Clinical Scorecard: Shifts in the Circulation and Testing of Endemic Respiratory Viruses Before, During, and After the COVID-19 Pandemic
At a Glance
Category
Detail
Condition
Endemic respiratory virus circulation disrupted by SARS-CoV-2 pandemic
Key Mechanisms
Displacement of virus circulation due to overlapping seasonality with SARS-CoV-2 and public health countermeasures
Target Population
Patients tested for respiratory viruses in Cleveland, Ohio (children and adults)
Care Setting
Outpatient and hospital-based respiratory virus testing within a large tertiary hospital system
Key Highlights
Winter-dominant viruses (influenza A, RSV) showed significant declines and prolonged recovery post-pandemic onset.
Spring (human metapneumovirus, parainfluenza 3) and year-round viruses (adenovirus, rhinovirus/enterovirus) quickly returned to prepandemic positivity levels.
Altered seasonality observed with influenza A shifting to semiannual peaks before normalizing by 2024.
Guideline-Based Recommendations
Diagnosis
Use nucleic acid amplification testing from nasopharyngeal swabs for respiratory virus detection.
Exclude antigen testing and viral culture due to low usage and sensitivity.
Management
Anticipate prolonged resurgence and altered seasonality for winter viruses post-pandemic.
Prepare healthcare systems for atypical timing and severity of respiratory virus outbreaks following pandemic disruptions.
Monitoring & Follow-up
Track respiratory virus positivity trends longitudinally to detect shifts in seasonality and peak timing.
Monitor for resurgence patterns especially in winter viruses to inform public health responses.
Risks
Displacement and altered circulation patterns may strain healthcare resources due to unexpected outbreak timing and severity.
Delayed recovery of winter viruses could increase vulnerability in populations during off-season peaks.
Patient & Prescribing Data
Patients undergoing respiratory virus testing in a large tertiary care system in Cleveland, Ohio
Recovery patterns of respiratory viruses vary by seasonality; management strategies should consider prolonged disruptions in winter viruses and quicker normalization in spring and year-round viruses.
Clinical Best Practices
Employ consistent nucleic acid amplification testing for accurate respiratory virus surveillance.
Incorporate knowledge of altered virus seasonality post-pandemic into clinical and public health planning.
Prepare for atypical respiratory virus outbreaks with flexible resource allocation and patient care strategies.
