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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Epidemiology and Infectious Diseases</journal-id><journal-title-group><journal-title xml:lang="en">Epidemiology and Infectious Diseases</journal-title><trans-title-group xml:lang="ru"><trans-title>Эпидемиология и инфекционные болезни</trans-title></trans-title-group></journal-title-group><issn publication-format="print">3034-2007</issn><issn publication-format="electronic">3034-2015</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">636484</article-id><article-id pub-id-type="doi">10.17816/EID636484</article-id><article-id pub-id-type="edn">INNHJW</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Original study articles</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Оригинальные исследования</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Etiologic structure of severe acute respiratory viral infections in children of different ages in the post-COVID period</article-title><trans-title-group xml:lang="ru"><trans-title>Этиологическая структура тяжёлых острых респираторных вирусных инфекций у детей разного возраста в постковидный период</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8717-9474</contrib-id><contrib-id contrib-id-type="spin">2149-3650</contrib-id><name-alternatives><name xml:lang="en"><surname>Lelenkova</surname><given-names>Evgenia V.</given-names></name><name xml:lang="ru"><surname>Леленкова</surname><given-names>Евгения Викторовна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>lelenkova_ev@niivirom.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8863-1031</contrib-id><contrib-id contrib-id-type="spin">7021-4024</contrib-id><name-alternatives><name xml:lang="en"><surname>Puzanov</surname><given-names>Zakhar S.</given-names></name><name xml:lang="ru"><surname>Пузанов</surname><given-names>Захар Сергеевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>zaxar.ru@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0008-8001-9452</contrib-id><contrib-id contrib-id-type="spin">7325-6620</contrib-id><name-alternatives><name xml:lang="en"><surname>Filatova</surname><given-names>Polina I.</given-names></name><name xml:lang="ru"><surname>Филатова</surname><given-names>Полина Игоревна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>polifila1997@gmail.com</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5074-7925</contrib-id><contrib-id contrib-id-type="spin">3383-1054</contrib-id><name-alternatives><name xml:lang="en"><surname>Korotkova</surname><given-names>Inna A.</given-names></name><name xml:lang="ru"><surname>Короткова</surname><given-names>Инна Александровна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>korotkova_ia@niivirom.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7286-6079</contrib-id><contrib-id contrib-id-type="spin">2081-9246</contrib-id><name-alternatives><name xml:lang="en"><surname>Markarian</surname><given-names>Alexandr Yu.</given-names></name><name xml:lang="ru"><surname>Маркарян</surname><given-names>Александр Юрьевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Cand. Sci. (Biology)</p></bio><bio xml:lang="ru"><p>канд. биол. наук</p></bio><email>markaryan_ay@niivirom.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6137-5437</contrib-id><contrib-id contrib-id-type="spin">1519-4862</contrib-id><name-alternatives><name xml:lang="en"><surname>Chernysheva</surname><given-names>Anna E.</given-names></name><name xml:lang="ru"><surname>Чернышева</surname><given-names>Анна Евгеньевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>chernysheva_ae@niivirom.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9380-8727</contrib-id><contrib-id contrib-id-type="spin">6242-5087</contrib-id><name-alternatives><name xml:lang="en"><surname>Panova</surname><given-names>Anna E.</given-names></name><name xml:lang="ru"><surname>Панова</surname><given-names>Анна Евгеньевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>panova_ae@niivirom.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3223-8219</contrib-id><contrib-id contrib-id-type="spin">2372-5134</contrib-id><name-alternatives><name xml:lang="en"><surname>Semenov</surname><given-names>Alexandr V.</given-names></name><name xml:lang="ru"><surname>Семенов</surname><given-names>Александр Владимирович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Dr. Sci. (Biology), Professor</p></bio><bio xml:lang="ru"><p>д-р биол. наук, профессор</p></bio><email>semenov_av@niivirom.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Federal Scientific Research Institute of Viral Infections «Virome»</institution></aff><aff><institution xml:lang="ru">Федеральный научно-исследовательский институт вирусных инфекций «Виром»</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Ural State Medical University</institution></aff><aff><institution xml:lang="ru">Уральский государственный медицинский университет</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2025-09-22" publication-format="electronic"><day>22</day><month>09</month><year>2025</year></pub-date><pub-date date-type="pub" iso-8601-date="2025-10-09" publication-format="electronic"><day>09</day><month>10</month><year>2025</year></pub-date><volume>30</volume><issue>2</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>88</fpage><lpage>97</lpage><history><date date-type="received" iso-8601-date="2024-09-25"><day>25</day><month>09</month><year>2024</year></date><date date-type="accepted" iso-8601-date="2025-07-02"><day>02</day><month>07</month><year>2025</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2025, Eco-vector</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2025, Эко-вектор</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="en">Eco-vector</copyright-holder><copyright-holder xml:lang="ru">Эко-вектор</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/" start_date="2028-10-09"/></permissions><self-uri xlink:href="https://rjeid.com/1560-9529/article/view/636484">https://rjeid.com/1560-9529/article/view/636484</self-uri><abstract xml:lang="en"><p><bold>Background: </bold>The etiology of acute respiratory infections includes more than 300 simultaneously circulating viruses. Identification of a specific pathogen is only possible using molecular genetic methods. Acute respiratory infections most commonly affect young children (under 6 years of age), school-age children, and adults over 65 years. In some cases, infection symptoms require hospitalization.