A New Breath: Dynamics of Respiratory Infections After the Lifting of Non-Pharmaceutical Interventions Related to COVID-19

Keyrouz, Rouba; Habr, Bassem; Antar Soutou, Marianne; Abou Ismail, Sirine; Abifadel, Marianne; Najjar-Pellet, Josette; Gerbaka, Bernard; Haddad, Elie

doi:10.3390/microorganisms13122710

Open AccessArticle

A New Breath: Dynamics of Respiratory Infections After the Lifting of Non-Pharmaceutical Interventions Related to COVID-19

by

Rouba Keyrouz

^1,†,

Bassem Habr

^2,†

,

Marianne Antar Soutou

³

,

Sirine Abou Ismail

³,

Marianne Abifadel

³,

Josette Najjar-Pellet

⁴,

Bernard Gerbaka

⁵ and

Elie Haddad

^1,*

¹

Infectious Disease Department, Faculty of Medicine, Saint Joseph University, Hôtel-Dieu de France, Beirut 1107 2180, Lebanon

²

Pulmonary and Critical Care Department, Faculty of Medicine, Saint Joseph University, Hôtel-Dieu de France, Beirut 1107 2180, Lebanon

³

Laboratoire Rodolphe Mérieux Liban, Faculty of Pharmacy, Saint Joseph University, Beirut 1004 2020, Lebanon

⁴

Fondation Mérieux, Beirut 1100 2050, Lebanon

⁵

Pediatrics Department, Faculty of Medicine, Saint Joseph University, Hôtel-Dieu de France, Beirut 1107 2180, Lebanon

^*

Author to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

Microorganisms 2025, 13(12), 2710; https://doi.org/10.3390/microorganisms13122710

Submission received: 7 September 2025 / Revised: 14 November 2025 / Accepted: 25 November 2025 / Published: 27 November 2025

(This article belongs to the Special Issue New Knowledge in the Study of Coronaviruses: Towards One Health and Whole Genome Sequencing Approaches, 2nd Edition)

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Abstract

The epidemiology of respiratory viruses shifted considerably following the COVID-19 pandemic and the subsequent rollback of non-pharmaceutical interventions (NPIs). The initial global containment strategies implemented during the SARS-CoV-2 outbreak profoundly altered viral transmission dynamics and circulation patterns. As the World Health Organization (WHO) declared COVID-19 no longer a public health emergency in May 2023, viral circulation began reverting to pre-pandemic trends. This retrospective observational study examined the evolving epidemiological patterns of respiratory infections during and after the lifting of NPI, assessing associated clinical manifestations and their relationship with patient-specific risk factors. Data were collected from 307 patients tested between October 2021 and December 2024 using a respiratory multiplex PCR at the Rodolphe Mérieux Laboratory in Lebanon. Results revealed a reemergence of pre-pandemic seasonal trends for most viruses. Rhinovirus remained the most prevalent pathogen, likely due to the absence of a vaccine. Respiratory syncytial virus (RSV) and Influenza A resumed their characteristic winter peaks, while human metapneumovirus (HMPV) showed no co-infections, suggesting viral interference. The persistence of Influenza A and SARS-CoV-2 appeared influenced by vaccine coverage, viral mutations, and environmental factors. Multiplex PCR testing proved to be a valuable yet costly tool for both diagnosis and epidemiological surveillance. Overall, this study highlights the importance of continued viral monitoring in the post-NPI period, reflecting both the effectiveness of NPIs in limiting viral spread and the importance of ensuring wider access to advanced diagnostic methods.

Keywords: non-pharmaceutical interventions (NPIs); viral epidemiology; respiratory infection; virus; multiplex PCR; seasonal variation; coinfection; COVID-19; signs and symptoms; viral interference

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MDPI and ACS Style

Keyrouz, R.; Habr, B.; Antar Soutou, M.; Abou Ismail, S.; Abifadel, M.; Najjar-Pellet, J.; Gerbaka, B.; Haddad, E. A New Breath: Dynamics of Respiratory Infections After the Lifting of Non-Pharmaceutical Interventions Related to COVID-19. Microorganisms 2025, 13, 2710. https://doi.org/10.3390/microorganisms13122710

AMA Style

Keyrouz R, Habr B, Antar Soutou M, Abou Ismail S, Abifadel M, Najjar-Pellet J, Gerbaka B, Haddad E. A New Breath: Dynamics of Respiratory Infections After the Lifting of Non-Pharmaceutical Interventions Related to COVID-19. Microorganisms. 2025; 13(12):2710. https://doi.org/10.3390/microorganisms13122710

Chicago/Turabian Style

Keyrouz, Rouba, Bassem Habr, Marianne Antar Soutou, Sirine Abou Ismail, Marianne Abifadel, Josette Najjar-Pellet, Bernard Gerbaka, and Elie Haddad. 2025. "A New Breath: Dynamics of Respiratory Infections After the Lifting of Non-Pharmaceutical Interventions Related to COVID-19" Microorganisms 13, no. 12: 2710. https://doi.org/10.3390/microorganisms13122710

APA Style

Keyrouz, R., Habr, B., Antar Soutou, M., Abou Ismail, S., Abifadel, M., Najjar-Pellet, J., Gerbaka, B., & Haddad, E. (2025). A New Breath: Dynamics of Respiratory Infections After the Lifting of Non-Pharmaceutical Interventions Related to COVID-19. Microorganisms, 13(12), 2710. https://doi.org/10.3390/microorganisms13122710

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A New Breath: Dynamics of Respiratory Infections After the Lifting of Non-Pharmaceutical Interventions Related to COVID-19

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