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Risk factors for progression to bronchitis or pneumonia in hospitalized children with human rhinovirus infection: a

Qiaoyan Dai1, Jingying Zhou1, Ying Chen1

  • 1Department of Pediatrics, The First Affiliated Hospital of Ningbo University, Ningbo, China.

Frontiers in Pediatrics
|April 30, 2026
PubMed

Insights

Human rhinovirus (HRV) infections in children can lead to bronchitis or pneumonia. Bronchitis is linked to airway obstruction, while pneumonia risk factors include prior antibiotic use and co-infections.

Area of Science:

  • Pediatric Infectious Diseases
  • Respiratory Medicine
  • Machine Learning in Healthcare

Background:

  • Human rhinovirus (HRV) is a major cause of pediatric respiratory infections and hospitalizations.
  • Risk factors for progression to bronchitis versus pneumonia in children with HRV infection are not well understood.

Purpose of the Study:

  • To identify and differentiate independent predictors for bronchitis and pneumonia progression in children with HRV infection.
  • To utilize a machine learning approach for risk factor analysis.

Main Methods:

  • Retrospective cohort study of 1,125 hospitalized children with HRV infection.
  • Two-stage feature selection (Random Forest, LASSO) followed by multinomial logistic regression.
  • Quantification of associations between clinical factors and disease progression.

Main Results:

  • 29% progressed to bronchitis, 59% to pneumonia.
  • Bronchitis strongly associated with dyspnea, wheezing, and cough (airway obstruction).
  • Pneumonia linked to prior antibiotic use, viral co-infection, and coagulation abnormalities. Older age was protective; elevated IgM was a common risk factor.

Conclusions:

  • Bronchitis progression in children with HRV is primarily driven by airway obstruction.
  • Pneumonia progression involves more complex factors like prior medication, co-infections, and coagulopathy.
  • Findings aid in early risk stratification and targeted interventions for pediatric HRV infections.
Abstract

Keywords:
bronchitismachine learningpediatric infectious diseasespneumoniarhinovirus

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