{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:45:53Z","timestamp":1791945953388,"version":"4.3.4"},"reference-count":52,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Acute respiratory infections (ARIs) constitute a major cause of pediatric morbidity. Their epidemiological patterns have been significantly altered across COVID\u201019 pandemic. This study aims to comparatively analyze the epidemiology and viral etiology of ARIs in pediatric inpatients across the pre\u2010, peri\u2010, and post\u2010COVID\u201019 eras. This retrospective study analyzed electronic health records of patients aged 13 years or younger who were admitted to Kiang Wu Hospital with an ARI diagnosis between January 1, 2018, and December 31, 2023. A total of 14\u2009712 ARIs cases were included, with 6734 (mean [standard deviation]\u2009=\u2009281\u2009\u00b1\u200949\/month), 4382 (125\u2009\u00b1\u200981\/month), and 3596 cases (275\u2009\u00b1\u2009143\/month) from the pre\u2010, peri\u2010, and post\u2010COVID\u201019 eras, respectively. Toddlers consistently dominated across all periods, while preschool and school\u2010aged cases declined during the peri\u2010pandemic and rebounded post\u2010pandemic. Variation was in epidemiological shifts among different viral pathogens. Specifically, the peak infection rate of Influenza virus A was 8.9%\u201311.3% (January\u2013February) in pre\u2010COVID and 12.8%\u201319.1% (April, September\u2013October) in the post\u2010COVID\u201019 era, while mostly 0.0% during the peri\u2010pandemic. Respiratory syncytial virus demonstrated a marked seasonality shift from pre\u2010pandemic autumn\u2010winter peaks (August\u2013September: 21.7%\u201328.0%; December\u2013January: 12.3%\u201323.7%) to an unprecedented autumn surge (61.2%) during the peri\u2010pandemic, followed by an amplified spring epidemic (49.6%) during the post\u2010pandemic era. Human metapneumovirus experienced a 3\u2010month phase delay in peak activity (pre\u2010pandemic era: March\u2013April, and post\u2010pandemic era: June\u2013July). The study revealed rising viral prevalence, contrasting with U\u2010shaped hospitalization trends, with seasonal and viral differences suggesting varied non\u2010pharmaceutical intervention susceptibility. Shifts toward older children and changing co\u2010infection patterns highlight the need for adaptive surveillance and response systems.<\/jats:p>","DOI":"10.1002\/jmv.70664","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T12:59:03Z","timestamp":1761224343000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Viral Epidemiology and Etiology of Acute Respiratory Infections Among Hospitalized Pediatric Patients in Macao Across the Pre\u2010, Peri\u2010, and Post\u2010COVID\u201019 Era"],"prefix":"10.1002","volume":"97","author":[{"given":"Cho Ian","family":"Wong","sequence":"first","affiliation":[{"name":"Department of Pediatrics Kiang Wu Hospital Macau China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zheng","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Mechanism and Quality of Chinese Medicine, Institute of Chinese 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