Early risk identification for recurrent wheezing in children with respiratory syncytial virus infections.

OBJECTIVE

To evaluate the predictive value of peripheral blood eosinophil (EOS) count and nasopharyngeal microbiota for recurrent wheezing in children following respiratory syncytial virus (RSV) lower respiratory tract infections.

METHODS

This retrospective study included 614 children with RSV infection and an external validation cohort of 164 children. Clinical data, hematological parameters, and nasopharyngeal microbiota profiles were collected. Logistic regression was used to identify independent predictors of recurrent wheezing. A predictive model was developed and validated using receiver operating characteristic (ROC) and calibration curves.

RESULTS

Peripheral blood EOS count, serum 25(OH)D and IgM levels, and nasopharyngeal bacterial colonization (notably and ) were significantly associated with recurrent wheezing. The predictive model showed moderate-to-good diagnostic performance (AUC = 0.747) and consistent accuracy in the external validation cohort (AUC = 0.741).

CONCLUSION

Peripheral blood EOS count and nasopharyngeal microbiota composition are critical predictors of recurrent wheezing following RSV infection. The predictive model may aid in early risk stratification and personalized intervention to prevent recurrent wheezing in pediatric patients.