探讨新型冠状病毒（COVID-19）流行前后儿童肺炎支原体（MP）和常见急性呼吸道感染（ARTI）病毒谱的变化趋势，为制定儿童ARTI预防策略提供实验室数据支撑。

收集2017年至2022年间广州医科大学附属第一医院的儿童ARTI病例，分析患儿的MP和常见急性呼吸道病毒检测结果以及患者的临床数据。

共纳入患儿15 485例。<1岁为婴儿组（3213例， 20.8%），1~5岁为学龄前期组（9186例，59.3%），6~14岁为学龄期组（3086例，19.9%）。腺病毒（ADV）、乙型流感病毒（IVB）和MP在疫情后阳性率大幅降低（P<0.05），疫情前阳性率最高的病毒是ADV（18.5%），其次是MP（16.1%）、甲型流感病毒（IVA）（15.3%），三者两两比较差异均无统计学意义（均P>0.05）。疫情后阳性率最高的病毒是IVA（16.1%），其次是呼吸道合胞病毒（RSV）（12.9%），两者差异无统计学意义（P>0.05）。除了MP性别间的阳性率差异有统计学意义（女性患儿阳性率高于男性患儿阳性率，P<0.05），其余病毒性别间阳性率差异无统计学意义。按年龄分组，疫情前ADV阳性率最高的为学龄前期组（21.6%），其次是学龄期组（13.6%），两者比较差异有统计学意义（P<0.05），但疫情后学龄前期组（6.7%）与学龄期组（3.9%）的阳性率差异无统计学意义（P>0.05）。RSV无论在疫情前后，阳性率最高的均为婴儿组（疫情前21.0%，疫情后24.3%）。IVA无论疫情前后，阳性率最高的均为学龄期组（疫情前23.0%，疫情后30.5%）。IVB在疫情前阳性率最高的为学龄期组（8.4%，P<0.05），疫情后各年龄分组的阳性率差异无统计学意义（P>0.05）。MP无论在疫情前后，阳性率最高的均为学龄期组（疫情前32.4%，疫情后7.3%；P<0.05）；疫情前ADV、IVB常在春、夏季流行，疫情后出现散发状态，无明显流行季节。IVA疫情前常在冬季高发，而疫情后除了冬季，也出现了夏季流行的特征。

COVID-19后儿童ARTI常见于学龄期儿童，RSV则以婴儿最为常见，女童为MP易感人群。ADV、IVB、MP在疫情后阳性率大幅降低，RSV和IVA是疫情后较为常见的儿童ARTI病毒。ADV、IVB在疫情后出现散发状态，无明显流行季节，而IVA则出现了多季节流行的特征。

To explore changes in the epidemiological characteristics of mycoplasma pneumoniae (MP) and common acute respiratorytract infection (ARTI) virus spectrum in children before and after the coronavirus disease 2019 (COVID-19) epidemic, to provide laboratory data support for formulating the prevention strategy of ARTI in children.

A retrospective research was carried out on children with ARTI admitted to the First Affiliated Hospital of Guangzhou Medical University during 2017 to 2022.

A total of 15 485 children were enrolled in the study. The group <1 year old was defined as the infant group (3213, 20.8%). The group between 1 to 5 years old was defined as the preschool group (9186, 59.3%). The group between 6 to 14 years old was defined as the school-age group (3086, 19.9%). The positive rate of adenovirus (ADV), influenza B virus (IVB) and MP decreased significantly after COVID-19 epidemic (P<0.05). The virus with the highest positive rate before the epidemic was ADV (18.5%), followed by MP (16.1%) and influenza A virus (IVA) (15.3%), and there was no statistically significant difference in pairwise comparison between the three (all P>0.05). The virus with the highest positive rate after the epidemic is IVA (16.1%), followed by respiratory syncytial virus (RSV) (12.9%), and the difference between the two is not statistically significant (P>0.05). Except for the gender difference in the positivity rate of MP (the positivity rate of female patients was higher than that of male patients, P<0.05), there was no gender difference in the positivity rate of other viruses. By age group, the highest positive rate of ADV before the epidemic was in the preschool age group (21.6%), followed by the school-age group (13.6%), with a statistically significant difference (P<0.05). However, there was no statistically significant difference in positive rates between the preschool age group (6.7%) and the school-age group (3.9%) after the epidemic (P>0.05). The positive rate was the highest in the infant group of RSV both before (21.0%) and after (24.3%) the epidemic. The positive rate was the highest in the school-age group of IVA both before (23.0%) and after (30.5%) the epidemic. The positive rate was the highest in the school-age group of IVB before the epidemic (8.4%, P<0.05), but no significant difference between three groups after the epidemic (P>0.05). The positive rate was the highest in the school-age group of MP both before (32.4%) and after (7.3%) the epidemic (P<0.05). Before the COVID-19 epidemic, ADV and IVB were prevalent in spring and summer, and sporadic after the epidemic, with no obvious epidemic seasons. IVA was prevalent in winter before the epidemic, there was also summer epidemic characteristic now.

ARTI is common seen in school-age children after the epidemic. RSV is most common detected in infancy, and girls are susceptible to MP. The positive rates of ADV, IVB and MP decreased significantly after the COVID-19 epidemic. ADV and IVB showed sporadic status after the epidemic without obvious epidemic season, while IVA showed multi-season epidemic characteristics.