Work

Risk factors for progression to bronchitis or pneumonia in hospitalized children with human rhinovirus infection: a retrospective cohort study using machine learning

Year: 2026

Type: article

Abstract: Background Human rhinovirus (HRV) is a leading cause of acute respiratory infections and hospitalization in children. However, risk factors for progression to bronchitis vs. pneumonia remain incompletely characterized. Objective This study aimed to identify and distinguish independent predictors for these outcomes using a machine learning approach. Methods A retrospective cohort study was conducted among hospitalized children with HRV infection at the First Affiliated Hospital of Ningbo University. A two-stage feature selection method (Random Forest and LASSO) was used, followed by multinomial logistic regression to quantify associations with progression to bronchitis or pneumonia. Results Of 1,125 children, 29% progressed to bronchitis and 59% to pneumonia. Multinomial logistic regression revealed distinct risk profiles. Progression to bronchitis was strongly associated with lower airway obstruction, including dyspnea ( OR: 4.35, 95% CI : 2.35–8.06), wheezing on auscultation ( OR: 2.98, 95% CI : 1.89–4.69), and cough ( OR: 2.61, 95% CI : 1.52–4.49). Progression to pneumonia was uniquely linked to prior antibiotic use ( OR: 2.09, 95% CI : 1.34–3.25), viral co-infection ( OR: 1.97, 95% CI : 1.25–3.10), and coagulation abnormalities ( OR: 1.04, 95% CI : 1.00–1.08). Elevated IgM was a common risk factor for both, while older age was protective against both ( OR: 0.89, 95% CI : 0.83–0.96). Conclusion Bronchitis progression is primarily associated with airway obstruction, whereas pneumonia is linked to more complex clinical scenarios, including prior medication, co-infections, and coagulopathy. These findings can improve early risk stratification and guide targeted interventions.

Source: Frontiers in Pediatrics

DOI: 10.3389/fped.2026.1787440

Authors: Qiaoyan Dai, Jingying Zhou, Ying Chen, Qidong Ye

Institution: Ningbo University

Language: English

Topic: Respiratory viral infections research

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801