Abstract
Introduction: Viral respiratory infections are a significant cause of morbidity and mortality worldwide. Viruses are implicated in more than 80% of respiratory infections. Objectives: The aim of this work was to study the epidemiology of respiratory viruses and assess the impact of the COVID-19 pandemic on their circulation between 2019 and 2023. Materials and methods: This retro-prospective descriptive study was conducted at the Virology Laboratory of the Mohammed V Military Teaching Hospital in Rabat, Morocco from September 2019 to April 2023. Samples were collected from patients admitted with acute respiratory infection that tested negative for SARS-CoV-2 by PCR and underwent multiplex respiratory PCR test using the BioFire® Respiratory 2.1 kit on a nasopharyngeal swab. Demographic data were extracted from Laboratory Information System. Statistical analysis was carried out using SPSS 22.0 and Microsoft Excel. Results: A total of 1050 PCR tests were performed. The positivity rate was 54% (564 patients). The median age of patients with a positive PCR was 31 years (1-91 years). The M/F sex ratio was 1.52. The positivity rate was 57%, 53%, 72%, 52% and 44% during the years 2019 (September to December), 2020, 2021, 2022 and 2023 (January to April) respectively. Among the viruses detected, Enterovirus/Rhinovirus was the most common (50%), followed by Influenza virus (16%) and Respiratory Syncytial Virus (11%). Four hundred fifty positive PCRs was mono-infections (80%) and 114 (20%) were co-infections, of which 108 were with 2 viruses and 6 with 3 viruses. Conclusion: The implementation and lifting of pandemic-related barrier measures significantly influenced respiratory virus circulation, aligning with seasonal patterns. In our context, Enterovirus/Rhinovirus and Influenza testing is recommended first for adults whereas Enterovirus/Rhinovirus and RSV testing is recommended first for children. Otherwise, multiplex testing should be considered for severe cases or those with risk factors.
References
Edderdouri K, Kabbaj H, Laamara L, Lahmouddi N, Lamdarsi O, Zouaki A et al. Contribution of the FilmArray BioFire® Technology in the Diagnosis of Viral Respiratory Infections during the COVID-19 Pandemic at Ibn Sina University Hospital Center in Rabat: Epidemiological Study about 503 Cases. Adv Virol. 2023;2679770. doi: 10.1155/2023/2679770.
Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270‑273.
Baroudy NRE, Refay ASE, Hamid TAA, Hassan DM, Soliman MS, Sherif L. Respiratory Viruses and Atypical Bacteria Co-Infection in Children with Acute Respiratory Infection. Open Access Maced J Med Sci. 2018;6(9):15881593.
Serge AG, Stéphane C, Christian C, Frédérique C, Philippe F, Gaffet E, et al. Avis relatif aux mesures de prévention des infections respiratoires virales (incluant la mise à jour des avis Covid-19). In: Haut conseil de la santé publique. 2023. Available via: https://hal.science/hal-04234782 (Accessed 18 Septembre 2024).
Sullivan SG, Carlson S, Cheng AC, Chilver MB, Dwyer DE, Irwin M, et al. Where has all the influenza gone? The impact of COVID-19 on the circulation of influenza and other respiratory viruses, Australia, March to September 2020. Euro Surveill. 2020;25(47):2001847.
Azzam R. Épidémiologie des virus respiratoires au CHU de Marrakech : Comparaison entre 2 périodes avant la Covid-19 et après la Covid-19. [Thèse]. Marrakech : Université Cadi Ayyad; 2021.
Wang H, Zheng Y, Deng J, Wang W, Liu P, Yang F, et al. Prevalence of respiratory viruses among children hospitalized from respiratory infections in Shenzhen, China. Virol J. 2016;13:39.
De Francesco MA, Pollara C, Gargiulo F, Giacomelli M, Caruso A. Circulation of Respiratory Viruses in Hospitalized Adults before and during the COVID-19 Pandemic in Brescia, Italy: A Retrospective Study. Int J Environ Res Public Health. 2021;18(18):9525.
Park JY, Kim HI, Kim JH, Park S, Hwang YI, Jang SH, et al. Changes in respiratory virus infection trends during the COVID-19 pandemic in South Korea: the effectiveness of public health measures. Korean J Intern Med. 2021;36(5):1157‑1168.
EL Ouazzani K. Le diagnostic moléculaire des agents respiratoires pathogènes chez l’enfant : Impact du Panel respiratoire Filmarray. [Thèse]. Marrakech : Université Cadi Ayyad; 2019.
Greenberg SB, Atmar RL. Chronic airway disease: the infection connection. Trans Am Clin Climatol Assoc.1999;110:38‑50.
Khor CS, Sam IC, Hooi PS, Quek KF, Chan YF. Epidemiology and seasonality of respiratory viral infections in hospitalized children in Kuala Lumpur, Malaysia: a retrospective study of 27 years. BMC Pediatr. 2012;12:32.
Ly N, Tokarz R, Mishra N, Sameroff S, Jain K, Rachmat A, et al. Multiplex PCR analysis of clusters of unexplained viral respiratory tract infection in Cambodia. Virol J. 2014;11:224.
Mc Clelland EE, Smith JM. Gender specific differences in the immune response to infection. Arch Immunol Ther Exp (Warsz). 2011;59(3):203‑213.
Kuo SC, Shih SM, Chien LH, Hsiung CA. Collateral Benefit of COVID-19 Control Measures on Influenza Activity, Taiwan. Emerg Infect Dis. 2020;26(8):1928‑1930.
Kim JM, Jung HD, Cheong HM, Lee A, Lee NJ, Chu H, et al. Nationwide surveillance of human acute respiratory virus infections between 2013 and 2015 in Korea. J Med Virol. 2018;90(7):1177‑1183.
Cowling BJ, Ali ST, Ng TWY, Tsang TK, Li JCM, Fong MW, et al. Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study. Lancet Public Health. 2020;5(5):e279‑88.
Cannell JJ, Vieth R, Umhau JC, Holick MF, Grant WB, Madronich S, et al. Epidemic influenza and vitamin D. Epidemiol Infect. 2006;134(6):1129‑1140.
Busson L, Bartiaux M, Brahim S, Konopnicki D, Dauby N, Gérard M, et al. Contribution of the FilmArray Respiratory Panel in the management of adult and pediatric patients attending the emergency room during 2015-2016 influenza epidemics: An interventional study. Int J Infect Dis. 2019;83:32‑39.
Marcil S, Kabbaj H, Jroundi I, Barakat A, Mahraoui C, Chafiq S et al. Epidemiology and diagnosis of the severe acute viral respiratory infections in patients admitted at Ibn Sina University Hospital Rabat- Morocco. Dis Disord, 2018 doi: 10.15761/JDD.1000112
Martin ET, Kuypers J, Wald A, Englund JA. Multiple versus single virus respiratory infections: viral load and clinical disease severity in hospitalized children. Influenza Other Respir Viruses. 2012;6(1):71‑77.
Zhang D, He Z, Xu L, Zhu X, Wu J, Wen W, et al. Epidemiology characteristics of respiratory viruses found in children and adults with respiratory tract infections in southern China. I Int J Infect Dis. 2014;25:159‑164.
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Copyright (c) 2025 Mohamed Rida Tagajdid, Hicham Elannaz, Rachid Abbi, Mohamed Rida ZNADY, Rhita Slimani, Safae Elkorchi, Abdelilah Laraqui, Bouchra El Mchichi, Nadia Touil, Khalid Ennibi, Driss Radallah, Amal El Hamsas El Youbi, Reggad Ahmed, Z Elkasmi, Amin Idriss Lahlou