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Symptoms Associated With Respiratory Pathogens in Young Children: 2019-2025

Daniel C Payne1,2, Huan Xu1, Allison R Burrell1

  • 1Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Pediatrics
|July 26, 2026
PubMed

Insights

Infants with acute respiratory illnesses (ARIs) show varied symptoms and outcomes, with some experiencing severe respiratory distress. Understanding these differences in children is key to improving pediatric health and managing infections like influenza and RSV.

Area of Science:

  • Pediatric infectious diseases
  • Respiratory medicine
  • Epidemiology

Background:

  • Acute respiratory illnesses (ARIs) are a significant health concern in early childhood.
  • These infections present a wide spectrum of respiratory symptoms and clinical outcomes.
  • Understanding symptom variability is crucial for effective pediatric care.

Purpose of the Study:

  • To describe the symptomology profiles of acute respiratory tract infections in a cohort of healthy US children.
  • To investigate the medical outcomes associated with different respiratory pathogen infections.
  • To identify factors influencing symptom severity and healthcare utilization in pediatric ARIs.

Main Methods:

  • A longitudinal birth cohort study in Cincinnati, Ohio, collected weekly nasal swabs and biweekly symptom surveys from November 2019 to August 2025.
  • Nasal swabs were analyzed for various respiratory pathogens using Luminex NxTAG Respiratory Pathogen Panel and Flu SC2 assay.
  • Pathogen-specific infections were linked to symptom data, with co-infections excluded to isolate individual pathogen effects.

Main Results:

  • 15,898 ARIs were documented in 1223 children. Infants showed higher odds of respiratory distress with influenza A, RSV A, RSV B, human metapneumovirus, and SARS-CoV-2 compared to older children.
  • Influenza A infections were more frequently associated with fever and anorexia than influenza B. Asymptomatic infections were common, with most symptomatic cases managed at home.
  • Gastrointestinal symptoms like vomiting and diarrhea were prevalent during RSV and influenza infections.

Conclusions:

  • Significant variability exists in respiratory tract infection symptoms and outcomes among healthy US children.
  • Further research into the causes of symptom severity disparities could lead to improved child health strategies.
  • Frequent gastrointestinal symptoms during ARIs and distinct differences between influenza A and B symptom profiles warrant attention.
Abstract

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