Respiratory tract infections in children frequently necessitate medical attention, ranging from pediatrician visits to emergency department admissions or hospital stays.
New research published in JAMA Network Open explored the reasons behind severe complications in children with acute respiratory infections. The findings indicate that children with two or more chronic health conditions, or those transferred from another hospital, were more likely to experience severe illness.
According to the study’s authors, led by researchers at the University of Toronto, identifying the characteristics and risk factors for severe disease in this patient group is crucial for optimizing care and resource allocation.
The study analyzed data from 2,585 children admitted with respiratory tract infections to two Canadian hospitals, the Hospital for Sick Children in Toronto and BC Children’s Hospital in Vancouver, between July 1, 2022, and June 30, 2023.
A significant portion, over half (50.6%), had at least one chronic condition, with neurologic, developmental, or genetic conditions being the most prevalent. Additionally, a third of the children (34%) had been transferred from another healthcare facility.
The research highlighted that children with multiple chronic conditions or those who were transferred faced a higher risk of severe illness. Severe outcomes were defined as requiring respiratory support like BiPAP or invasive ventilation, needing extracorporeal membrane oxygenation (ECMO), experiencing cardiac arrest, or death. The risk of mortality in this group remained low, under 2%.
The authors emphasized that children with two or more chronic conditions demonstrated a considerably elevated risk of severe outcomes. This suggests that these children are a high-risk group who should be prioritized for preventive measures and new prophylactic treatments.
The study also noted that 15% of the children had viral co-infections, but these did not appear to worsen their illness. The researchers concluded that in this cohort, the prevalence of severe and non-severe outcomes was comparable between children with single viral infections and those with multiple viral infections.