{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:17:36Z","timestamp":1787753856180,"version":"build-2784847793"},"reference-count":20,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,8]]},"abstract":"\n Object\u0131ve<\/jats:title>\n \n The coronavirus disease 2019 pandemic and associated non-pharmaceutical interventions, including school closure, mask use, and social distancing, substantially altered the epidemiology of pediatric respiratory infections. However, their impact on pediatric Group A\n Streptococcus<\/jats:italic>\n pharyngitis remains incompletely understood. This study evaluated temporal trends in Group A\n Streptococcus<\/jats:italic>\n positivity across the coronavirus disease 2019 era and factors independently associated with Group A\n Streptococcus<\/jats:italic>\n positivity.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In this retrospective cohort study, pediatric patients aged 0\u201318 years presenting with suspected acute tonsillopharyngitis at a tertiary pediatric outpatient clinic between October 2018 and December 2025 were evaluated. Group A\n Streptococcus<\/jats:italic>\n positivity was defined based on a positive rapid antigen detection test and\/or positive throat culture for\n Streptococcus pyogenes<\/jats:italic>\n . Patients were categorized into pre-pandemic (October 2018 to February 2020), pandemic (March 2020 to May 2023), and post-pandemic (June 2023 to December 2025) periods. Group A\n Streptococcus<\/jats:italic>\n positivity rates were compared using chi-square tests, and multivariable logistic regression adjusted for epidemiological period, age, sex, and diagnostic method was performed.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In total, 24,166 deduplicated clinical episodes were included. Group A\n Streptococcus<\/jats:italic>\n positivity increased significantly across the three epidemiological periods, from 19.7% in the pre-pandemic period to 28.4% during the pandemic and 35.1% in the post-pandemic period (\n p<\/jats:italic>\n \u2009<\u20090.001). Compared with the pandemic period (reference category), the post-pandemic period was independently associated with higher odds of Group A\n Streptococcus<\/jats:italic>\n positivity (odds ratio, 1.37; 95% confidence interval, 1.29\u20131.46;\n p<\/jats:italic>\n \u2009<\u20090.001), whereas the pre-pandemic period was associated with lower odds (odds ratio, 0.66; 95% confidence interval, 0.61\u20130.71;\n p<\/jats:italic>\n \u2009<\u20090.001). Increasing age (odds ratio, 1.02; 95% confidence interval, 1.01\u20131.03;\n p<\/jats:italic>\n \u2009<\u20090.001) and male sex (odds ratio, 1.08; 95% confidence interval, 1.02\u20131.14;\n p<\/jats:italic>\n \u2009=\u20090.005) were also independently associated with Group A\n Streptococcus<\/jats:italic>\n positivity.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Group A\n Streptococcus<\/jats:italic>\n positivity increased progressively across the coronavirus disease 2019 era. These trends likely reflect combined effects of healthcare utilization, diagnostic testing practices, age distribution, and transmission dynamics rather than a single explanatory mechanism. Continued epidemiological surveillance is needed to better understand pediatric Group A\n Streptococcus<\/jats:italic>\n pharyngitis.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/03000605261475117","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:28:11Z","timestamp":1787585291000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Temporal trends in pediatric group A streptococcal pharyngitis across the coronavirus disease 2019 era: A large retrospective cohort study"],"prefix":"10.1177","volume":"54","author":[{"given":"Yunus","family":"Nas","sequence":"first","affiliation":[{"name":"Hisar Hospital Intercontinental"},{"name":"Hisar Hospital Intercontinental"},{"name":"Do\u011fu\u015f University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00fcveyda","family":"G\u00f6z\u00fck\u00fc\u00e7\u00fck","sequence":"additional","affiliation":[{"name":"Hisar Hospital Intercontinental"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilmi","family":"Bay\u0131rl\u0131","sequence":"additional","affiliation":[{"name":"Hisar Hospital Intercontinental"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5337-5226","authenticated-orcid":false,"given":"Basri","family":"\u00c7ak\u0131ro\u011flu","sequence":"additional","affiliation":[{"name":"Hisar Hospital Intercontinental"},{"name":"Faculty of Medicine, \u00dcsk\u00fcdar University, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.2174\/1573396320666230726145436"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis847"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(05)70267-X"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-2648"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2021.100103"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6937a6"},{"key":"e_1_3_3_8_2","first-page":"100015","article-title":"The impact of the COVID-19 pandemic on influenza, respiratory syncytial virus, and other seasonal respiratory virus circulation in Canada: A population-based study","volume":"1","author":"Groves HE","year":"2021","unstructured":"Groves HE, Pich\u00e9-Renaud PP, Peci A, et al. The impact of the COVID-19 pandemic on influenza, respiratory syncytial virus, and other seasonal respiratory virus circulation in Canada: A population-based study. Lancet Reg Health Am 2021; 1: 100015.","journal-title":"Lancet Reg Health Am"},{"key":"e_1_3_3_9_2","article-title":"Changes in the incidence of invasive disease due to Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis during the COVID-19 pandemic in 26 countries and territories in the Invasive Respiratory Infection Surveillance Initiative: A prospective analysis of surveillance data","volume":"3","author":"Brueggemann AB","year":"2021","unstructured":"Brueggemann AB, van Rensburg MJJ, Shaw D, et al. Changes in the incidence of invasive disease due to Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis during the COVID-19 pandemic in 26 countries and territories in the Invasive Respiratory Infection Surveillance Initiative: A prospective analysis of surveillance data. Lancet. Digit Health 2021; 3: e360\u2013e370.","journal-title":"Lancet. Digit Health"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/piae022"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1542\/pir.2023-005976"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1183\/20734735.0151-2021"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.3906\/sag-2004-174"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens13111007"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-0133"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms13081871"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-023-05211-w"},{"key":"e_1_3_3_18_2","first-page":"343","article-title":"Streptococcal pharyngitis: rapid evidence review","volume":"109","author":"Hamilton JL","year":"2024","unstructured":"Hamilton JL, McCrea L II. Streptococcal pharyngitis: rapid evidence review. Am Fam Physician 2024; 109: 343\u2013349.","journal-title":"Am Fam Physician"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2013182117"},{"key":"e_1_3_3_20_2","first-page":"101576","article-title":"Ongoing epidemic of scarlet fever in Shanghai and the emergence of M1UK lineage group A Streptococcus: a 14-year surveillance study across the COVID-19 pandemic period","volume":"58","author":"Cai J","year":"2025","unstructured":"Cai J, Zhou X, Zhang C, et al. Ongoing epidemic of scarlet fever in Shanghai and the emergence of M1UK lineage group A Streptococcus: a 14-year surveillance study across the COVID-19 pandemic period. 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