ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Clinical and Diagnostic Microbiology and Immunology
This article is part of the Research TopicA One Health Approach to Infection Prevention and Antimicrobial ResistanceView all 8 articles
Epidemiological Shift and Clinical Characteristics of Rhinovirus Genotypes in Acute Respiratory Tract Infection Cases in Kunming, China, from 2019 to 2023
Provisionally accepted
Guiqian Zhang1
Limei Ba1Luping Liu1Ting Su1
Hongyan Zhu1
Ya Xu1Yufan Zhang1Yafei Huang1Xin Fan1Jinxiu Wan1Jianmei Gao1Hailong Li2Min Su1*- 1The First People’s Hospital of Yunnan Province, Kunming, China
- 2The First People's Hospital of Honghe State, Gejiu, China
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Background: We aimed to investigate the impact of the coronavirus disease 2019 (COVID-19) outbreak on the genetic diversity and clinical severity of rhinovirus (RV) in acute respiratory tract infection (ARTI) cases in Kunming, China. Methods: A total of 25,769 patients with ARTI from September 1, 2019 to December 31, 2023 were enrolled. Patients with COVID-19 were excluded from the study. Nasopharyngeal swabs were collected and screened for RV using multiplex reverse transcription polymerase chain reaction. RV-positive samples underwent nested PCR targeting the VP4/VP2 region. The amplified products were sequenced for genotype identification. Results: A total of 1,017 RV-positive cases were identified (detection rate 3.95%; 1,017/25,769), and all three RV species—RV-A, RV-B, and RV-C—were detected; RV-A was the most prevalent. Overall, 128 distinct RV genotypes, 40 untyped strains, and 1 recombinant strain (A1B) were identified. The predominant genotypes differed between age groups: those <18 years were mainly infected with C-untyped, A36, and A12, whereas those ≥18 years had C1, B52, and A60. Among RV-positive cases, 42.97% were associated with lower respiratory tract infections (LRTI), mainly caused by RV-A and RV-C. RV-C was associated with higher C-reactive protein and procalcitonin. This is a provisional file, not the final typeset article Co-occurrences were recorded in 24.98% (254/1,017) of RV-positive cases and were associated with prolonged hospitalization. RV exhibited no clear seasonal pattern; however, following the COVID-19 outbreak, RV-C was replaced by RV-A. Conclusions: RV remains endemic with significant genetic diversity in the region. The COVID-19 pandemic led to a notable shift in the dominant circulating species from RV-A to RV-C. Emerging mutant strains have contributed to increased disease severity. Both RV-C and RV-A contribute to LRTI in children.
Keywords: Rhinovirus, Genotype, Epidemiological shift, Clinical Characteristics, Kunming
Received: 02 Aug 2025; Accepted: 27 Oct 2025.
Copyright: © 2025 Zhang, Ba, Liu, Su, Zhu, Xu, Zhang, Huang, Fan, Wan, Gao, Li and Su. 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: Min Su, 15368029691@qq.com
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