Non-SARS-CoV-2 respiratory tract infections in pediatric populations during the pandemic.

Respiratory tract infections (RTIs) remain a major concern in pediatric care, as they can pose life-threatening risks to children. While SARS-CoV-2 receives substantial public concern, identifying other respiratory pathogens in SARS-CoV-2-negative patients is crucial for guiding clinical management. In this study, the etiology of RTIs among 156 SARS-CoV-2-negative children in 2022 was analyzed using BIOFIRE® FilmArray® Respiratory Panel 2.1 assay, VIASURE rhinovirus + enterovirus detection kit, and an in-house realtime-PCR for human bocavirus. Of the 156 samples tested with the FilmArray®, 96 (61.5%) were positive for viral pathogens, with human rhinovirus/enterovirus (HRV/EV) being the most prevalent (92.7%). Targeted PCR assay confirmed that 97.8% of HRV/EV detections were rhinoviruses, which were significantly associated with asthma (OR = 9.0, 95% CI = 2.0-14.2, P = 0.005). Human bocavirus (HBoV) was detected in 40 out of 144 samples (27.8%) using real-time PCR. Multivariable analysis identified age as the only factor associated with HBoV detection (OR = 0.8, 95% CI: 0.7-1.0, P = 0.014), although it was noted 45.5% of pneumonia cases were HBoV-positive. Overall, 75.7% of co-detections involved HBoV, most frequently with HRV/EV. Co-detections were significantly associated with male gender (OR = 2.9, 95% CI = 1.2-7.3, P = 0.024) and fever (OR = 6.3, 95% CI = 2.0-19.8, P = 0.002). Our study demonstrates the occurrence of viral co-detections in pediatric patients with non-SARS-CoV-2 RTIs during the pandemic. The frequent detection of rhinovirus and HBoV warrants further investigation into their clinical significance in Taiwanese children with RTIs.