Objective To investigate the epidemiological characteristics of common respiratory viruses and atypical pathogens in late-term neonates during the pandemic period of Coronavirus Disease 2019 (COVID-19) and the impact of non-pharmaceutical interventions (NPIs) on neonatal respiratory pathogens.

Methods A total of 2, 452 late-term hospitalized neonates caused by respiratory infection symptoms at the Children′s Hospital of Soochow University from January 2018 to February 2023 were included in the study. Data from January 2018 to December 2019 were used as pre-pandemic control group, and data from January 2020 to December 2021 were used as post-pandemic control group. The changes in nucleic acid test results for eight common pathogens in hospitalized children during the pandemic period of COVID-19 were retrospectively analyzed. Data from March 2020 to February 2023 were compared to summarize the epidemiological characteristics of neonatal respiratory pathogens in different seasons after the normalization of the pandemic period of COVID-19.

Results Among the 2, 452 hospitalized neonates, 364(14.85%) tested positive for pathogens, with respiratory syncytial virus (RSV) having the highest detection rate of 262 cases (10.69%), followed by parainfluenza viruses (PIVS) with 64 cases (2.61%). The total number of positive cases for the eight pathogens before and after the pandemic control measures were 229(17.1%) and 96(12.3%) respectively. The detection rate after the pandemic control measures was significantly lower than before (P < 0.05). The detection rates of all eight pathogens decreased after the pandemic control measures, but only the difference in the RSV detection rate was statistically significant (P < 0.05). The peak month for RSV-positive cases was delayed by one month after the pandemic control measures compared to pandemic control before, and there were two peaks in RSV incidence in 2022. PIVS was more prevalent in spring, summer, and autumn before the pandemic control measures, but became more prevalent in winter afterward, with a higher peak in positive cases detected after the control measures than pandemic control before; the seasonality of PIVS infection changed.

Conclusion After the implementation of pandemic control measures for COVID-19, the detection rate and epidemiology of common respiratory pathogens in late-term neonates with respiratory infections in Suzhou have changed. NPIs such as wearing masks, hand hygiene, maintaining social distance, and avoiding unnecessary outings have a certain preventive effect on the outbreak of respiratory pathogens.