{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T22:54:01Z","timestamp":1780959241786,"version":"3.54.1"},"reference-count":32,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"unspecified","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,2,25]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Post-COVID-19 respiratory infection patterns require updated epidemiological data. To investigate the prevalence and infection patterns of upper respiratory tract infections (URTIs), a survey was conducted to assess the presence of influenza A (IFV A), influenza B (IFV B), respiratory syncytial virus (RSV), human rhinovirus (HRV), adenovirus (Adv), and SARS-CoV-2 among outpatients diagnosed with URTIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A community-based cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Three cities in Sichuan, China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>1174 outpatients diagnosed with URTIs from December 2023 to February 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Oropharyngeal swabs were collected using sterile flocked swabs, preserved at 4\u00b0C and analysed within 24 hours. Viral nucleic acid was extracted automatically and detected via multiplex PCR-melting curve analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Results showed in positive detection rates varied significantly by age (p&lt;0.001), peaking in children (77.42%), followed by adolescents (73.23%), adults (63.59%) and older adults (57.58%). IFV B and A predominated, followed by HRV, Adv, RSV and SARS-CoV-2. 12 co-infection types were identified, with HRV\/Adv and IFV B\/HRV most prevalent. In children and adolescents, co-infections were significantly more common, with predominant types including HRV\/Adv, HRV\/RSV and RSV\/IFV B.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study reveals persistent influenza dominance and age-stratified co-infection risks and provides critical baseline data for optimising respiratory infectious disease control in the post-pandemic era.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-110369","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T15:35:33Z","timestamp":1773934533000},"page":"e110369","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Cross-sectional study of respiratory virus infections in upper respiratory tract infection patients: post-COVID-19 pandemic trends in Sichuan, China"],"prefix":"10.1136","volume":"16","author":[{"given":"Ying","family":"Li","sequence":"first","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Wenjiang District People\u2019s Hospital of Chengdu, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Mianyang People\u2019s Hospital, Mianyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Bazhong Maternal and Child Health Hospital, Bazhong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pingchang County Maternity and Child Healthcare Hospital, Bazhong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Reagent Research and Development, Capitalbio Technology (Chengdu), Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Mianyang People\u2019s Hospital, Mianyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoying","family":"Lin","sequence":"additional","affiliation":[{"name":"Research and Development Department, Fujian CapitalBio Medical Laboratory, Fuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinsong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Bazhong Maternal and Child Health Hospital, Bazhong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiawen","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Reagent Research and Development, Capitalbio Technology (Chengdu), Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuyao","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Wenjiang District People\u2019s Hospital of Chengdu, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongquan","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Reagent Research and Development, Capitalbio Technology (Chengdu), Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiyuan","family":"Xu","sequence":"additional","affiliation":[{"name":"Research and Development Department, Fujian CapitalBio Medical Laboratory, Fuzhou, China"},{"name":"Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2037-343X","authenticated-orcid":false,"given":"Guanbin","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Intelligent Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China"},{"name":"Department of Laboratory Medicine, Fujian Medical University, Fuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"2026031908351991000_16.3.e110369.1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1003550","article-title":"Global