Pandemic-Driven Shifts in RSV Diversity, Evolution, and Global Spread
- 1Department of Pediatric Infectious Diseases and Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
Abstract
The COVID-19 pandemic dramatically disrupted the seasonal circulation of RSV, with subsequent heterogeneous global resurgence. We aimed to characterize how pandemic-era disruptions restructured global RSV transmission dynamics, evolutionary patterns, and drivers of reemergence. We show that RSV-A and RSV-B genetic diversity underwent profound pandemic-associated suppression followed by heterogeneous resurgence. The post-pandemic period was characterized by pronounced changes in diversity, with the emergence of novel RSV-A genotypes (A.D.3 and A.D.5.2) and the expansion of the RSV-B, B.D.E.1 genotype. The recovery of RSV-B deviated strongly from neutral expectations and positive selection was detected at 20 sites in the G glycoprotein, F fusion protein, and M2-2 regulatory protein. Phylogeographic reconstruction revealed a sharp decline in international viral spread during the pandemic, followed by increasing persistence. Europe consistently served as the predominant global source, followed by Western Pacific and North America. Air-travel volume was the strongest predictor of dissemination (log coefficient >0.68 for both subtypes). Post-pandemic RSV resurgence represented fundamental epidemiological restructuring shaped by a population bottleneck, positive selection and major impact of air-travel. These findings underscore the need for robust genomic surveillance to track the global circulation of lineages, and to monitor effectiveness of pharmaceutical interventions given the emergence of new genotypes.
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BibTeX
@misc{gustanibuss2026pandemicdriven,
title = {{Pandemic-Driven Shifts in RSV Diversity, Evolution, and Global Spread}},
author = {E. Gustani-Buss and D. M. Weinberger and N. D. Grubaugh and V. Colizza and Y. Shao and M. Suchard and A. Evers and N. I. Mazur and J. G. Wildenbeest and R. J. Lebbink and H. J. A. A. v. Zoggel and L. Bont and P. Lemey},
howpublished = {medRxiv},
year = {2026},
month = nov,
doi = {10.64898/2026.11.02.26367099},
url = {https://www.medrxiv.org/content/10.64898/2026.11.02.26367099v1},
note = {CC BY-ND},
}
RIS
TY - UNPB
TI - Pandemic-Driven Shifts in RSV Diversity, Evolution, and Global Spread
AU - E. Gustani-Buss
AU - D. M. Weinberger
AU - N. D. Grubaugh
AU - V. Colizza
AU - Y. Shao
AU - M. Suchard
AU - A. Evers
AU - N. I. Mazur
AU - J. G. Wildenbeest
AU - R. J. Lebbink
AU - H. J. A. A. v. Zoggel
AU - L. Bont
AU - P. Lemey
PY - 2026
DA - 2026/11/02
PB - medRxiv
DO - 10.64898/2026.11.02.26367099
UR - https://www.medrxiv.org/content/10.64898/2026.11.02.26367099v1
AB - The COVID-19 pandemic dramatically disrupted the seasonal circulation of RSV, with subsequent heterogeneous global resurgence. We aimed to characterize how pandemic-era disruptions restructured global RSV transmission dynamics, evolutionary patterns, and drivers of reemergence. We show that RSV-A and RSV-B genetic diversity underwent profound pandemic-associated suppression followed by heterogeneous resurgence. The post-pandemic period was characterized by pronounced changes in diversity, with the emergence of novel RSV-A genotypes (A.D.3 and A.D.5.2) and the expansion of the RSV-B, B.D.E.1 genotype. The recovery of RSV-B deviated strongly from neutral expectations and positive selection was detected at 20 sites in the G glycoprotein, F fusion protein, and M2-2 regulatory protein. Phylogeographic reconstruction revealed a sharp decline in international viral spread during the pandemic, followed by increasing persistence. Europe consistently served as the predominant global source, followed by Western Pacific and North America. Air-travel volume was the strongest predictor of dissemination (log coefficient >0.68 for both subtypes). Post-pandemic RSV resurgence represented fundamental epidemiological restructuring shaped by a population bottleneck, positive selection and major impact of air-travel. These findings underscore the need for robust genomic surveillance to track the global circulation of lineages, and to monitor effectiveness of pharmaceutical interventions given the emergence of new genotypes.
ER -