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Factors Associated with More Severe Disease in Infants and Children with Pertussis in the Post-Pandemic Era: A

Antonio Gatto1, Danilo Buonsenso1,2,3, Eleonora Rulli1

  • 1Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.

Pathogens (Basel, Switzerland)
|October 29, 2025
PubMed

Insights

Pertussis (whooping cough) is severe in infants. Unvaccinated status, younger age, and lower weight are key risk factors for hospitalization, highlighting the importance of vaccination for preventing severe pediatric pertussis.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Epidemiology

Background:

  • Pertussis (whooping cough) is a significant respiratory illness in children, particularly infants.
  • Post-pandemic pertussis outbreaks raise questions about evolving risk factors for severe disease.
  • Understanding current risk factors is crucial for managing pediatric pertussis.

Purpose of the Study:

  • To identify demographic and clinical factors associated with severe pertussis (hospitalization) in children.
  • To compare risk factors for hospitalization in the post-pandemic era versus pre-pandemic periods.
  • To inform strategies for preventing severe pediatric pertussis.

Main Methods:

  • Retrospective analysis of 71 children diagnosed with *Bordetella pertussis* infection.
  • Comparison of clinical and demographic variables between outpatients and hospitalized patients.
  • Statistical analysis to identify factors associated with hospitalization.

Main Results:

  • Younger age (p < 0.001), lower body weight (p = 0.0005), and lack of vaccination (p < 0.00001) were significantly associated with hospitalization.
  • No significant differences in clinical symptoms, oxygen saturation, fever, or viral co-infection were observed between groups.
  • Unvaccinated status, younger age, and lower weight are primary risk factors for severe pertussis requiring hospitalization.

Conclusions:

  • Unvaccinated status, younger age, and lower body weight are critical risk factors for hospitalization in pediatric pertussis.
  • Vaccination plays a vital role in protecting infants and preventing severe outcomes.
  • Early risk stratification and targeted vaccination are essential for managing vulnerable infants with pertussis.

Keywords:
Bordetella pertussisCOVID-19childrenpertussispost COVID-19

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