Factors associated with the severity of RSV-induced lower respiratory tract infections in children at Phrachomklao Hospital, Phetchaburi
Keywords:
Respiratory syncytial virus, RSV‑LRTI, Bronchiolitis, risk factors of recurrent seizures within 24 hours, Disease severity, Infants, ChildrenAbstract
Background: Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection (LRTI) and hospitalization in young children, with various severities such as bronchiolitis and respiratory failure.
Objective: To identify factors associated with severe RSV‑associated LRTI (RSV‑LRTI) among hospitalized children aged 0–59 months.
Methods: We conducted a retrospective study of children aged 0–59 months hospitalized with laboratory‑confirmed RSV‑LRTI (bronchiolitis or pneumonia) at Phrachomklao Hospital, Phetchaburi, from 1 July 2022 to 31 October 2024. Severe disease was defined as any of: Admission to the pediatric intensive care unit (PICU) and/or need for high‑flow nasal cannula (HFNC), non‑invasive ventilation, or endotracheal intubation. Data were collected from electronic medical records. Associations were assessed by using logistic regression and presented as odds ratios (ORs) with 95% confidence intervals (CIs).
Results: Of 723 RSV‑positive children, 631 had LRTI, 286 were hospitalized, and 220 met inclusion criteria for analysis. Severe disease occurred in 55/220 (25.0%); 44 (24.5%) required HFNC and 11 (5.0%) were intubated; no in‑hospital deaths occurred. Nearly half were <12 months old (103/220, 46.8%); boys constituted 116/220 (52.7%). In crude analyses, asthma remained independently associated with severity (OR 15.5; 95% CI 3.84–62.65; p<0.001); other evaluated factors were not significant.
Conclusion: One of four hospitalized children with RSV‑LRTI had severe disease. Asthma identified a high‑risk subgroup that may benefit from closer monitoring and earlier escalation of respiratory support.
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