Viral etiology and prognosis of severe acute respiratory tract infection in out-patient children under 5 years of age
Objective To investigate the etiology and prognosis of severe acute respiratory infection(SARI)in<5 year old outpatients.Methods The data of 199 children with SARI admitted to the outpatient department of the Xi'an Children's Hospital from January 2022 to December 2023 were included.Nasopharyngeal swabs were collected and the etiology of SARI virus in children was determined by polymerase chain reaction(PCR)within 48 h of study inclusion.The factors influencing respiratory support and length of stay in SARI children were analyzed by multiple linear regression.Results Among the 199 patients included,183 patients had positive nasopharyngeal swabs,with a positive rate of 92.0%.One pathogen was found in 124(62.3%)positive patients,two pathogens were found in 53(26.6%)positive patients,and three pathogens were found in 6(3.0%)positive patients.The most commonly detected viruses were rhinovirus(42.7%,85/199),respiratory syncytial virus(33.2%,66/199)and parainfluenza virus(14.1%,28/199).Respiratory syncytial virus was detected in 40(54.8%)of the samples collected from infants aged 0 to 6 months,significantly higher than the frequency found in other age groups(P<0.05).Adenoviruses were more common in the>12-24 month age group(22.0%).Age-specific weight Z score(β=-0.223,95%CI=-1.042--0.136,P=0.011)and SpO2(β=-0.237,95%CI=-0.21--0.037,P=0.006)were the influencing factors for respiratory support days in children with SARI.Age-specific weight Z score(β=-0.223,95%CI=-1.049--0.124,P=0.013)and SpO2(β=-0.209,95%CI=-0.204--0.020,P=0.017)were the factors influencing the length of hospital stay in SARI children.Conclusions The findings of this study highlight the importance of viruses as SARI-associated pathogens in this population.Children at risk of a severe course of disease can be identified by measuring their age-specific weight Z score and SpO2 on admission.