Publication date: Jul 18, 2026
Community-acquired pneumonia (CAP) is a significant cause of hospitalization and mortality in children. Non-pharmacological interventions (NPIs) implemented during the COVID-19 pandemic were associated with changes in the transmission dynamics of respiratory pathogens. The present study aimed to analyze changes in the pathogenic characteristics of hospitalized children with CAP in a single-center pediatric cohort in Changzhou, China, before and after the outbreak of COVID-19. We retrospectively reviewed demographic information, hospitalization records, and pathogen-detection results of children admitted for CAP at Changzhou Children’s Hospital, Jiangsu Province, China, from 2018 to 2023. The analyzed pathogens included eight target bacteria and seven respiratory viruses. A total of 29,552 children hospitalized with CAP were included, including 15,124 in the pre-pandemic period, 9024 in the pandemic period, and 5404 in the post-pandemic period. The male-to-female ratio was 1. 42:1, and the median age was 16 months (IQR: 5. 0-37. 0). Hospitalizations generally peaked in autumn and winter from 2018 to 2022, whereas an off-season peak occurred in May 2023. The overall bacterial positivity increased from 9. 94% before the pandemic to 13. 96% during the pandemic and 13. 68% after the pandemic, while viral positivity increased from 16. 52% to 21. 43% and 21. 06%, respectively. In contrast, coinfection positivity decreased from 6. 89% before the pandemic to 5. 13% during the pandemic and 3. 02% after the pandemic. Across all three periods, Escherichia coli consistently ranked first among bacterial detections, while RSV remained the predominant virus among viral detections. Noticeable shifts in the detection spectrum and positivity rates of common bacterial and viral pathogens were observed among hospitalized children with CAP following the implementation and relaxation of COVID-19 prevention and control policies. Continuous long-term surveillance is needed to refine targeted prevention strategies and optimize clinical treatment protocols for pediatric CAP. Not applicable.
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| Concepts | Keywords |
|---|---|
| CAP | |
| COVID-19 | |
| Epidemiology | |
| NPIs | |
| Pandemic period |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | community-acquired pneumonia |
| disease | MESH | CAP |
| disease | MESH | COVID-19 pandemic |
| disease | MESH | included |
| disease | MESH | coinfection |
| disease | MESH | Infectious Diseases |
| disease | MESH | Dis |
| drug | DRUGBANK | Troleandomycin |
| drug | DRUGBANK | Trametes versicolor fruiting body |
| pathway | REACTOME | Reproduction |
| disease | MESH | Emergency |
| disease | MESH | Respiratory infections |
| disease | MESH | infections |
| disease | MESH | death |
| disease | MESH | pneumonia |
| disease | MESH | syndrome |
| disease | MESH | influenza |
| disease | MESH | ICD |
| disease | MESH | parainfluenza |