The Effects of Non-pharmacological Interventions During the COVID-19 Pandemic on Viral Respiratory Infections in Neonates During and Just After the Pandemic Era

Objective: During the coronavirus disease 2019 (COVID-19) pandemic, these globally implemented nonpharmacological interventions (NPIs) have altered the circulation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as well as other respiratory viruses in the community. To evaluate the impact of NPIs on the incidence and severity of viral respiratory tract infection (RTI) in newborns during and after the COVID-19 pandemic. Methods: The study was performed as a retrospective design between 2020-2023. Newborns with signs of upper or lower RTI who had undergone real-time polymerase chain reaction (RT-PCR) testing were included. The study was divided into 3 periods by considering the intervals when NPIs were strictly applied (period 1), relaxed (period 2), and removed (period 3). The incidence, viral diversity, and clinical severity of neonates with viral RTI were compared between the periods. Results: During the study 109 viral agents were detected in 100 neonates. The percentage of RTI cases was significantly lower in period 1 (5% vs 41% and 54% in periods 1, 2, 3 respectively, p: 0.001). A total of 9 different viral agents were isolated from neonates with decreasing frequency, including respiratory syncytial virus (RSV) (35%), rhinovirus/enterovirus (31%), SARS-CoV-2 (13%), parainfluenza virus (PIV) (7.2%) and other viruses (13.8%). In the first period, the infant with RSV was not present. RSV was detected at the highest rate in period 3, although there was no significant difference between periods. RSV peaks were detected in November and December in period 2 and 3. Rhinovirus/enterovirus was detected in all study periods with similar percentages. The percentages requiring non-invasive mechanical ventilation, inhaled budesonide, and inhaled salbutamol were significantly higher in period 3. Conclusion: The incidence of viral RTI (especially RSV) increased significantly after the removal of NPIs in period 3, viral RTI was more severe in this period. RSV-associated RTI peaks in newborns shifted a few months earlier in post-pandemic period.