Observational studyBMC infectious diseases2026
Respiratory viral infections in children under five during two consecutive autumn-winter seasons.
Observational study in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRespiratory viral infections are a leading cause of hospitalization in children < 5 years. Understanding viral circulation, co-infections, and disease severity is essential for prevention and clinical management.
methodsThis retrospective, single-center observational study was conducted between September 2023 and April 2025, and was based on multiplex PCR viral panel results obtained from respiratory samples of children under 5 years of age referred to IRCCS Policlinico. Repeated respiratory samples from the same patient yielding identical results were considered a single episode. When multiple samples collected < 7 days apart showed alternating positive and negative results, only the first positive sample was considered. Descriptive statistics and Fisher's exact test evaluated episode characteristics, virus circulation, and co-infections. Logistic regression analysis identified factors associated with pediatric high-dependency ward or intensive care unit admission.
resultsA total of 2,512 respiratory episodes in 2,239 patients were analyzed; 1,405 (55.9%) occurred in male patients, with a median(IQR) age of 1.03 (0.26-2.17) years. Pediatric high-dependency ward admission and intensive care unit admissions were reported in 432 (21.7%) and 103 (5.2%) of 1990 episodes with available clinical data, respectively. Human rhinovirus (HRV, 31.4%) was the most frequently detected pathogen, followed by RSV-A/B (13.9%). Co-infections were detected in 598 (37.6%) samples, most commonly HRV plus enterovirus (21.4%). Compared with 2023/2024, the 2024/2025 season showed reduced circulation of RSV (18.4% vs. 13.9%, P = 0.006) and human metapneumovirus (MPV; 8.9% vs. 5.5%, P = 0.002), alongside increased influenza A/B (7.4% vs. 11.8%, P = 0.0005). Logistic regression analysis revealed that pediatric high-dependency ward or intensive care unit admission was positively associated with lower respiratory tract symptoms and with the detection of RSV A/B, HRV, MPV, human enterovirus, human parainfluenza virus, and adenovirus (P < 0.05).
conclusionRespiratory viruses remained prevalent among symptomatic children < 5 years, with HRV predominating across seasons. A reduction in RSV circulation was observed in 2024/2025, temporally coinciding with nirsevimab introduction, even though no direct attribution can be made in the absence of individual-level immunization data. Overall, these findings support continued hospital-based virological surveillance in young children to monitor changes in viral circulation and clinical burden.
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