579 - Epidemiology of rhinovirus/enterovirus infection among children less than 5 years of age living in central New York during the COVID-19 pandemic

Poster Number: 579
Publication Number: 579.417

Danielle K. Daniels, SUNY Upstate Medical University, Camillus, NY, United States; Rachel Fisher, State University of New York Upstate Medical University, Cicero, NY, United States; Manika Suryadevara, Upstate Golisano Children's Hospital, Syracuse, NY, United States; Dongliang Wang, SUNY Upstate Medical University, Syracuse, NY, United States; Joseph Domachowske, SUNY Upstate Medical University, Syracuse, NY, United States

Background: Decreased circulation of endemic respiratory viruses has been documented since the start of the COVID-19 pandemic. Re-emergence of rhinovirus/enterovirus occurred early, achieving pre-pandemic rates before other respiratory viruses.

Objective: We plan to describe local rhinovirus/enterovirus epidemiology across central New York before and after the start of the pandemic.

Design/Methods: Using the LIS database of a single academic medical center, we collected retrospective data on children < 5 yrs who tested positive for rhinovirus/enterovirus via multiplex PCR assay between January 2015 and April 2021. Clinical and demographic data were recorded. Sample collection dates were organized by year for each calendar week. Weekly percent positivity rates were calculated by dividing the number of positive samples by the total tested over the same period. Regional and national data were downloaded from the CDC’s NREVSS database.

Results: 5,832 (35%) of the 16,908 respiratory samples collected from eligible children during the 6-year study period were positive for rhinovirus/enterovirus, with at least one additional respiratory pathogen co-detected from 1,230 (21%) samples. The mean age of children testing positive was 1.6 yrs; 56% were male. 64% identified as White, 23% Black or African American, 11% Other, 1% American Indian or Alaska Native, and 0.5 % Asian.
 
After the onset of the pandemic, there was a rapid decline in local rhinovirus/enterovirus percent positivity rates, reaching a nadir of 2.1% during calendar week 22 (May) and returning to pre-pandemic levels (28.9%) by week 29 (July). Between week 22, 2020 and week 18, 2021, local mean percent positivity (19.8%) exceeded those reported from both regional (7.3%) and national (4.5%) databases. The number of samples tested increased by 24% between 2019 and 2020, and by 42% between 2020 and 2021. Children tested in 2019 were younger than those tested in 2020 (1.5 vs. 1.7 yrs; p< 0.05) with a longer mean length of stay (3.2 vs. 1.1 days; p< 0.05). The percentage of Black or African Americans among positive cases steadily increased from 19% (2019) to 29% (2020) to 31% (2021), while rates among Whites declined from 69% (2019) to 57% (2020) to 52% (2021).Conclusion(s): When compared to regional and national data, rhinovirus/enterovirus circulation across central NY returned to pre-pandemic rates sooner with higher percent positivity. Over time, we observed an increase in the mean age of children testing positive and shorter mean lengths of stay. Black or African Americans disproportionately tested positive at rates that exceeded those observed pre-pandemic.
Rhinovirus/enterovirus circulation 2019-2021National, regional and central New York rhinovirus/enterovirus percent positivity from January 1, 2019 through April 30, 2021
Positive rhinovirus/enterovirus cases by race 2015-2021