Key result
Picornaviridae CNS infections affect patients ~31 years younger than those with Herpesviridae.
Why the study?
This study aimed to characterize the epidemiology of viral infections in cerebrospinal fluid samples over a six-year period spanning the COVID-19 pandemic, with a focus on children under 6.
Observational (n=4,673)
No
Viral CNS infections exhibit a strongly age-dependent distribution, with a notable decrease in enterovirus circulation during the COVID-19 pandemic.
May inform age-specific CNS testing in young children; extends pandemic trend data but remains hypothesis-generating.
OBJECTIVES: This study aimed to characterize the epidemiology of viral infections in cerebrospinal fluid (CSF) samples over a six-year period spanning the COVID-19 pandemic, with a focus on children under 6. METHODS: In a retrospective, single-centre study at a tertiary hospital, 5294 CSF samples were analyzed between January 2019 and December 2024. Of the 4,673 deduplicated samples, 234 (5.1%) were positive for at least one virus. 111 (47.4%) of the 234 came from children under the age of six. RESULTS: Patients infected with Picornaviridae (enterovirus or parechovirus) were significantly younger than those infected with Herpesviridae (mean age: 7.7 vs 38.3 years, respectively; p<0.0001). We observed two age peaks in Picornaviridae positivity (before 6 months, and between 2 and 14 years) and one in Herpesviridae positivity (between 6 months and 2 years). As expected, the prevalence of Picornaviridae was significantly higher in summer (p=0.0002), while that of Herpesviridae did not change greatly over time. The prevalence of enterovirus infections was significantly lower during the COVID-19 pandemic period; this might reflect the influence of public health measures, changes in healthcare-seeking behaviour, and/or natural variability. CONCLUSIONS: Our epidemiological study of viral CNS infections highlighted a strongly age-dependent distribution and decreased enterovirus circulation during the COVID-19 period.
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Aubry et al. (2026) conducted an observational in Viral CNS infections (n=4,673). Picornaviridae infection vs. Herpesviridae infection was evaluated on Mean age of infected patients (p=<0.0001). Patients with viral CNS infections caused by Picornaviridae were significantly younger than those infected with Herpesviridae (mean age 7.7 vs 38.3 years; p<0.0001).
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