The Impact of the COVID-19 Pandemic on Respiratory Syncytial Virus Infection: A Narrative Review

Abstract

Respiratory syncytial virus (RSV) is one of the most common respiratory viruses. It not only affects young children but also the elderly and immunocompromised patients. After the emergence of SARS-CoV-2 and the corona virus disease 2019 (COVID-19) era, a dramatic reduction in RSV activity was found, which coincided with the implementation of public health and social measures (PHSMs). However, the correlation is more complicated than we initially thought. After PHSMs were gradually lifted, a seasonality shift and a delayed RSV outbreak with greater number of infected patients were found in numerous countries, such as Israel, Australia, South Africa, New Zealand, France, United States, and Japan. Several hypotheses and possible reasons explaining the interaction between SARS-CoV-2 and RSV were mentioned. Since RSV vaccinations are still under investigation, administration of palivizumab should be considered in high-risk patients. In the post-COVID-19 era, greater attention should be paid to a further resurgence of RSV. In this narrative review, we conducted a thorough review of the current knowledge on the epidemiology of RSV during the COVID-19 era, the out-of-season outbreak of RSV, and the data on co-infection with RSV and SARS-CoV-2.

Keywords:

• COVID-19 pandemic
• SARS-CoV-2
• respiratory syncytial virus
• influenza virus
• respiratory tract infection

Acknowledgments

The authors did not receive any financial support for conducting this review or publication. PYL was supported in part by the NSTC with grant numbers MOST 110-2314-B-075A-011 and by the Taichung Veterans General Hospital with grant numbers TCVGH-1123901C and TCVGH-1123901D.

Disclosure

The authors report no conflicts of interest in this work.