Epidemiological Study of Respiratory Virus Infections in Pediatric Patients with Systemic Inflammatory Response Syndrome

Background: Respiratory infections are a common cause of systemic inflammatory response syndrome (SIRS) in pediatric patients. However, literature specifically addressing respiratory viruses that lead to SIRS or sepsis in children is limited, primarily consisting of case reports and lacking data for more comprehensive conclusions. Objectives: This study aims to investigate the relationship between respiratory viral infections and SIRS in children, focusing on virus detection rates, patient profiles, and the incidence of septic shock associated with different respiratory viruses. Methods: A retrospective analysis was conducted from January 2022 to December 2023 on hospitalized children diagnosed with respiratory infections and SIRS. Respiratory viruses were detected through qualitative PCR testing, and procalcitonin levels were measured using an enzyme-linked fluorescent immunoassay. Results: A total of 931 pediatric patients with SIRS were tested for respiratory viruses and/or other pathogens. Among these, 298 (32.0%) were positive for respiratory viruses, with 263 (28.2%) cases attributed solely to respiratory viruses. Human rhinovirus (HRV) had the highest infection rate at 37.3% (98/263), followed by human adenovirus (HAdV) at 24.3% (64/263). Seasonal distribution among the 263 SIRS cases associated with respiratory viral infections showed the highest incidence in spring (39.5%), followed by summer (25.5%), winter (17.9%), and autumn (17.1%). Septic shock rates were highest among cases of influenza A) FluA(, human metapneumovirus (hMP), and co-infections, with incidences of 27.8%, 18.2%, and 22.7%, respectively. There was significant variation in septic shock rates across different viral infections in pediatric patients (P < 0.001). Conclusions: Many hospitalized children with respiratory viral infections develop SIRS, and a subset of these cases can progress to septic shock.