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Assessing the Impact of COVID-19 on Epidemiological Changes of Severe Paediatric Respiratory Syncytial Virus (RSV) Infections in Malaysia
  • Adli Ali,
  • Asrul Abdul Wahab
National University of Malaysia Faculty of Medicine

Corresponding Author:[email protected]

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Adli Ali
National University of Malaysia Faculty of Medicine
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Asrul Abdul Wahab
National University of Malaysia Faculty of Medicine
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Introduction Tropical seasonality of respiratory syncytial virus (RSV) is one of the leading causes of hospitalization and mortality among children with respiratory tract infections. The non-pharmaceutical preventive measures implemented worldwide against Covid-19 may have also reduced the transmission of RSV, hence altering its epidemiological seasonality. However, with easing of Covid-19 restrictions, studies reported a drastic rebound of cases due to poor protective immunity from long-term reduced exposure to RSV. Thus, this is the first study to evaluate the changes of RSV epidemiology before, during and after Covid-19 pandemic in Malaysia. Methods We analyzed collated data from 2017 to 2022, involving 4084 children aged <12 years who were admitted for severe respiratory infections requiring non-invasive ventilation (NIV). Results Generally, we reported significant inverse relationship between RSV and Covid-19 infections during the pandemic (2020-2021) (p<0.05). In 2020, RSV positivity rate declined sharply to 8.3% and 5.9%, respectively in the 2 prominent seasons. Time series analysis showed a tremendous decrease in cases compared to the expected values, with the first season (98.3%, CI 95%) and second season (95.7%, CI 95%). However, with the lifting of the restriction order in 2022, RSV infections rose sharply with a positivity rate of 36.3% which was higher than before Covid-19 pandemic. Conclusion This study provides evidence of increasing RSV cases after Covid-19 pandemic due to immunity debt. Hence, the healthcare system must be prepared to deal with future RSV outbreaks with appropriate implementation of prophylaxis and public health measures.
10 Sep 2023Submitted to Influenza and other respiratory viruses
11 Sep 2023Assigned to Editor
11 Sep 2023Submission Checks Completed
22 Oct 2023Reviewer(s) Assigned