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Journal of Health Sciences and Medicine

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Original Article
Epidemiological shift in neonatal viral lower respiratory tract infections during and after the COVID-19 pandemic: changes in pathogen dDistribution and clinical severity
Abstract
Aims: To evaluate the impact of the COVID-19 pandemic on the epidemiology and clinical characteristics of viral lower respiratory tract infections (LRTIs) in young infants admitted to a neonatal intensive care unit (NICU). Methods: This single-center retrospective cohort study included 235 young infants hospitalized with viral LRTI between January 2018 and January 2024. Patients were categorized into pre-pandemic (n=54), during the pandemic (n=64), and post-pandemic (n=117) periods. Demographic characteristics, viral pathogen distribution, respiratory support requirements, length of stay, and clinical morbidities were compared. Multivariate logistic regression was performed to identify predictors of invasive mechanical ventilation (IMV). Results: RSV was the most frequently identified pathogen (49.8%), followed by SARS-CoV-2 (8.5%), influenza (6.4%), and rhinovirus (3.0%); no pathogen was detected in 24.7% of cases. Viral distribution differed significantly across pandemic periods (?² test, p=0.017; Cramer’s V=0.35). RSV proportion increased from 40.7% (pre-pandemic) to 53.0% (post-pandemic), while SARS-CoV-2 emerged during the pandemic (20.3%). Respiratory support requirements differed significantly (p=0.002; Cramer’s V=0.22), with invasive ventilation decreasing from 50.0% (pre-pandemic) to 20.5% (post-pandemic). Length of NICU stay did not differ significantly among periods (p=0.354). Clinical morbidities were comparable across periods (all p>0.05). In multivariate analysis, RSV-related infection independently predicted IMV (OR 4.36, 95% CI 2.15-8.84, p

Keywords : Young infants, viral lower respiratory tract infection, COVID-19, respiratory syncytial virus, viral pathogen distribution, invasive mechanical ventilation

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Article available in :
Volume 9, Issue 3, 2026
Page : 727-733
https://doi.org/10.32322/jhsm.1895085
Article Information
Received : 23 Şub 2026
Accepted : 28 Mar 2026
Published : 19 May 2026
Corresponding Author :

Hasan Avşar: Department of Neonatology, Gaziantep Liv Hospital, Gaziantep, Turkiye

[email protected]
Citation : Avşar H, Bülbül A, Baş EK, et al. Epidemiological shift in neonatal viral lower respiratory tract infections during and after the COVID-19 pandemic: changes in pathogen dDistribution and clinical severity. J Health Sci Med. 2026;9(3):727-733. doi:10.32322/jhsm.1895085

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