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In a cohort study of 516 children with viral respiratory infections who were hospitalized, researchers found 34 (6.6%) developed severe disease—defined as a clinical severity score greater than 3 (on a scale of 1-6), as published in JAMA Network Open. Respiratory syncytial virus (RSV) and influenza were strongly associated with worse outcomes. In multivariable analysis, RSV diagnosis (adjusted odds ratio [AOR], 4.26; 95% confidence interval [CI], 1.80–10.10) and influenza diagnosis (AOR, 4.13; 95% CI, 1.88–9.04) significantly increased the risk of severe infection. Influenza was associated with higher intensive care unit admission and longer hospital stays. Within the cohort, 3 deaths occurred in patients with influenza due to a hyperinflammatory-related syndrome. Preexisting comorbidities, particularly cardiac or pulmonary disease (AOR, 5.25; 95% CI, 1.47–18.78) and congenital malformations (AOR, 4.94; 95% CI, 1.23–19.93), independently increased severity risk. Age and viral or bacterial coinfections were not associated with worse outcomes.Â
Keep an eye on young patients: The authors of this study, which was conducted in Italy, note that RSV is the leading cause of severe respiratory disease in young children. Early detection and confirmatory diagnosis of RSV and influenza through polymerase chain reaction testing can help prioritize patients for careful monitoring, they say.