Time trend of respiratory viruses before and during the COVID-19 pandemic in severe acute respiratory virus infection in the Sultanate of Oman between 2017 and 2022.

Introduction: Severe acute respiratory illness (SARI) is a potentially lethal condition, necessitating thorough medical care. COVID-19 underscored the SARI threat, but other high-risk pathogens require monitoring alongside SARS-CoV-2. Oman instituted a comprehensive testing system to gauge the prevalence of these pathogens between 2017 and 2021, aiding resource allocation and public health responses to potential respiratory pathogen outbreaks. Methods: Samples from SARI cases admitted to ICU were tested for pathogens using the Fast-Track Diagnostic (FTD) molecular assay, a respiratory virus panel (RVP) that tests for 21 pathogens, including 20 viruses, by qPCR. Results: Between 2017 and 2022, ~30 000 samples were analysed using the RVP panel. Among SARI patients, 8%-42% tested positive for respiratory pathogens, with 4% showing multiple infectious agents, especially in children under 10. A drop in positivity during 2020-2021 can be attributed to SARS-CoV-2 control measures, followed by a rebound in infections in early 2022. Discussion: The COVID-19 pandemic heightened awareness of respiratory pathogens' spread without adequate control measures. Influenza A/B, human rhinoviruses and respiratory syncytial virus constituted over 50% of severe acute respiratory illness cases in Oman over the past 5 years. During the pandemic, the incidence of these infections significantly declined, demonstrating the efficacy of COVID-19 prevention measures in reducing spread of other pathogens.