Impact of COVID-19 on Influenza Virus Trends and Subtypes in Saudi Arabia: A Cross-Sectional Analysis
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Background Influenza is a highly infectious respiratory illness that imposes a substantial health burden globally. The COVID-19 pandemic led to major shifts in respiratory viruses’ transmission. This study investigates the effect of the COVID-19 pandemic on influenza virus trends in Saudi Arabia, focusing on changes in influenza activity, subtype distribution, and seasonal patterns across pre- and post-pandemic periods. Methods Influenza data from the World Health Organization (WHO) FluNet database were analyzed, comparing influenza cases, subtype distributions, and seasonal trends before (2017–2020) and after (2021–2024) the COVID-19 pandemic in Saudi Arabia. Statistical tests, including the Chi-Square Test, two-proportion z-tests, and the Kolmogorov-Smirnov test, were utilized to evaluate the changes in influenza patterns. Results The findings of this study showed a substantial increase in the number of influenza virus testing and positive cases post-COVID-19 compared to the pre-COVID-19 period. In addition, the results revealed an altered distribution of influenza subtypes circulating in the Saudi Arabia post-pandemic, with a notable reduction in the prevalence of H1N1 pdm09 (39.23% vs.19.99%, p < 0.0001), and a dramatic increase in H3N2 (0.02% vs.17.59%, p < 0.0001), which was nearly absent in the pre-pandemic period. Conclusions This report underscores significant changes in influenza patterns in Saudi Arabia following the COVID-19 pandemic. These changes are likely influenced by reduced community immunity and the return of international travel after COVID-19 restrictions were lifted. This study highlights the importance of continuous surveillance to inform public health strategies and effectively manage future outbreaks in the post-pandemic landscape.
