ArticleFrontiers in pediatrics2026
Limited discriminatory value of C-reactive protein for viral coinfection and respiratory severity in children evaluated in the emergency department for acute respiratory tract illness.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: C-reactive protein is often measured in children who present to an acute care facility with acute respiratory tract illness (ARTI), and multiplex polymerase chain reaction (PCR) testing on respiratory samples frequently identifies more than one pathogen per encounter in children with ARTI. Whether CRP differentiates single-virus from multiple virus infections or improves prediction of clinical course of ARTI is uncertain. Objective: To assess whether age-stratified CRP differs by viral coinfection status, and whether CRP adds discriminatory value beyond clinical variables for predicting advanced respiratory support, after accounting for selection bias, probable bacterial coinfection, repeated encounters and overadjustment. Methods: This was a retrospective encounter-level cohort study of 17,089 encounters with ARTI in which multiplex respiratory polymerase chain reaction (PCR) testing was performed in the emergency department (ED) between Jan 1, 2019, and Dec 31, 2025. Encounters were not restricted to pathogen-positive results on the PCR. The analytic cohort comprised encounters with a measured CRP ( Results: Compared with untested encounters, tested patients were sicker (pediatric ward admission 74.0% vs. 36.3% [SMD 0.82]; pneumonia 23.4% vs. 9.6% [SMD 0.38]; antibiotic use 59.5% vs. 20.9% [SMD 0.86%]; PICU admission 45.1% vs. 28.5% [SMD 0.35]. RV/EV positivity was lower among tested encounters (30.7% vs. 41.4%, SMD - 0.23]. Within the CRP cohort, 3,037 (61.4%) met criteria for probably bacterial coinfection. After excluding probably bacterial coinfection, only RSV retained as significant single vs. coinfection CRP difference (3.0 vs. 5.2 mg/L, Conclusions: CRP testing is preferentially measured in patients who already appear sicker. After accounting for probably bacterial infection, CRP does not reliably distinguish single from multi-virus ARTI except for RSV in younger children, and it does not provide clinically useful incremental discrimination beyond simple clinical variables for advanced respiratory support.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.