{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T16:57:42Z","timestamp":1783702662586,"version":"3.55.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"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. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Acute respiratory infections (ARIs) are major global public health concerns. Understanding the epidemiological characteristics and evolution patterns of respiratory pathogens before and after the coronavirus disease 2019 (COVID-19) pandemic is crucial for disease control and prevention. This study identified the epidemiological characteristics and pathogen distribution in hospitalized patients with ARIs in Yongzhou, China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was conducted on 10,728 hospitalized patients with ARIs at a tertiary hospital in Yongzhou, China, from January 2019 to June 2024. Respiratory specimens were tested using standardized protocols including multiplex real-time PCR for detecting common respiratory pathogens (FluA and FluB, RSV, ADV, HRV, and MP) and next-generation sequencing for additional pathogen identification when clinically indicated. Statistical analyses included descriptive statistics for demographic and clinical characteristics, and chi-square tests for comparing categorical variables across different age groups, seasons, and time periods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 43.12% (4,626\/10,728) of samples were positive for at least one pathogen. The most frequently detected pathogens were FluA (11.95%), RSV (9.61%), and MP (8.73%). RSV primarily affected children under 5\u202fyears (38.63% of RSV cases), while SARS-CoV-2 showed higher detection rates in older adult populations (64.81% of COVID-19 cases). Co-infections were found in 23.76% (1,099\/4,626) of positive samples, with preschool children (2\u20135\u202fyears) showing the highest rate at 32.58%. MP (<jats:italic>n<\/jats:italic> =\u202f398, 36.21% of all co-infections) with HRV (<jats:italic>n<\/jats:italic> =\u202f338, 30.76% of all co-infections) were the most frequently detected pathogens in co-infections. Significant seasonal variations were observed, with winter showing the highest pathogen detection rates (49.04%, <jats:italic>p<\/jats:italic> &amp;lt;\u202f0.001), and seasonal patterns changed notably during the COVID-19 pandemic. The frequency and patterns of co-infections showed marked differences across pre-pandemic, pandemic, and post-pandemic (January 2023\u2013June 2024) periods. Co-infections occurred in 1,209 cases, with significant differences across study periods: 20.6% in pre-pandemic, 0.6% during pandemic, and 78.8% in post-pandemic periods (<jats:italic>p<\/jats:italic> &amp;lt;\u202f0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study revealed distinct age-dependent and seasonal distribution patterns of respiratory pathogens in Yongzhou, China. The significant changes in pathogen circulation dynamics before, during, and after the COVID-19 pandemic highlight the importance of continuous surveillance of respiratory viruses. These findings provide valuable insights for optimizing local ARI prevention and treatment services.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1614985","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T05:25:24Z","timestamp":1752729924000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Epidemiological characteristics of acute viral and mycoplasma respiratory infections in Yongzhou, China: a retrospective descriptive 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