Prevalence of influenza A and B and respiratory syncytial virus infections before and during COVID-19 pandemic in the pediatric population in Lebanon: A retrospective study

Seasonal influenza and RSV outbreaks cause considerable morbidity and mortality in the pediatric population worldwide. The COVID-19 pandemic has changed virus epidemiology. Until today, it is still unclear how this pandemic affected the transmission of common respiratory viruses. The present study aimed at comparing the prevalence of RSV and influenza A/B infection before and during the COVID-19 pandemic in the Lebanese pediatric population. A multicenter retrospective cross-sectional study was performed from September 2018 to December 2022 at the Lebanese American University Medical Center - Rizk Hospital and Abou Jaoude Hospital in Lebanon. Included were children (0-18 years) tested for Influenza A and B and RSV by Rapid Influenza Diagnostic Test and Rapid Antigen Testing, respectively, taken by nasopharyngeal swab at both hospitals where the study was conducted. Data collection was retrieved from the medical records of the patients. The statistical analysis was performed using SPSS software, version 30.0. This study has considered all ethical measures. Among a total of 1069 children tested, 19.7% tested positive for influenza A, 11.9% for influenza B, and 13.8% for RSV. The study found that young infants were significantly less susceptible to contracting these viruses compared to older children and adolescents (p < 0.001). A statistically significant difference in the odds of testing positive was observed between the two hospitals (p = 0.011), and a significant temporal trend in influenza circulation was noted (p < 0.05). The prevalence of co-infection was low with no statistically significant differences (p = 0.779). The COVID-19 pandemic and its associated preventive measures led to a significant decrease in the spread of influenza A and B and RSV among the Lebanese pediatric population. Conversely, the post-lockdown period saw a notable resurgence of these infections, with low coinfection occurrences. These results have important implications for public health strategies aimed at controlling respiratory virus infections.