burden of influenza-associated lower respiratory tract infections and hospitalizations among adults: A systematic review and meta-analysis","volume":"18","author":"Lafond","year":"2021","journal-title":"PLoS Med"},{"key":"2026031908351991000_16.3.e110369.2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(17)33293-2"},{"key":"2026031908351991000_16.3.e110369.3","doi-asserted-by":"crossref","DOI":"10.1002\/rmv.2340","article-title":"SARS-CoV-2 and dengue virus co-infection: Epidemiology, pathogenesis, diagnosis, treatment, and management","volume":"33","author":"Prapty","year":"2023","journal-title":"Rev Med Virol"},{"key":"2026031908351991000_16.3.e110369.4","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1016\/S0140-6736(22)00383-X","article-title":"SARS-CoV-2 co-infection with influenza viruses, respiratory syncytial virus, or adenoviruses","volume":"399","author":"Swets","year":"2022","journal-title":"The Lancet"},{"key":"2026031908351991000_16.3.e110369.5","doi-asserted-by":"publisher","DOI":"10.1016\/SO140-6736(20)30566-3"},{"key":"2026031908351991000_16.3.e110369.6","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.1016\/S2352-4642(21)00333-3","article-title":"Respiratory syncytial virus: paying the immunity debt with interest","volume":"5","author":"Hatter","year":"2021","journal-title":"Lancet Child Adolesc Health"},{"key":"2026031908351991000_16.3.e110369.7","doi-asserted-by":"publisher","DOI":"10.1111\/irv.12884"},{"key":"2026031908351991000_16.3.e110369.8","doi-asserted-by":"crossref","DOI":"10.3389\/fcimb.2023.1200617","article-title":"Changing patterns of infectious diseases in children during the COVID-19 pandemic","volume":"13","author":"Yang","year":"2023","journal-title":"Front Cell Infect Microbiol"},{"key":"2026031908351991000_16.3.e110369.9","first-page":"713","article-title":"Rational use of antibiotics to treat respiratory tract infections","volume":"8","author":"File","year":"2002","journal-title":"Am J Manag Care"},{"key":"2026031908351991000_16.3.e110369.10","doi-asserted-by":"crossref","DOI":"10.1002\/jmv.28367","article-title":"High incidence of the virus among respiratory pathogens in children with lower respiratory tract infection in northwestern China","volume":"95","author":"Yan","year":"2023","journal-title":"J Med Virol"},{"key":"2026031908351991000_16.3.e110369.11","doi-asserted-by":"crossref","DOI":"10.1186\/s12931-024-02862-7","article-title":"Influenza A, Influenza B, human respiratory syncytial virus and SARSCoV-2 molecular diagnostics and epidemiology in the post COVID-19 era","volume":"25","author":"Lu\u0161trek","year":"2024","journal-title":"Respir Res"},{"key":"2026031908351991000_16.3.e110369.12","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-023-15880-9","article-title":"Resurgence of influenza and respiratory syncytial virus in Egypt following two years of decline during the COVID-19 pandemic: outpatient clinic survey of infants and children, October 2022","volume":"23","author":"Kandeel","year":"2022","journal-title":"BMC Public Health"},{"key":"2026031908351991000_16.3.e110369.13","doi-asserted-by":"crossref","first-page":"6319","DOI":"10.1038\/s41598-023-33627-9","article-title":"The epidemiological features of respiratory tract infection using the multiplex panels detection during COVID-19 pandemic in Shandong province, China","volume":"13","author":"Zhang","year":"2023","journal-title":"Sci Rep"},{"key":"2026031908351991000_16.3.e110369.14","doi-asserted-by":"crossref","first-page":"e6","DOI":"10.1016\/j.jinf.2021.07.013","article-title":"Epidemiology and co-infection patterns in patients with respiratory tract infections in southern China between 2018 and 2020","volume":"83","author":"Liang","year":"2021","journal-title":"J Infect"},{"key":"2026031908351991000_16.3.e110369.15","doi-asserted-by":"crossref","DOI":"10.1016\/j.heliyon.2023.e22302","article-title":"Epidemiology of respiratory pathogens in patients with acute respiratory tract infection in Xiamen, China: A retrospective survey from 2020 to 2022","volume":"9","author":"Hong","year":"2023","journal-title":"Heliyon"},{"key":"2026031908351991000_16.3.e110369.16","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0911530"},{"key":"2026031908351991000_16.3.e110369.17","doi-asserted-by":"publisher","DOI":"10.1111\/irv.12432"},{"key":"2026031908351991000_16.3.e110369.18","doi-asserted-by":"crossref","first-page":"1536","DOI":"10.3201\/eid2408.180063","article-title":"Variation in Influenza B Virus Epidemiology by Lineage, China","volume":"24","author":"Yang","year":"2018","journal-title":"Emerg Infect