Early and rapid prediction of severe Human Bocavirus 1 pneumonia in children: an age-stratified Nomogram Model based on admission data.

This study aims to identify independent risk factors for severe Human Bocavirus 1(HBoV1) pneumonia in children across different age groups and to develop reliable age-stratified nomogram models based on early admission data for the rapid prediction of disease progression and severity. A total of 370 children with HBoV1 pneumonia hospitalized at Tianjin Children's Hospital from September 2022 to August 2024 were retrospectively analyzed. Patients were divided into three age groups for analysis: Group 1 (< 24 months), Group 2 (24-47 months), and Group 3 (≥ 48 months). Multivariate logistic regression was used to identify independent risk factors. Of 370 HBoV1 pneumonia cases, severe pneumonia occurred in 145 (39.2%), with the highest incidence in Group 3 (50.6%, 42/83) versus 37.7% (43/114) and 34.7% (60/173) in other groups. For Group 1, the prediction model included BMI, maximum temperature before admission, pleural thickening, CK, CKMB, and IL-6. For Group 2, the key predictors were history of eczema, pleural thickening, and N%. For Group 3, the model incorporated L%, ALB, CK, C3, and Absolute CD3 Cell Count. The areas under the ROC curve for the three age-specific models were 0.819 (95% CI: 0.7405-0.8978), 0.729 (95% CI: 0.652-0.8064), and 0.801 (95% CI: 0.7064-0.8952), respectively. The decision curve analysis curve demonstrated outstanding net benefit. The C-index values in each group were respectively 0.791, 0.727, and 0.768.

conclusionThis study develops age-stratified prediction models for severe human bocavirus 1 pneumonia in children based on early admission data. Nomograms for all three age groups exhibited good calibration performance and demonstrated clinical applicability. WHAT IS KNOWN: • Human Bocavirus 1 (HBoV1) is a significant respiratory pathogen in children, capable of causing pneumonia with varying severity, from mild to life-threatening. • Age is a key predictor of severe pneumonia in children. WHAT IS NEW: • The clinical manifestations and laboratory findings in children with Human Bocavirus 1 pneumonia exhibit age-specific characteristics. • Based on early admission data, this study developed age-stratified prediction models for severe Human Bocavirus 1 pneumonia in children, which demonstrated good performance.