ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Clinical Infectious Diseases
Volume 15 - 2025 | doi: 10.3389/fcimb.2025.1599536
This article is part of the Research TopicExploring SARS-CoV-2 Inflammatory Responses and Potential Targets for TreatmentView all 8 articles
The dynamic etiology and epidemiological patterns of acute respiratory tract infections during and post non-pharmacological interventions of SARS-CoV-2 in Shenzhen, China: A two years' prospective cohort study from June 2022
Provisionally accepted
Guohao Fan1
Qi Qian1Yimin Tang1Jiexiang Liu1Liuqing Yang1Yun Peng1Yuanlong Lin1
Guanyong Ou1Yanling Luo1
Chenguang Shen2*
Yang Yang1*
Yingxia Liu1*- 1Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
- 2Southern Medical University, Guangzhou, Guangdong, China
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Background The rigorous non-pharmacological interventions (NPIs) during SARS-CoV-2 outbreak posed a deep impact on the etiology and epidemiology of acute respiratory tract infections (ARTIs). We aimed to elucidate the changing patterns during and post NPIs of SARS-CoV-2 in Shenzhen, China. Methods A total of 4610 outpatients with ARTIs from the fever clinic of our hospital were enrolled between June 2022 and May 2024, and nasopharyngeal swabs were collected and tested for twenty-five common respiratory pathogens using well-established RT-qPCR. The two year’s period was further divided into three stages: Stage 1 with strict NPIs, Stage 2 with outbreak of SARS-CoV-2 and Stage 3 with regular epidemic of SARS-CoV-2. Demographic and clinical data were also collected and analyzed. Results Overall, 57.05% (2630/4610) of patients were positive for at least one of tested respiratory pathogens, with top five pathogens of IAV (17.09%), H.influenzae (13.97%), SARS-CoV-2 (10.11%), IBV (7.38%) and HAdV (5.66%). Except for SARS-CoV-2, IAV and H.influenzae dominated the three stages, while the other pathogens varied. Meanwhile, positivity rates of most viral pathogens have increased post NPIs. Moreover, HAdV and H.influenzae infections were more frequently found in males. and higher overall rates of viral and bacterial infections were found in both children and the elderly. Notably, the results indicate a higher positivity rate in summer and autumn, with the lowest rate observed in winter. The overall co-infection rate was 24.62%, and the most frequent co-infections were between IAV, SARS-CoV-2, HAdV and H.influenzae. Conclusions In conclusion, the etiology and epidemiological patterns of ARTIs during and post NPIs of SARS-CoV-2 in Shenzhen have changed overtime, and sex, age and seasonal patterns were also found. The findings could provide useful information for the public health measures and the clinical management of respiratory infections.
Keywords: Acute respiratory tract infections, etiology, non-pharmacological interventions, prospective cohort study, Southern China
Received: 25 Mar 2025; Accepted: 04 Sep 2025.
Copyright: © 2025 Fan, Qian, Tang, Liu, Yang, Peng, Lin, Ou, Luo, Shen, Yang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Chenguang Shen, Southern Medical University, Guangzhou, 510515, Guangdong, China
Yang Yang, Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
Yingxia Liu, Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
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