Viral Etiology and Risk Factors of Bronchiolitis: A Cross-Sectional Study Analysis

Abstract

Abstract Background&Aims This study analyzed the factors associated with admission to the pediatric intensive care unit of children with viral respiratory infections. The authors aimed to determine the predictors that are specifically pathogen, biomarker, and clinical symptom-specific in order to understand better what drives the most severe cases. Methods This is a cross-sectional study at a tertiary pediatric facility located in Al Qassim. The research recruited medical records for patients admitted between June 1, 2023, to May 30, 2024. Only patients between 0 to 60 months old and whose infections were positively diagnosed using the PCR test were included. The patient with chronic illness, non-viral infection, and incomplete medical records were excluded. The requirement for PICU admission based on signs and symptoms, hospitalization details, biomarker levels, and length of stay (LOS) from admission were the study's major and minor outcomes. For the purpose of analysis of the data, the study has adopted descriptive statistics, Chi-square tests, and logistic regression analysis with SPSS version 25 to predict admissions to the PICU. Results A total of 234 patients, among whom 42 were admitted into the PICU and 192 into the ward. Different variables including demography, PCR for viruses, levels of all biomarkers and signs and symptoms were taken in the comparison. In the PICU group, cyanosis was very common; up to 40% of patients were admitted with it, compared to 9.4% of patients in the wards (p <0.001). The PICU group had a higher proportion of underweight patients, at 9.5%, whereas the rate of obesity was much lower than that in the ward at 7.1%. The SpO2 was also significantly lower among the patients in the PICU, reflecting a greater severity of illness. Age, low oxygen saturation, and cyanosis were also found to be significant predictors by logistic regression analysis. Specifically, children less than 2 years of age and those with profoundly low SpO2 levels were likely to require care in the intensive care unit. These findings present crucial factors associated with the need for escalated care in pediatric patients. Conclusions Viral infections, particularly RSV and rhinovirus/enterovirus, are the most common cause of hospital admission in the PICU. Critical factors such as age, weight-for-age, cyanosis, and oxygen saturation are strong predictors of PICU admission. Early monitoring plays a critical role in improving outcomes for patients with respiratory infections, highlighting the importance of timely intervention.