Respiratory viral detection and severity risk factors in hospitalized children with community-acquired pneumonia following relaxation of COVID-19 non-pharmaceutical interventions: a 20-month retrospective cohort in Guilin, China
- 1The School of Public Health, Guilin Medical University, Guilin, China
- 2The Affiliated Hospital, Guilin Medical University, Guilin, China
- 3School of Medicine, Lishui University, Lishui, China
Abstract
Background: After the withdrawal of COVID-19 non-pharmaceutical interventions (NPIs) in China, we characterized the demographic, clinical and virological features of virus-positive community-acquired pneumonia (CAP) in children younger than 5 years during the post-NPI period.
Methods: We conducted a retrospective study using electronic medical records from a tertiary hospital in Guilin, China. We enrolled 1,255 children hospitalized with CAP between December 2022 and July 2024. All participants were tested for five respiratory viruses: respiratory syncytial virus (RSV), parainfluenza virus (PIV), adenovirus (ADV), influenza-A (Flu-A) and influenza-B (Flu-B).
Results: Of 1,255 hospitalized CAP cases, 681 (54%) were virus-positive, including 112 (16% of virus-positive cases) who met severe CAP (SCAP) criteria. RSV showed the highest detection rate (23%, 292/1,255), followed by PIV, ADV, Flu-A and Flu-B; detection patterns differed significantly across age groups. Bacterial co-detection was common among virus-positive cases. Multivariable analysis identified bacterial co-detection (OR 1.90, 95% CI [1.12–3.23]), wheeze (OR 1.59, 95% CI [1.02–2.49]), and chronic comorbidities (OR 2.44, 95% CI [1.5 7–3.78]) as independent risk factors for severe disease, whereas rhinorrhoea was associated with reduced severity (OR 0.43, 95% CI [0.27–0.66]).
Conclusion: Among virus-positive cases, RSV was the most frequently detected virus in children younger than 5 years hospitalized with CAP during the post-NPI period in Guilin, China. Early identification of independent risk factors for SCAP may help clinicians’s recognition high-risk children promptly.
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BibTeX
@article{wang2026respiratory,
title = {{Respiratory viral detection and severity risk factors in hospitalized children with community-acquired pneumonia following relaxation of COVID-19 non-pharmaceutical interventions: a 20-month retrospective cohort in Guilin, China}},
author = {Xin Wang and Junli Bu and Qiqing Wan and Zhi Yin and Xiaoying Zhang and Yiping Gu},
journal = {PeerJ},
year = {2026},
month = nov,
doi = {10.7717/peerj.21849},
url = {https://peerj.com/articles/21849},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Respiratory viral detection and severity risk factors in hospitalized children with community-acquired pneumonia following relaxation of COVID-19 non-pharmaceutical interventions: a 20-month retrospective cohort in Guilin, China
AU - Xin Wang
AU - Junli Bu
AU - Qiqing Wan
AU - Zhi Yin
AU - Xiaoying Zhang
AU - Yiping Gu
PY - 2026
DA - 2026/11/09
JO - PeerJ
DO - 10.7717/peerj.21849
UR - https://peerj.com/articles/21849
AB - Background: After the withdrawal of COVID-19 non-pharmaceutical interventions (NPIs) in China, we characterized the demographic, clinical and virological features of virus-positive community-acquired pneumonia (CAP) in children younger than 5 years during the post-NPI period. Methods: We conducted a retrospective study using electronic medical records from a tertiary hospital in Guilin, China. We enrolled 1,255 children hospitalized with CAP between December 2022 and July 2024. All participants were tested for five respiratory viruses: respiratory syncytial virus (RSV), parainfluenza virus (PIV), adenovirus (ADV), influenza-A (Flu-A) and influenza-B (Flu-B). Results: Of 1,255 hospitalized CAP cases, 681 (54%) were virus-positive, including 112 (16% of virus-positive cases) who met severe CAP (SCAP) criteria. RSV showed the highest detection rate (23%, 292/1,255), followed by PIV, ADV, Flu-A and Flu-B; detection patterns differed significantly across age groups. Bacterial co-detection was common among virus-positive cases. Multivariable analysis identified bacterial co-detection (OR 1.90, 95% CI [1.12–3.23]), wheeze (OR 1.59, 95% CI [1.02–2.49]), and chronic comorbidities (OR 2.44, 95% CI [1.5 7–3.78]) as independent risk factors for severe disease, whereas rhinorrhoea was associated with reduced severity (OR 0.43, 95% CI [0.27–0.66]). Conclusion: Among virus-positive cases, RSV was the most frequently detected virus in children younger than 5 years hospitalized with CAP during the post-NPI period in Guilin, China. Early identification of independent risk factors for SCAP may help clinicians’s recognition high-risk children promptly.
SN - 2167-8359
ER -