{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T17:01:06Z","timestamp":1784739666479,"version":"3.55.0"},"reference-count":6,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,11,17]],"date-time":"2024-11-17T00:00:00Z","timestamp":1731801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"HMRF\u2014Commissioned Programme for Influenza Research","award":["INF-CUHK-2"],"award-info":[{"award-number":["INF-CUHK-2"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>The study highlights the significant changes in respiratory virus epidemiology following the lifting of COVID-19 restrictions. Method: In this single-centre retrospective study, the virological readouts of adenovirus (AdV), influenza virus A (IAV), influenza virus B (IBV), parainfluenza viruses (PIV) 1, 2, 3, 4, respiratory syncytial virus (RSV), and coupled enterovirus and rhinovirus (EV\/RV) were extracted from the respiratory specimens of paediatric patients in Hong Kong from January 2015 to February 2024. The subjects were stratified into five age groups. Results: The study included 18,737 and 6001 respiratory specimens in the pre-COVID-19 and post-COVID-19 mask mandate period, respectively. The mean age of hospitalised patients increased from 3.49 y \u00b1 0.03 y to 4.37 y \u00b1 0.05 y after the COVID-19 lockdown. The rates of single-virus infection and co-infection were significantly higher in the post-COVID-19 mask mandate period. The odds ratio for AdV for all age groups (OR: 4.53, 4.03, 2.32, 2.46, 1.31) and RSV in older children from 3 years old and above (OR: 1.95, 3.38, p &lt; 0.01) were significantly elevated after the COVID-19 outbreak. Conclusions: Our findings suggest that public health measures to contain COVID-19 may have unintended consequences on children\u2019s natural exposure and immunity to other respiratory viruses, potentially increasing their morbidity in the post-pandemic era.<\/jats:p>","DOI":"10.3390\/v16111786","type":"journal-article","created":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T05:36:45Z","timestamp":1731908205000},"page":"1786","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Respiratory Viral Infection Patterns in Hospitalised Children Before and After COVID-19 in Hong Kong"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2650-922X","authenticated-orcid":false,"given":"Jason Chun Sang","family":"Pun","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong (CUHK), 6\/F Lui Che Woo Clinical Sciences Building, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China"},{"name":"Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, 8\/F Research Office, Tower A, Hong Kong Children\u2019s Hospital, 1 Shing Cheong Road, Kowloon Bay, Kowloon, Hong Kong, China"},{"name":"Laboratory for Paediatric Respiratory Research, Li Ka Shing Institute of Health Sciences, Rm 201, Li Ka Shing Medical Sciences Building, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7843-1740","authenticated-orcid":false,"given":"Kin Pong","family":"Tao","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong (CUHK), 6\/F Lui Che Woo Clinical Sciences Building, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China"},{"name":"Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, 8\/F Research Office, Tower A, Hong Kong Children\u2019s Hospital, 1 Shing Cheong Road, Kowloon Bay, Kowloon, Hong Kong, China"},{"name":"Laboratory for Paediatric Respiratory Research, Li Ka Shing Institute of Health Sciences, Rm 201, Li Ka Shing Medical Sciences Building, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacy Lok Sze","family":"Yam","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong (CUHK), 6\/F Lui Che Woo Clinical Sciences Building, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China"},{"name":"Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, 8\/F Research Office, Tower A, Hong Kong Children\u2019s Hospital, 1 Shing Cheong Road, Kowloon Bay, Kowloon, Hong Kong, China"},{"name":"Laboratory for Paediatric Respiratory Research, Li Ka Shing Institute of Health Sciences, Rm 201, Li Ka Shing Medical Sciences Building, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kam Lun","family":"Hon","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong (CUHK), 6\/F Lui Che Woo Clinical Sciences Building, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6360-4608","authenticated-orcid":false,"given":"Paul Kay Sheung","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China"},{"name":"SH Ho Research Centre for Infectious Diseases Faculty of Medicine, Rm 207, 2\/F, S.H. Ho Research Centre for Infectious Diseases, JC School of Public Health Building, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert Martin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong (CUHK), 6\/F Lui Che Woo Clinical Sciences Building, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China"},{"name":"Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, 8\/F Research Office, Tower A, Hong Kong Children\u2019s Hospital, 1 Shing Cheong Road, Kowloon Bay, Kowloon, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6485-0926","authenticated-orcid":false,"given":"Renee Wan Yi","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong (CUHK), 6\/F Lui Che Woo Clinical Sciences Building, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China"},{"name":"Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, 8\/F Research Office, Tower A, Hong Kong Children\u2019s Hospital, 1 Shing Cheong Road, Kowloon Bay, Kowloon, Hong Kong, China"},{"name":"Laboratory for Paediatric Respiratory Research, Li Ka Shing Institute of Health Sciences, Rm 201, Li Ka Shing Medical Sciences Building, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China"},{"name":"SH Ho Research Centre for Infectious Diseases Faculty of Medicine, Rm 207, 2\/F, S.H. Ho Research Centre for Infectious Diseases, JC School of Public Health Building, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1038\/s41392-022-00919-x","article-title":"ACE2-independent infection of T lymphocytes by SARS-CoV-2","volume":"7","author":"Shen","year":"2022","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/S1473-3099(22)00544-8","article-title":"Quantifying the RSV immunity debt following COVID-19: A public health matter","volume":"23","author":"Billard","year":"2023","journal-title":"Lancet Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1016\/S0140-6736(22)01277-6","article-title":"Preparing for uncertainty: Endemic paediatric viral illnesses after COVID-19 pandemic disruption","volume":"400","author":"Messacar","year":"2022","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e218824","DOI":"10.1001\/jamanetworkopen.2021.8824","article-title":"Clinical characteristics and transmission of COVID-19 in children and youths during 3 waves of outbreaks in Hong Kong","volume":"4","author":"Chua","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s41479-021-00083-w","article-title":"The role of co-infections and secondary infections in patients with COVID-19","volume":"13","author":"Feldman","year":"2021","journal-title":"Pneumonia"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Maltezou, H.C., Papanikolopoulou, A., Vassiliu, S., Theodoridou, K., Nikolopoulou, G., and Sipsas, N.V. (2023). COVID-19 and Respiratory Virus Co-Infections: A Systematic Review of the Literature. 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