Severe Acute Respiratory Tract Infections in Hospitalized Children: Study Sheds Light on Burden and Risk Factors
Written By : Medha Baranwal
Medically Reviewed By : Dr. Kamal Kant Kohli
Published On 2026-06-29 15:00 GMT | Update On 2026-06-30 07:31 GMT
Canada: A recent cohort study found that children hospitalized with acute respiratory tract infections frequently have underlying chronic medical conditions and often require intensive care interventions.
The findings highlight the significant burden of severe respiratory illness in pediatric patients and highlight the importance of understanding epidemiologic patterns and risk factors for severe disease. Such insights can help guide healthcare resource allocation, improve preparedness, and optimize clinical outcomes for hospitalized children.
Published in JAMA Network Open, the study by Haifa Mtaweh and colleagues at The Hospital for Sick Children in Toronto examined the clinical characteristics of children hospitalized with acute respiratory tract infections (RTIs) and identified factors associated with severe disease.
Acute RTIs are a major cause of pediatric hospitalization, with disease patterns influenced by changing viral circulation, seasonality, population immunity, and events such as the COVID-19 pandemic. Identifying children at higher risk of severe illness is important for improving clinical care and healthcare planning.
The retrospective cohort study included 2,585 children aged 0 to 18 years who were hospitalized with acute RTIs at two Canadian pediatric hospitals between July 2022 and June 2023. The median age was 2.5 years, and 59.7% of participants were boys.
The study revealed the following findings:
- Among the 2,585 hospitalized children with acute respiratory tract infections, 50.6% had at least one chronic medical condition.
- Neurologic, developmental, and genetic disorders were the most common underlying chronic conditions.
- More than one-third of patients (34.0%) were transferred from another healthcare facility before admission.
- Viral testing was performed in 90.2% of children, and a respiratory virus was identified in 70.7% of those tested.
- The most frequently detected viruses were respiratory syncytial virus (RSV) and enterovirus-rhinovirus.
- Viral coinfections were identified in 338 children.
- Severe disease developed in 551 children, accounting for 21.3% of the study population.
- Severe illness was defined by the need for noninvasive or invasive mechanical ventilation, extracorporeal membrane oxygenation (ECMO), kidney replacement therapy, cardiac arrest, or death.
- Children with two or more chronic conditions had a 62% higher risk of developing severe disease (adjusted risk ratio [aRR] 1.62).
- Children transferred from a referring hospital were nearly five times more likely to experience severe disease (aRR 4.73).
- The median length of hospital stay was 3 days.
- Although viral coinfections were common, they were not associated with an increased risk of severe disease.
The authors acknowledged several limitations, including the study's retrospective design, potential diagnostic misclassification, and the lack of direct comparison with community hospitals. They also noted that viral circulation patterns may change over time, highlighting the importance of continued surveillance.
Overall, the findings indicate that severe respiratory illness remains a considerable burden among hospitalized children. The researchers concluded that recognizing high-risk patients, particularly those with multiple chronic conditions, can help clinicians prioritize care, allocate resources effectively, and improve outcomes for children admitted with acute respiratory tract infections.
Reference:
Mtaweh H, Kaziev CL, Feinstein CA, et al. Acute Respiratory Tract Infections and Severe Disease Among Hospitalized Children. JAMA Netw Open. 2026;9(6):e2617575. doi:10.1001/jamanetworkopen.2026.17575
Our comments section is governed by our Comments Policy . By posting comments at Medical Dialogues you automatically agree with our Comments Policy , Terms And Conditions and Privacy Policy .
Disclaimer: This website is primarily for healthcare professionals. The content here does not replace medical advice and should not be used as medical, diagnostic, endorsement, treatment, or prescription advice. Medical science evolves rapidly, and we strive to keep our information current. If you find any discrepancies, please contact us at corrections@medicaldialogues.in. Read our Correction Policy here. Nothing here should be used as a substitute for medical advice, diagnosis, or treatment. We do not endorse any healthcare advice that contradicts a physician's guidance. Use of this site is subject to our Terms of Use, Privacy Policy, and Advertisement Policy. For more details, read our Full Disclaimer here.
NOTE: Join us in combating medical misinformation. If you encounter a questionable health, medical, or medical education claim, email us at factcheck@medicaldialogues.in for evaluation.