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April 24, 2026SHILAP Revista de lepidopterología0 citationsOpen Access

Clinical manifestations in children with parechovirus A and respiratory tract infection

LSLars Høsøien SkankeIHInger HeimdalHLHilde Lysvand

Key Result

Single parechovirus A detection was strongly associated with upper respiratory tract infections compared to lower respiratory tract infections in children (age-adjusted OR 11.3).

Key Points

  • This research aims to understand the role of parechovirus A in respiratory tract infections among children.
  • Analyzed clinical and virological data from hospitalized children and those attending day-care with respiratory infections.
  • Conducted nasopharyngeal aspirate tests for parechovirus A and other viruses using culture and PCR.
  • Utilized multivariable logistic regression to assess associations between parechovirus A and types of respiratory tract infections.
  • 4.6% of hospitalized children with respiratory tract infections had single detections of parechovirus A.
  • Strong association found between single parechovirus A detection and upper respiratory tract infections versus lower respiratory tract infections (age-adjusted OR 11.3).
  • In day-care, single detections of parechovirus A were linked to pharyngitis and tonsillitis; however, it did not affect disease severity in cases with co-detections of RSV and HRV.

Study Design

Type

Observational (n=3,713)

Multicenter

No

Structured PICO

Does Parechovirus A infection impact clinical manifestations and disease severity in children with respiratory tract infections?

P
Population
Children <16 years old with respiratory tract infections (RTI) from two observational studies: a hospital study (n=3,552) and a day-care study (n=161).
I
Intervention
Parechovirus A (PeV-A) infection (single detection or co-detected with other viruses)
C
Comparator
Children with other respiratory viruses (single RSV or single HRV) or lower respiratory tract infections
O
Outcome
Clinical manifestations (upper vs. lower respiratory tract infection) and disease severity (severity score ≥3)

Single Parechovirus A detection is associated with mild upper respiratory tract infections like pharyngitis and tonsillitis in children, but its co-detection does not worsen disease severity in those with RSV or HRV.

Main Result

Effect estimate: OR 11.3 (95% CI 3.1-41.3)

Limitations

  • Observational study design is prone to selection bias and precludes assumptions about causality
  • Day-care study had a limited size
  • Both studies were performed at one center
  • Low number of children with single PeV-A detection
  • Use of a non-validated clinical severity score
  • Genotyping of PeV-A and bacterial cultures were not performed in the day care study
  • Classification of clinical findings relied on clinical judgement without objective guidelines
  • Observational study design prone to selection bias
  • Not suitable to study the impact of viral and bacterial codetections and precludes assumptions about causality
  • Single-center studies

Abstract

Background The role of parechovirus A (PeV-A) in respiratory tract infections (RTI) in children remains unclear. Objectives and methods We used clinical and virological data from two observational studies to study PeV-A in RTIs in children: a study of children admitted to hospital with RTI, and a study of children examined for RTI while attending day care centres. All had clinical examination and one nasopharyngeal aspirate analysed for PeV-A and 18 other viruses and bacteriae by culture and PCR-tests. Results In the hospital study 4.6% (15/323) PeV-A positive RTIs were single virus detections. In 95.4% (308/323) other viruses were co-detected, including 28 with PeV-A and respiratory syncytial virus (RSV) and 77 with PeV-A and human rhinovirus (HRV). Multivariable logistic regression analysis showed strong association between single PeV-A and upper RTI (URTI) vs. lower RTI (LRTI) (age-adjusted OR 11.3, 95% CI 3.1−41.3). By retrospective evaluation of medical records, PeV-A was a likely cause of mainly pharyngitis and tonsillitis in 10/15 children with single PeV-A. In multivariable logistic regression modelling the presence of PeV-A had no impact on clinical manifestations and short-term outcomes in children with codetected RSV and HRV. In the day-care study PeV-A was detected in 30 children, among who 8/10 with single PeV-A had pharyngitis and tonsillitis. Conclusion Single PeV-A detection was associated with pharyngitis and tonsillitis among children in day-care and hospital. Most hospitalized children with PeV-A had LRTI and viral codetections, but the presence of PeV-A did not impact disease severity in those with RSV and HRV.

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Cite This Study

Skanke et al. (2026) conducted an observational in Respiratory tract infection (n=3,713). Single Parechovirus A (PeV-A) detection vs. Lower respiratory tract infection / viral codetections was evaluated on Upper respiratory tract infection (URTI) vs lower respiratory tract infection (LRTI) (OR 11.3, 95% CI 3.1-41.3). Single parechovirus A detection was strongly associated with upper respiratory tract infections compared to lower respiratory tract infections in children (age-adjusted OR 11.3).

synapsesocial.com/papers/69eb0803553a5433e34b3384https://doi.org/10.3389/fped.2026.1818273
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