Why has the epidemiology of RSV changed during the COVID-19 pandemic?

The coronavirus disease 2019 (COVID-19) pandemic has drastically perturbed the epidemiology of Respiratory Syncytial Virus (RSV) respiratory tract infections in children. The reasons for this are not clear. In this article, we review the current literature and critically discuss the different theories to explain why the epidemiology of RSV has changed during the COVID-19 pandemic. Proposed mechanisms include decreased viral immunity in vulnerable age groups caused by the prolonged lack of RSV circulation early in the pandemic, potential Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2)-induced immune dysregulation, viral interactions between SARS-CoV-2 and RSV, and modifications in health-seeking behaviors as well as heath systems factors. Research in viral genomics and phylogeny, and more robust immunology research is needed to guide RSV prevention and health care resource planning. Copyright & COPY; 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Automated summary

The COVID-19 pandemic has had a profound impact on the epidemiology of Respiratory Syncytial Virus (RSV) infections in children. Various theories have been proposed to explain this change, including decreased viral immunity, immune dysregulation induced by SARS-CoV-2, viral interactions between SARS-CoV-2 and RSV, and changes in health-seeking behaviors and healthcare systems. Further research in viral genomics and immunology is needed to guide RSV prevention and healthcare resource planning.