{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T06:05:11Z","timestamp":1790057111320,"version":"4.0.1"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>COVID-19-related non-pharmaceutical interventions (NPIs) disrupted the circulation of many respiratory pathogens. After these measures were lifted, pediatric respiratory pathogen activity may have changed in pathogen-specific ways. However, laboratory-based evidence using continuous multi-year data, interrupted time-series analysis, and contextual factors such as meteorology, air quality, and school calendars remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single-center retrospective laboratory study of pediatric and neonatal inpatients aged 0\u201314 years with clinically diagnosed lower respiratory tract infection from January 2021 to December 2025. After 7-day deduplication within the same child, 20,250 throat-swab testing records were included. The NPI period was January 2021\u2013December 2022, and the post-NPI period was January 2023\u2013December 2025. Thirteen pathogen categories were analyzed using period comparisons, interrupted time-series models, and multivariable logistic regression incorporating meteorological factors, air quality index, and school-term status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall positivity was higher in the post-NPI period than in the NPI period (75.4% vs. 58.8%), and co-detection was also higher in the post-NPI period (15.2% vs. 6.0%). Pathogen-specific interrupted time-series analysis showed heterogeneous patterns: human adenovirus showed a robust immediate level decrease (\u221213.00 percentage points; 95% CI, \u221220.13 to \u22125.87; FDR-adjusted\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.005), whereas human rhinovirus showed a significant positive trend change after the January 2023 interruption (+1.07 percentage points per month; 95% CI, 0.63\u20131.50; FDR-adjusted\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), with a positive post-NPI slope (+0.64 percentage points per month). Higher temperature was associated with lower positivity of human respiratory syncytial virus, influenza A H1N1 (2009) virus, and influenza B virus, but higher positivity of human parainfluenza virus and human bocavirus. School-term status was associated with higher human rhinovirus positivity (aOR, 1.84; 95% CI, 1.34\u20132.52; FDR-adjusted\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The NPI and post-NPI periods showed distinct and heterogeneous temporal patterns in pediatric respiratory pathogen detection. These findings support integrated hospital-based laboratory surveillance centered on pathogen-specific temporal trends and interpreted alongside demographic, multi-pathogen, environmental, school-calendar, and longer-term temporal context.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1889078","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:40:39Z","timestamp":1790055639000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ecological reshaping of pediatric respiratory pathogen profiles after COVID-19-related non-pharmaceutical interventions were lifted: a 5-year interrupted time-series study"],"prefix":"10.3389","volume":"14","author":[{"given":"Lijun","family":"Du","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Beijing Anzhen Nanchong Hospital of Capital Medical University and Nanchong Central 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