Peer-reviewedCC BY-NC 4.0Acta Paediatrica (Oslo, Norway : 1992)19 Aug 2026

Clinical Features and Predictors of Hospital Stay in Paediatric Epstein–Barr Virus Infectious Mononucleosis: A Multicentre Cohort Study

Lasse H. Nyhegn^1,2
Sara Yde Steffensen³
Sabine Frølich Maarbjerg³
Luise Borch^4,5
Marianne Kragh Thomsen^5,6
Mette Holm^1,5

6 affiliations

¹Department of Paediatric and Adolescent Medicine Aarhus University Hospital Aarhus Denmark
²National Heart and Lung Institute Imperial College London London UK
³Department of Paediatric and Adolescent Medicine Regional Hospital Randers Randers Denmark
⁴Department of Paediatrics and Adolescent Medicine Gødstrup Hospital Herning Denmark
⁵Department of Clinical Medicine Aarhus University Aarhus Denmark
⁶Department of Clinical Microbiology Aarhus University Hospital Aarhus Denmark

Abstract

Aim: To describe age‐specific clinical features and identify predictors of length of hospital stay in children and adolescents with primary Epstein–Barr virus (EBV) infectious mononucleosis (IM).

Methods: This multicentre retrospective cohort study included all children and adolescents aged 0–17 years with a verified primary EBV infection in the Central Denmark Region between March 2020 and March 2025.

Results: Among 1657 serologically verified primary EBV infections, 307 patients (18.5%) required EBV‐related hospitalisation. Hospitalisation incidence increased with age. Although adolescents accounted for most EBV‐related admissions (77.5%), EBV‐infected children below 7 years were hospitalised more often (one in four) than children aged 7 years or older (one in seven). The most common presenting symptoms were tonsillitis (77%), fever (75%) and lymphadenopathy (64%). Hepatic dysfunction was frequent, particularly among adolescents, whereas anaemia and hyperbilirubinemia occurred more often in younger children. Prolonged length‐of‐stay was independently associated with hyperbilirubinemia, elevated C‐reactive protein, organomegaly and secondary bacterial infection.

Conclusion: Disease severity in paediatric EBV infection was associated with inflammatory and hepatic complications rather than age. Early identification of these features may support risk stratification and optimise inpatient care.

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BibTeX RIS

BibTeX

@article{nyhegn2026clinical,
  title = {{Clinical Features and Predictors of Hospital Stay in Paediatric Epstein–Barr Virus Infectious Mononucleosis: A Multicentre Cohort Study}},
  author = {Lasse H. Nyhegn and Sara Yde Steffensen and Sabine Frølich Maarbjerg and Luise Borch and Marianne Kragh Thomsen and Mette Holm},
  journal = {Acta Paediatrica (Oslo, Norway : 1992)},
  year = {2026},
  month = aug,
  doi = {10.1111/apa.70707},
  url = {https://doi.org/10.1111/apa.70707},
  note = {CC BY-NC 4.0},
}

RIS

TY  - JOUR
TI  - Clinical Features and Predictors of Hospital Stay in Paediatric Epstein–Barr Virus Infectious Mononucleosis: A Multicentre Cohort Study
AU  - Lasse H. Nyhegn
AU  - Sara Yde Steffensen
AU  - Sabine Frølich Maarbjerg
AU  - Luise Borch
AU  - Marianne Kragh Thomsen
AU  - Mette Holm
PY  - 2026
DA  - 2026/08/19
JO  - Acta Paediatrica (Oslo, Norway : 1992)
DO  - 10.1111/apa.70707
UR  - https://doi.org/10.1111/apa.70707
AB  - Aim: To describe age‐specific clinical features and identify predictors of length of hospital stay in children and adolescents with primary Epstein–Barr virus (EBV) infectious mononucleosis (IM).  Methods: This multicentre retrospective cohort study included all children and adolescents aged 0–17 years with a verified primary EBV infection in the Central Denmark Region between March 2020 and March 2025.  Results: Among 1657 serologically verified primary EBV infections, 307 patients (18.5%) required EBV‐related hospitalisation. Hospitalisation incidence increased with age. Although adolescents accounted for most EBV‐related admissions (77.5%), EBV‐infected children below 7 years were hospitalised more often (one in four) than children aged 7 years or older (one in seven). The most common presenting symptoms were tonsillitis (77%), fever (75%) and lymphadenopathy (64%). Hepatic dysfunction was frequent, particularly among adolescents, whereas anaemia and hyperbilirubinemia occurred more often in younger children. Prolonged length‐of‐stay was independently associated with hyperbilirubinemia, elevated C‐reactive protein, organomegaly and secondary bacterial infection.  Conclusion: Disease severity in paediatric EBV infection was associated with inflammatory and hepatic complications rather than age. Early identification of these features may support risk stratification and optimise inpatient care.
SN  - 0803-5253
SN  - 1651-2227
ER  -

Abstract

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