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Published on: November 10, 2023
Clinical Characteristics of Paediatric RSV, Influenza, and SARS-CoV-2 Infections: Insights from Three Consecutive
Weronika Balas1, Katarzyna Balas1, Maria Gancarczyk1
1Clinical Department of Paediatrics and Allergology, National Medical Institute of the Ministry of the Interior and Administration, 02-507 Warsaw, Poland.
Insights
Respiratory Syncytial Virus (RSV) infections in children often present with severe respiratory symptoms and delayed hospital admission. Influenza and SARS-CoV-2 typically show milder upper respiratory symptoms, with distinct age-related patterns observed for each virus.
Area of Science:
- Pediatrics
- Infectious Diseases
- Respiratory Medicine
Background:
- Retrospective analysis of clinical presentations of three major respiratory viruses in children.
- Covers three consecutive winter seasons (2022-2025).
Purpose of the Study:
- To compare the clinical manifestations of RSV, Influenza, and SARS-CoV-2 in hospitalized children.
- To identify age-specific patterns in disease presentation for each virus.
Main Methods:
- Analysis of 321 hospitalized children (≤17 years).
- Statistical methods included Chi-squared test and multivariable logistic regression.
- Odds ratios (OR) and 95% confidence intervals (CI) were calculated.
Main Results:
- RSV was linked to abnormal lung sounds and delayed admission (≥4 days).
- RSV in infants (<6 months) showed higher CRP, reduced appetite, and prolonged fever compared to older children.
- Influenza and COVID-19 (SARS-CoV-2) showed milder symptoms, with specific age-related findings like higher CRP in COVID-19 patients.
Conclusions:
- RSV presents with more severe respiratory illness and later hospitalizations.
- Influenza and SARS-CoV-2 generally have milder courses with upper respiratory symptoms.
- Virus-specific and age-specific patterns underscore the need for ongoing surveillance and comparative research.
Background:
The purpose of this study was to retrospectively analyse the clinical presentation of RSV, Influenza, and SARS-CoV-2 infections in children across three consecutive seasons (2022/2023; 2023/2024; and 2024/2025).
Methods:
Of the 321 hospitalised patients, 129 (36%) tested positive for RSV, 110 (38%) for Influenza, and 82 (26%) for SARS-CoV-2. Children were aged ≤ 17 years (median: 15 months). The data were statistically analysed using the χ2 test, multinomial multivariable logistic regression, OR (odds ratio), and 95% CI (confidence interval).
Results:
Significant independent predictors of RSV infection were auscultatory abnormalities (OR: 15.9 [1.49-169]) and hospital admission ≥ 4 days after symptom onset (OR: 32.5 [1.19-907]). Among RSV-positive patients, compared with those aged < 6 months, those aged 7-24 months were more likely to present with higher CRP levels (OR 1.06 [1.003-1.13]), reduced appetite (OR 6.7 [1.62-27.67]), and longer duration of fever (OR 7.22 [1.47-35.59]), while in children > 24 months, only a longer duration of fever remained significant (OR 16.82 [2.14-162.4]). In Influenza, reduced appetite was the only characteristic feature in the 7-24-month age group (OR 13.55 [1.79-102.81]). In COVID-19, children aged 7-24 months more frequently had higher CRP levels (OR 1.108 [1.001-1.226]) and chronic diseases (OR 7.59 [1.115-51.64]), whereas in those >24 months, only CRP was significant (OR 1.16 [1.047-1.31]).
Conclusions:
RSV was associated with severe respiratory manifestations and later hospital admission, whereas Influenza and SARS-CoV-2 were characterised by milder courses with predominant upper respiratory symptoms. Observed age- and virus-specific patterns highlight the importance of continued surveillance and comparative research on major respiratory viruses in children.
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