Srisingh Klaita, Khongthongprasert Sawangwong, Jaturabundit Tarit, Soponwaree Nattacha, Klangsombat Kittiporn, Sriwad Chadawan, Oilmungmool Nongluk, Phuaksaman Chutima, Lawanaskol Suppachai
Division of Pulmonology, Department of Pediatrics, Faculty of Medicine, Naresuan University Hospital, Naresuan University, Phitsanulok, Thailand.
Department of Radiology, Faculty of Medicine, Naresuan University Hospital, Naresuan University, Phitsanulok, Thailand.
J Thorac Dis. 2025 Jul 31;17(7):4565-4575. doi: 10.21037/jtd-2024-2170. Epub 2025 Jul 24.
Respiratory syncytial virus (RSV) infection is a significant burden for children under 5 years of age. While RSV is a common cause of acute lower respiratory tract infection (ALRTI), routine confirmatory testing is not widely practiced. Identifying risk factors for RSV infection can help inform clinical decision-making and guide appropriate management in emergency departments. The objective of this study is to determine the risk factors associated with RSV infection in children hospitalized with ALRTI.
A retrospective case-control study was conducted among pediatric patients under 5 years of age diagnosed with ALRTI at Naresuan University Hospital between January 2018 and December 2020. Data were extracted from electronic medical records. RSV diagnoses were confirmed using a rapid RSV antigen test. Potential risk factors-including prematurity, family history of atopic disease, past respiratory illness, history of ALRTI contact, and underlying disease-were analyzed using a multivariable logistic model in Stata version 17.0.
Among 3,579 children hospitalized with ALRTI, 459 (13%) were diagnosed with RSV infection. Peaks in RSV-ALRTI were observed in September, October, and November across 2018-2020. Significant risk factors identified through multivariable logistic regression analysis included the rainy season [odds ratio (OR) =15.51; 95% confidence interval (CI): 1.74-138.42; P=0.01], daycare attendance (OR =3.00; 95% CI: 1.27-7.10; P=0.01), lung crepitations (OR =2.60; 95% CI: 1.23-5.50; P=0.01), and oxygen supplementation (OR =2.38; 95% CI: 1.07-5.30; P=0.03).
This study highlights the significant clinical burden of RSV in ALRTI, with RSV-ALRTI accounting for 13% of all ALRTI cases. Notably, RSV-ALRTI cases peaked during the rainy season, specifically in September, October, and November. The identified risk factors for RSV-ALRTI include the rainy season, daycare attendance, lung crepitations, and the need for oxygen supplementation. These findings underscore the importance of early identification and management of high-risk patients, particularly during peak seasonal periods. Clinically, these risk factors can help guide targeted prevention and treatment strategies, improving patient outcomes and optimizing resource allocation in healthcare settings.
呼吸道合胞病毒（RSV）感染是5岁以下儿童的一项重大负担。虽然RSV是急性下呼吸道感染（ALRTI）的常见病因，但常规确诊检测并未广泛开展。识别RSV感染的风险因素有助于为临床决策提供依据，并指导急诊科的适当管理。本研究的目的是确定因ALRTI住院的儿童中与RSV感染相关的风险因素。
对2018年1月至2020年12月期间在那黎宣大学医院被诊断为ALRTI的5岁以下儿科患者进行了一项回顾性病例对照研究。数据从电子病历中提取。使用快速RSV抗原检测确诊RSV感染。潜在风险因素，包括早产、特应性疾病家族史、既往呼吸道疾病、ALRTI接触史和基础疾病，在Stata 17.0版本中使用多变量逻辑模型进行分析。
在3579例因ALRTI住院的儿童中，459例（13%）被诊断为RSV感染。在2018 - 2020年期间，9月、10月和11月观察到RSV-ALRTI病例数达到峰值。通过多变量逻辑回归分析确定的显著风险因素包括雨季（比值比[OR]=15.51；95%置信区间[CI]：1.74 - 138.42；P = 0.01）、日托机构入托（OR = 3.00；95% CI：1.27 - 7.10；P = 0.01）、肺部啰音（OR = 2.60；95% CI：1.23 - 5.50；P = 0.01）和吸氧（OR = 2.38；95% CI：1.07 - 5.30；P = 0.03）。
本研究突出了RSV在ALRTI中的重大临床负担，RSV-ALRTI占所有ALRTI病例的13%。值得注意的是，RSV-ALRTI病例在雨季达到峰值，特别是在9月、10月和11月。确定的RSV-ALRTI风险因素包括雨季、日托机构入托、肺部啰音和吸氧需求。这些发现强调了早期识别和管理高危患者的重要性，特别是在季节性高峰期。临床上，这些风险因素有助于指导有针对性的预防和治疗策略，改善患者预后并优化医疗机构的资源分配。