</p> <p><bold>Aim:</bold> To investigate the etiology of severe acute respiratory infections in children of different ages during the epidemic seasons of 2022–2024.</p> <p><bold>Methods:</bold> A total of 646 nasopharyngeal swabs from patients hospitalized in pediatric hospitals in Yekaterinburg were examined using reverse transcription polymerase chain reaction. Specimens were collected according to approved criteria and tested for viral pathogens, including influenza A and B viruses (INFA, INFB) and other respiratory viruses included in the standard diagnostic panel.</p> <p><bold>Results: </bold>Over two epidemic seasons, 646 children were examined: 267 in 2022–2023 and 379 in 2023–2024. During this time, more than 60.0% of severe acute respiratory infections were confirmed viral. In 2022–2023, influenza accounted for 52.2% of cases. In this period, influenza A(H1N1)pdm09 virus and influenza B virus were circulating. Among non-influenza viruses, respiratory syncytial virus (HRsV), rhinovirus (HRV), and bocavirus (HBoV) were identified. In the following season, most cases of severe acute respiratory infections were caused by respiratory viruses, including HRsV, HRV, and adenoviruses (HAdV). Influenza A(H3N2) virus predominated among influenza cases. Analysis of coinfections with several respiratory viruses in one patient showed that in 2023–2024 the frequency of mixed infections more than doubled. In most cases, respiratory viruses were responsible for coinfections.</p> <p><bold>Conclusion:</bold> It is crucial to study the etiologic agents of respiratory infections in children that require hospitalization. This is especially relevant in the post-pandemic period of SARS-CoV-2, when circulation of other respiratory viruses, particularly influenza viruses, was suppressed.</p></abstract><trans-abstract xml:lang="ru"><p><bold>Обоснование.</bold> В этиологии острых респираторных инфекций насчитывают более 300 одновременно циркулирующих вирусов. Определить конкретного возбудителя возможно только с применением молекулярно-генетических методов. Чаще всего респираторными инфекциями болеют дети младшего возраста (до 6 лет), школьники и лица старше 65 лет. В некоторых случаях симптомы инфекции становятся причиной госпитализации пациентов.</p> <p><bold>Цель исследования.</bold> Изучить этиологию тяжёлых острых респираторных инфекций у детей разного возраста в эпидемические сезоны 2022–2024 гг.</p> <p><bold>Методы.</bold> С помощью метода полимеразной цепной реакции с обратной транскрипцией обследовали 646 носоглоточных мазков от пациентов, госпитализированных в детские стационары г. Екатеринбурга. Материал отбирали согласно утверждённым критериям и проверяли на наличие патогенов вирусной этиологии, а именно вирусов гриппа А, В (INFА, INFB) и других респираторных вирусов, входящих в стандартную диагностическую панель.</p> <p><bold>Результаты.</bold> За два сезона обследовали 646 детей, из них 267 детей — в эпидемический сезон 2022–2023 гг. и 379 — в сезон 2023–2024 гг. В анализируемые периоды на долю тяжёлых острых респираторных инфекций с установленной вирусной этиологией пришлось более 60,0% случаев. В 2022–2023 гг. доля инфекций, вызванных гриппом, составила 52,2%. В этот период циркулировали вирус гриппа А(H1N1)pdm09 и вируса гриппа B. Среди негриппозных вирусов определили респираторно-синцитиальный вирус (HRsV), риновирус (HRV) и бокавирус (HBoV). В следующем сезоне большинство случаев тяжёлых острых респираторных инфекций вызвали респираторные вирусы, включая HRsV, HRV и аденовирусы (HAdV). Среди вирусов гриппа в основном выявляли грипп А(H3N2). Анализ сочетанного выделения нескольких респираторных вирусов у одного пациента показал, что в сезоне 2023–2024 гг. частота микст-инфекций выросла более чем в 2 раза. В большинстве случаев сочетанные инфекции вызывали респираторные вирусы.</p> <p><bold>Заключение.</bold> Изучение этиологических агентов респираторных инфекций, симптомы которых потребовали госпитализации ребёнка, имеет важное значение. Это особенно актуально в период после пандемического распространения вируса SARS-CoV-2, для которого характерно подавление циркуляции других респираторных вирусов, в частности вирусов гриппа.</p></trans-abstract><kwd-group xml:lang="en"><kwd>severe acute respiratory infections</kwd><kwd>etiology</kwd><kwd>viral infections</kwd><kwd>children</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>тяжёлые острые респираторные инфекции</kwd><kwd>этиология</kwd><kwd>вирусные инфекции</kwd><kwd>дети</kwd></kwd-group><funding-group><award-group><funding-source><institution-wrap><institution xml:lang="ru">Федеральная служба по надзору в сфере защиты прав потребителей и благополучия человека</institution></institution-wrap><institution-wrap><institution xml:lang="en">Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing</institution></institution-wrap></funding-source><award-id>141-00102-21-00</award-id></award-group></funding-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Dracheva NA, Mazankova LN. 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