Dis"},{"key":"2026031908351991000_16.3.e110369.19","doi-asserted-by":"crossref","DOI":"10.1080\/21505594.2024.2310873","article-title":"Rhinovirus infection and co-infection in children with severe acute respiratory infection during the COVID-19 pandemic period","volume":"15","author":"Regina Malveste Ito","year":"2024","journal-title":"Virulence"},{"key":"2026031908351991000_16.3.e110369.20","doi-asserted-by":"publisher","DOI":"10.3201\/eid2711.211565"},{"key":"2026031908351991000_16.3.e110369.21","doi-asserted-by":"crossref","DOI":"10.4178\/epih.e2020056","article-title":"Outbreak investigation: transmission of COVID-19 started from a spa facility in a local community in Korea","volume":"42","author":"Han","year":"2020","journal-title":"Epidemiol Health"},{"key":"2026031908351991000_16.3.e110369.22","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1080\/22221751.2020.1787799","article-title":"Risk factors associated with COVID-19 infection: a retrospective cohort study based on contacts tracing","volume":"9","author":"Liu","year":"2020","journal-title":"Emerg Microbes Infect"},{"key":"2026031908351991000_16.3.e110369.23","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-024-10257-8","article-title":"Etiological analysis of acute respiratory infections in hospitalized children after the relaxation of COVID-19 non-pharmacological interventions in Quzhou, China","volume":"24","author":"Fu","year":"2024","journal-title":"BMC Infect Dis"},{"key":"2026031908351991000_16.3.e110369.24","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1186\/s12879-025-10654-7","article-title":"Retrospective study on the epidemiological characteristics of multi-pathogen infections of hospitalized severe acute respiratory tract infection and influenza-like illness in Xinjiang from January to May 2024","volume":"25","author":"Huang","year":"2025","journal-title":"BMC Infect Dis"},{"key":"2026031908351991000_16.3.e110369.25","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-023-02929-z"},{"key":"2026031908351991000_16.3.e110369.26","doi-asserted-by":"crossref","DOI":"10.29333\/ejgm\/7850","article-title":"The Possible Immunological Pathways for the Variable Immunopathogenesis of COVID\u201419 Infections among Healthy Adults, Elderly and Children","volume":"17","author":"Abdulamir","year":"2020","journal-title":"Electron J Gen Med"},{"key":"2026031908351991000_16.3.e110369.27","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0101440","article-title":"Risk Factors for Acute Respiratory Infection in the Australian Community","volume":"9","author":"Chen","year":"2014","journal-title":"PLoS ONE"},{"key":"2026031908351991000_16.3.e110369.28","doi-asserted-by":"publisher","DOI":"10.1002\/path.4462"},{"key":"2026031908351991000_16.3.e110369.29","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2025-075754","article-title":"Recommended Childhood and Adolescent Immunization Schedule: United States, 2026: Policy Statement","volume":"157","author":"O\u2019Leary","year":"2026","journal-title":"Pediatrics"},{"key":"2026031908351991000_16.3.e110369.30","doi-asserted-by":"crossref","DOI":"10.3390\/vaccines14010059","article-title":"Recommendations on Respiratory Syncytial Virus (RSV) Immunization Strategies for Infants and Young Children in Countries with Year-Round RSV Activity","volume":"14","author":"Cheah","year":"2026","journal-title":"Vaccines (Basel)"},{"key":"2026031908351991000_16.3.e110369.31","doi-asserted-by":"crossref","DOI":"10.1111\/irv.70057","article-title":"A Missed Opportunity? Exploring Changes in Influenza Vaccination Coverage During the COVID-19 Pandemic: Data From 12 Countries Worldwide","volume":"19","author":"Del Riccio","year":"2025","journal-title":"Influenza Other Respir Viruses"},{"key":"2026031908351991000_16.3.e110369.32","doi-asserted-by":"crossref","first-page":"e330","DOI":"10.1016\/S2666-5247(23)00031-9","article-title":"Infection and co-infection patterns of community-acquired pneumonia in patients of different ages in China from 2009 to 2020: a national surveillance study","volume":"4","author":"Liu","year":"2023","journal-title":"Lancet Microbe"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-110369","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T15:35:36Z","timestamp":1773934536000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-110369"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":32,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,19]]},"published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1136\/bmjopen-2025-110369"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-110369","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]}}}