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. 2025 Apr 19;25(1):563.
doi: 10.1186/s12879-025-10950-2.

Increased risk during winter: common respiratory viruses and clinical outcomes in hospitalized children

Furkan Kalayci  1 , Aslinur Ozkaya Parlakay  2 , Metin Yigit  3 , Gamze Nur Güler  3 , Betül Demircioglu Kalayci  3 , Aybuke Nur Cetin  3 , Merve Dervisoglu Yurteri  3 , Ece Karakose  3 , Kaan Celebier  3 , Naci Yilmaz  3 , Orkun Tolunay  3
Affiliations

Increased risk during winter: common respiratory viruses and clinical outcomes in hospitalized children

Furkan Kalayci et al. BMC Infect Dis. .

Abstract

Background: Acute respiratory infections (ARIs) are a leading cause of hospitalisation, severe morbidity, and mortality in children, representing a significant public health concern. This study aimed to evaluate the clinical features, laboratory findings, and outcomes of pediatric patients hospitalised due to ARIs caused by common respiratory viruses, including influenza virüs (IFV), human bocavirus (hBoV), human metapneumovirus(hMPV), human rhinovirus (hRV), and human respiratory syncytial virüs (hRSV).

Methods: We conducted a retrospective analysis of 1465 hospitalized pediatric patients at Ankara Bilkent City Hospital Children's Hospital between August 2019 and March 2024. Nasopharyngeal swabs were analyzed using multiplex real-time PCR to identify viral pathogens. Clinical data, including demographics, intensive care needs, respiratory support, and chronic health conditions, were reviewed.

Results: A total of 1465 hospitalized children were included in the study, with a median age of 3 years and 61.8% being male. Of these patients, 32.9% (n = 482) had chronic health conditions. IFV was detected in 30.1% of patients, hBoV in 28.3%, hRSV in 18.4%, hRV in 14.4%, and hMPV in 8.8%. Over half of the infections occurred during the winter months, with IFV being the most commonly observed virus. Fever was most frequently observed in IFV cases, while cough and hypoxia were more prevalent in hBoV and hRSV infections. Admission to the Pediatric Intensive Care Unit was necessary in 19.5% of cases, with 33.1% of these requiring invasive mechanical ventilation. Invasive mechanical ventilation was most frequently required in hBoV cases. The mortality rate was 8.7%, predominantly observed in patients with chronic health conditions; hBoV was associated with the highest mortality.

Conclusion: This study provides a comprehensive analysis of the clinical, laboratory, and radiological characteristics of children hospitalized due to viral lower respiratory tract infections, offering valuable insights into common respiratory pathogens. The findings underscore a higher incidence of these infections during the winter months. It is recommended that hBoV and IFV infections be closely monitored in children with underlying chronic conditions. Moreover, the study highlights the importance of meticulous management of hBoV and hRSV infections, given their association with an increased need for intensive care support.

Keywords: Human bocavirus; Human metapneumovirus; Human respiratory syncytial virus; Human rhinovirus; Influenza virus; Lower respiratory tract infections.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was conducted in accordance with the ethical standards of the institutional and national research committees, and with the 1975 Helsinki Declaration and its later amendments. Ethical approval was granted by the Ethics Committee of Ankara Bilkent City Hospital. As the study was retrospective in nature, the requirement for obtaining informed consent from participants was waived by the Ethics Committee of Ankara Bilkent City Hospital, in accordance with. General consent for the use of medical records in research was obtained as part of the routine admission process where applicable. Consent for publication: No interventions were performed on any patients for the purposes of this study; only existing medical records were utilized. Data was anonymized and confidentiality was maintained in compliance with ethical standards. The information used was in accordance with the general consent provided by patients at the time of their admission to the hospital. Competing interests: The authors declare no competing interests. Clinical trial registration: This study does not involve any clinical trials. Therefore, no clinical trial registration is required.

Figures

Fig. 1
Fig. 1
Grouping of chronic diseases
Fig. 2
Fig. 2
Distribution of multiplex PCR test results for common respiratory viruses among hospitalized patients
Fig. 3
Fig. 3
Monthly Distribution of Various Respiratory Viruses Detected by Multiplex PCR from 2019 to 2024
See this image and copyright information in PMC

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