Clinical Medicine University of Oslo Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7680-5698","authenticated-orcid":false,"given":"Alireza","family":"Tahamtan","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine Golestan University of Medical Sciences Gorgan Iran"},{"name":"Infectious Diseases Research Center Golestan University of Medical Sciences Gorgan Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61689-4"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_1748_22"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2018-212096"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2016.09.003"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1752-8062.2010.00257.x"},{"key":"e_1_2_12_7_1","first-page":"799","article-title":"Viruses as Precipitants of Asthmatic Attacks in Children","volume":"20","author":"Dick E.","year":"1972","journal-title":"Clinical Research"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1405870"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/1178636118758651"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2016.04.019"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/14787210.2016.1233814"},{"issue":"38","key":"e_1_2_12_12_1","first-page":"639","article-title":"The Role of Multiplex PCR in Respiratory Tract Infections in Children","volume":"111","author":"Krause J. 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