{
  "abstract": "Background: Non-pharmaceutical interventions (NPIs) during the COVID-19 pandemic disrupted respiratory pathogen transmission, but post-pandemic change in positivity patterns across pathogens, age groups, and co-infections remain incompletely characterized in children.\n\nMethods: We conducted a retrospective period-comparison study at two Guangzhou hospitals, encompassing 230,333 patient-period records (2018–2023). Using logistic regression, we compared adjusted odds ratios (aOR) for 16 pathogens across three pandemic periods (Pandemic-I: strict NPIs; Pandemic-II: relaxed NPIs; Post-pandemic: full reopening) versus pre-pandemic baseline, with age-period interactions tested by likelihood-ratio.\n\nResults: Most respiratory viruses and M. pneumoniae were suppressed in Pandemic-I, with notable exceptions such as rhinovirus, CMV, and bocavirus (influenza A aOR = 0.23; B aOR = 0.08). Post-pandemic changes in test positivity diverged: influenza A showed increased positivity across all ages (aOR = 1.23–1.74); RSV showed increased positivity in children <5 years (aOR = 1.50–1.86); M. pneumoniae showed a marked increase in positivity in school-aged children (5–9 years: aOR = 3.32); influenza B remained suppressed in young children (aOR = 0.53–0.58) but showed increased positivity in adolescents (aOR = 2.88). Age-period interactions were significant for all four ( p < 0.001). Bacterial changes were modest and should be interpreted cautiously because culture positivity is influenced by specimen type, hospitalization, antibiotic exposure, and culture indications. Co-infections shifted from bacterial–bacterial dominance in Pandemic-I (49.0%) to bacterial–influenza co-infections post-pandemic (22.9%).\n\nConclusion: The pandemic reshaped pediatric respiratory pathogen epidemiology in pathogen- and age-specific ways, and may warrant consideration of age-stratified surveillance and tailored prevention.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Clinical Laboratory, Guangdong Women and Children Hospital",
    "Graduate School, Guangzhou Medical University"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Huan Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Ru Bai"
    },
    {
      "affs": [
        1
      ],
      "name": "Zishan Tang"
    },
    {
      "affs": [
        0
      ],
      "name": "Ping Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Lingling Tang"
    },
    {
      "affs": [
        0
      ],
      "name": "Xianhua Zheng"
    },
    {
      "affs": [
        0
      ],
      "name": "Chunming Gu"
    },
    {
      "affs": [
        0
      ],
      "name": "Cunwei Ji"
    },
    {
      "affs": [
        0
      ],
      "name": "Yasha Luo"
    },
    {
      "affs": [
        0
      ],
      "name": "Mingyong Luo"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/22t2g79n3mw09.bib",
  "cited_by": 0,
  "doi": "10.3389/fmicb.2026.1992791",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727640/?tool=EBI",
  "id": "22t2g79n3mw09",
  "issns": [
    "1664-302X"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fmicb.2026.1992791/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2713|Respiratory viral infections research"
    ]
  ],
  "openalex": "W7223032948",
  "pdf_url": "https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2026.1992791/pdf",
  "pmcid": "PMC13727640",
  "pmid": "42978716",
  "published": "2026-10-20",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/22t2g79n3mw09.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:12Z",
      "native_id": "10.3389/fmicb.2026.1992791",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fmicb.2026.1992791/full"
    },
    {
      "first_seen": "2026-11-04T15:20:45Z",
      "native_id": "PMC:PMC13727640",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13727640"
    },
    {
      "first_seen": "2026-11-06T12:23:29Z",
      "native_id": "PMC13727640",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fmicb.2026.1992791"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Respiratory viral infections research",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Disruption and change in positivity of respiratory pathogen epidemiology in children during and after the COVID-19 pandemic, 2018–2023: a large-scale period-comparison study in Guangzhou, southern China",
  "title_text": "Disruption and change in positivity of respiratory pathogen epidemiology in children during and after the COVID-19 pandemic, 2018–2023: a large-scale period-comparison study in Guangzhou, southern China",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:20:47Z",
  "url": "https://research.draconitic.com/paper/22t2g79n3mw09",
  "venue": "Frontiers in Microbiology",
  "versions": []
}