TOPLINE

Infants younger than 1 year were more prone to respiratory distress and hospital visits for certain infections than older children. Most symptomatic episodes were managed at home.

METHODOLOGY

• Researchers analyzed data from a prospective birth cohort to describe symptom profiles and medical outcomes linked to respiratory pathogen-specific infections in children.
• They followed 1223 children (47.8% girls) in Ohio aged 2 weeks to 5 years, collecting data from 2019 to 2025.
• Mothers collected weekly nasal swabs starting when their child was 2 weeks old, with extra swabs collected when the child was ill, and completed twice weekly electronic symptom surveys.
• Samples were tested for a panel of viral and bacterial respiratory pathogens including SARS-CoV-2, and single-pathogen episodes were linked to the closest symptom report; 15,898 infection episodes were analyzed.

TAKEAWAY

• Runny nose and cough were the most common symptoms reported. Vomiting or diarrhea commonly occurred alongside some respiratory infections.
• Infants were significantly more likely than children aged 1-5 years to experience respiratory distress/dyspnea with influenza A, respiratory syncytial virus A and B, human metapneumovirus, and SARS-CoV-2 infections. They were also more likely to require hospital or emergency department visits for these infections.
• Influenza A infection episodes were linked to 2.77 times greater odds of fever and 2.94 times greater odds of anorexia than influenza B infection episodes.
• The incidence of asymptomatic infections ranged from 7.6% for influenza to nearly 45% for bocavirus infections, and 78.4% of symptomatic episodes were treated at home.

IN PRACTICE

“Accounting for the indirect economic and societal costs and transmission potential of less severe respiratory tract infections treated at home is critical to understand the complete burden of these pediatric respiratory pathogens,” the researchers of the study wrote.

SOURCE

The study was led by Daniel C. Payne, PhD, MSPH, of Cincinnati Children’s Hospital Medical Center in Cincinnati. It was published online on July 27 in Pediatrics.

LIMITATIONS

The study did not include testing for Bordetella pertussis. Symptoms such as headaches were challenging to capture in early life. Behavioral shifts related to COVID pandemic may have affected pathogen spread and patterns of care-seeking.

DISCLOSURES

The study received support from the National Institutes of Health/National Institute of Allergy and Infectious Diseases and the Open Philanthropy/Good Ventures Foundation. One author reported receiving institutional support from Bavarian Nordic and consulting for Merck and Moderna. Another author disclosed receiving institutional support, research funding, and honoraria from multiple commercial and noncommercial sources.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.