OBJECTIVE  To explore the clinical characteristics of pneumonia caused by respiratory syncytial virus (RSV) infection in children and summarize the risk factors for severe pneumonia.

METHODS  A total of 363 hospitalized children with pneumonia caused by RSV infection admitted to the Pediatric Respiratory Department of Guizhou Branch of Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine from May 2023 to May 2024 were selected as the study subjects. Clinical data of the children were collected, and a multivariate logistic regression model was used to summarize the risk factors for severe pneumonia caused by RSV infection in children.

RESULTS  Among the 363 hospitalized children with pneumonia caused by RSV infection, 239 were male (65.84%). The onset time concentrated in winter and spring. There were 245 cases (67.49%) not breastfed, 198 cases (54.54%) delivered by cesarean section, 17 cases (4.68%) of twins or more, 33 cases (9.09%) with a history of mechanical ventilation, 61 cases (16.80%) with common underlying diseases of eczema, 47 cases (12.95%) being premature infants, 203 cases with mixed infections and 132 cases with severe pneumonia. Common clinical manifestations in the 363 cases included cough, fever and lung rales. Most of the children required oxygen inhalation, sputum suction, hormones and admission to the PICU (15.43%, 56/363). The severe group had a younger age (median age approximately 4 months) and a lower birth weight (median weight 3.10 kg). The severe group showed a higher proportion of children with tachypnea, three-depression sign and both dry and moist rales on lung auscultation (all P＜0.001). Young age (OR=0.980), history of mechanical ventilation (OR=5.179), mixed infection (OR=1.729), both dry and moist rales on lung auscultation (OR=2.161), congenital heart disease (OR=5.587), premature birth (OR=2.647) and eczema (OR=0.489) were risk factors for severe pneumonia caused by RSV infection in children (P＜0.05).

CONCLUSIONS  Hospitalized RSV infections are concentrated in infants and young children, prevalent in winter and spring, with a majority being male. Common clinical manifestations include cough, fever and lung rales. Young age, history of mechanical ventilation, combination of underlying diseases (congenital heart disease, premature birth, eczema), mixed infections and both dry and moist rales on lung auscultation are risk factors for severe pneumonia caused by RSV infection in children.