No abstract

Background Viral acute respiratory tract infections (ARTI) are a leading cause of hospitalization in infants and young children. Methods During winter seasons 2014-2018, hospitalised children (<18 years) with symptoms of ARTI were prospectively included at the University Hospital Heidelberg/Germany. Nasopharyngeal swabs were obtained for multiplex molecular analysis of 10 groups of respiratory viruses, and clinical data was obtained using a standardized questionnaire. Results Of 1.353 children included in this study, 1.142 (84.4%) were positive for ≥1 viral pathogen. Single virus infection was detected in 797 (69.8%) children, whereas 345 (30.2%) children had co-infections with 2-4 viral pathogens. Respiratory syncytial virus (RSV), rhinovirus and influenza virus were the main pathogens detected. RSV-positive children had significantly more often lower ARTI including symptoms of severe cough, wheezing, chest indrawing, tachypnoea, and pulmonary rales. Hospitalized children <6 months represented the largest age group with detection of ≥1 viral pathogen in=455/528 (86.2%) children. Co-infection was more frequent in younger children and particularly for RSV with rhinovirus significantly associated with more severe respiratory symptoms (p=0.01). Conclusion A better understanding of the aetiology of viral ARTIs in children as provided for hospitalized children plays a key role for future strategies in prevention, control, and treatment of ARTIs.