key: cord-0893082-btuecatc authors: Letafati, Arash; Aghamirmohammadali, Fahimeh Sadat; Rahimi‐Foroushani, Abbas; Hasani, Seyed Abbas; Mokhtari‐Azad, Talat; Yavarian, Jila title: No human respiratory syncytial virus but SARS‐CoV‐2 found in children under 5 years old referred to Children Medical Center in 2021, Tehran, Iran date: 2022-03-08 journal: J Med Virol DOI: 10.1002/jmv.27685 sha: cd7414433cbbb88ad182e8b6490075a3ccaf6aaf doc_id: 893082 cord_uid: btuecatc Acute respiratory infections (ARIs) are one of the leading causes of illness and death among community members worldwide. Viral infections are the most common agents estimated to be involved in these patients. This study aimed to investigate the prevalence of human respiratory syncytial virus (hRSV) and severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) among children with ARIs. This study evaluated the presence of SARS‐CoV‐2 and hRSV in 168 throat and nasopharyngeal swab samples using real‐time RT‐PCR. All samples were collected from children under 5 years old with ARIs who attended Children's Medical Center, Tehran, Iran, and sent to the Iranian National Influenza Center with appropriate conditions in 2021. Chi‐square and Fisher's exact tests were used for comparison of the data of the prevalence of hRSV and SARS‐CoV‐2 infections among children. Of 168 patients examined, 95 (57%) were male and 73 (43%) female. Out of them, 47 (28%) cases were younger than 1 year old and 121 cases (72%) were 1–5 years old. The most common clinical manifestations of patients were cough (78%), nausea (31%), diarrhea (27%), and fever (18%). Among 168 patients, no hRSV was detected, while the SARS‐CoV‐2 genome was identified in 16 (9.5%) patients. Among 16 positive cases of SARS‐CoV‐2, 8 (50%) were under 1 year old and 8 positive cases were 1–5 years old. This study was performed at cold months of the year but due to the coronavirus disease 2019 pandemic and adherence to health protocols, school closures, and virtual classes, no cases of hRSV infections were identified. can cause many symptoms, ranging from mild self-limiting upper respiratory tract infections to severe bronchiolitis, pneumonia, and hypoxemia. 10 Before the coronavirus pandemic, 24% of hospitalizations of children under 5 years of age with ARI were due to the hRSV, but during the pandemic, the rate of hospitalization because of hRSV was decreased. 11 SARS-CoV-2 is a single-stranded positive-sense RNA virus and belongs to coronaviridae family and beta coronavirus genus. 12 The statistical analysis was performed using SPSS software, version 16. Chi-square and Fisher's exact tests were used for comparison of the data of the prevalence of hRSV and SARS-CoV-2 infections among children. The significance level was determined at p < 0.05. Of 168 patients examined, 95 (57%) were male and 73 (43%) female. We divided patients into two age groups: less than 1 year old and 1-5 years old which 47 (28%) cases were younger than 1 year old and 121 (72%) cases were 1-5 years old. The most common clinical manifestations of patients were cough (78%), nausea (31%), diarrhea (27%) and fever (18%), respectively. The SARS-CoV-2 genome was detected in 16 (9.5%) patients, while no hRSV genome was found in our study. Among SARS-CoV-2 positive patients, 50% were under 1 year old and 50% were between 1 and 5 years old. Association between age groups and SARS-CoV-2 prevalence was significant in statistical analysis (p < 0.048) ( Table 1) . Also, among clinical manifestations, cough, nausea, and diarrhea were associated with SARS-CoV-2 infection (p < 0.05). While fever and gender had no statistical correlation with SARS-COV-2 infection (p > 0.05). Furthermore, nausea was found mostly in males (p < 0.05) ( Table 2 ). ARIs have a high incidence and are easy to spread in society. Viruses are the most common pathogens in the development of ARIs. The study of the prevalence of respiratory viruses is of great importance for the control and treatment of these infections. 6, 7 Therefore, our study evaluated the prevalence of hRSV and SARS-CoV-2 in children with ARIs. In studies before the COVID-19 pandemic, the prevalence of hRSV and IFV was higher in these patients. 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