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How COVID-19 trends affected respiratory illness rates

In a recent study, researchers found that respiratory illness rates fell when precautions against COVID-19 were in place.

Respiratory illnesses commonly seen in pediatric patients decreased during the 2020 to 2021 influenza season, when precautions against COVID-19 were being made, according to a recent study.

Social distancing, mask wearing, and other precautions were taken during the COVID-19 pandemic. Along with preventing COVID-19 cases, these measures lowered the incidence of other illnesses, especially respiratory illnesses. 

As precautions were removed, cases of COVID-19 began to increase. Investigators conducted a study to observe if other respiratory illnesses increased with the reversal of COVID-19 precautions.

Data was gathered from a pediatric primary care network with about 375,000 pediatric patients. Information on the incidence of 9 common respiratory illnesses in children aged 0 to 17 years was then analyzed, with diagnoses from both in-person and telemedicine encounters analyzed.

Categories for respiratory illnesses included common cold, bronchiolitis, acute otitis media, croup, pneumonia, influenza, nonstreptococcal pharyngitis, sinusitis, and streptococcal pharyngitis. There were 1,573,838 encounters overall throughout 4 fall to winter seasons, 375,216 of which had one or more diagnoses for a respiratory illness.

All 9 common respiratory illnesses saw a reduction in the 2020 to 2021 season when compared to seasons prior to the pandemic, with influenza, bronchiolitis, and pneumonia seeing reduction rates of 95%. These reductions were not as great in the 2021 to 2022 season but were still significant when compared to prior seasons.

Common cold and nonstreptococcal pharyngitis were the only 2 illnesses without a significant reduction in the 2021 to 2022 season. As certain illnesses saw reductions when others did not, researchers speculated that multiple factors could have decreased incidence rates, such as infection control measure, changes in care-seeking behaviors, or an increase in circulation of specific viruses.

In many cases, diagnoses for respiratory illnesses were given to children who received a negative COVID-19 test after experiencing symptoms such as sore throat, fever, and cough. Researchers stated they are unsure if these diagnoses were given to avoid a COVID-19 diagnosis which would prevent return to school.

While January and February of 2022 were not included in the analysis, respiratory infections had decreased during that time, correlating with the SARS-CoV-2 Omicron variant and the return of pandemic precautions.


Hatoun J, Correa ET, Vernacchio L. COVID-19 pandemic-related changes in pediatric seasonal respiratory infections. Pediatrics. 2022. doi:10.1542/peds.2022-058618