Pulmonary consolidation and elevated BNP levels have emerged as independent predictors of cardiovascular events in RSV infection, according to a new study. RSV has traditionally been associated with respiratory morbidity; recent data suggest that its cardiovascular effects, such as hemodynamic instability and myocardial stress, have significant implications for pediatric outcomes. The study was published in the International Journal of Infectious Diseases by Jingwen Ni and colleagues.
This single-center, retrospective study included 105 pediatric patients diagnosed with RSV infection. Patients were divided into two groups: a group that developed cardiovascular events and another that did not. The study investigated various clinical and laboratory parameters, including troponin, BNP, NLR, BUN, D-dimer, pulmonary consolidation, and the initiation of vasopressor support, oxygen supplementation, or respiratory support. Independent risk factors were assessed in a logistic regression analysis to identify cardiovascular events, while the predictive value was measured using the AUC.
Results
The cardiovascular event group, among RSV-infected children, showed a significant elevation in:
Neutrophil-to-lymphocyte ratio (NLR)
B-type natriuretic peptide (BNP)
Blood urea nitrogen (BUN)
D-dimer
Patients in this group also required higher doses of vasopressors, higher oxygen concentrations, and had a greater proportion needing respiratory support.
The length of stay in the PICU was longer, and the hospitalization costs were higher compared to those of children without cardiovascular events.
Troponin levels did not exhibit superiority in the detection of cardiovascular events; furthermore, only a small number of children experienced a reduction in their left ventricular ejection fraction.
Pulmonary consolidation, with an OR that was not specified, and BNP, also with an OR that was not specified, were determined by logistic regression analysis to be independent risk factors for cardiovascular events.
Combining these two factors produced an AUC of 0.858, representing high predictive value.
Pulmonary consolidation combined with an elevated BNP was highly predictive of cardiovascular events in the RSV-infected children in this study. Further research is necessary to improve the early identification of risk factors, thereby enhancing clinical outcomes and reducing the intensive care burden.
Reference:
Ni, J., Hong, X., Dong, J., Zhao, M., Du, Z., Niu, W., & Fang, K. (2025). The predictive value of pulmonary consolidation combined with BNP for cardiovascular events in children with RSV infection. International Journal of Infectious Diseases: IJID: Official Publication of the International Society for Infectious Diseases, 160(108056), 108056. https://doi.org/10.1016/j.ijid.2025.108056
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