{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T17:39:08Z","timestamp":1789839548086,"version":"4.0.1"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Influenza Resp Viruses"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute respiratory tract infections (ARTI) remain a major public health burden in children globally. Nevertheless, regional data regarding postpandemic pathogen shifts, coinfection profiles, and risk factors associated with severe pediatric ARTI in Hangzhou, China, remain scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective observational study was conducted on 6701 hospitalized pediatric patients (0\u201318\u2009years) with ARTI in Hangzhou, China, from July 2023 to June 2025. Eleven respiratory pathogens were detected using fluorescence PCR\u2010capillary electrophoresis. Univariate and multivariable logistic regression analyses, alongside three machine learning models, were employed to identify risk factors. Age\u2010stratified and coinfection analyses were also performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Rhinovirus (RV),\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      <\/jats:styled-content>\n                      (Mp), and respiratory syncytial virus (RSV) were the most prevalent pathogens. The coinfection network was centered on RV, Mp, and adenovirus, with RV\u2010Mp being the most common dual infection. Mixed infections were associated with severe illness (4.3% vs. 3.5% in single infections vs. 1.6% in pathogen\u2010negative cases). Mp, bocavirus (Boca), and RV infections, along with reduced percentages of lymphocytes, monocytes, and eosinophils, were independent risk factors associated with severe illness, whereas older age was a protective factor. Logistic regression demonstrated the best predictive performance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study elucidates the dynamics of pediatric ARTI pathogens and coinfection characteristics 2\u2009years postpandemic in Hangzhou, China. It identifies key risk factors associated with severe pediatric ARTI, providing essential evidence to inform age\u2010specific clinical prevention, targeted interventions, and public health strategies for pediatric ARTI in the region.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/irv.70307","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T14:08:44Z","timestamp":1787148524000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Two\u2010Year Pathogen Dynamics, Coinfection Features, and Core Risk Factors Associated With Severe Pediatric Acute Respiratory Tract Infections in Hangzhou, China"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5917-2224","authenticated-orcid":false,"given":"Chao","family":"Song","sequence":"first","affiliation":[{"name":"Laboratory Medicine Center, Zhejiang Center for Clinical Laboratories Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2716-6264","authenticated-orcid":false,"given":"Jun","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Hangzhou Children's Hospital  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0777-8547","authenticated-orcid":false,"given":"Xinfeng","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Hangzhou Children's Hospital  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4711-1544","authenticated-orcid":false,"given":"Cuiying","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Hangzhou Children's Hospital  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu","family":"Teng","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Hangzhou Children's Hospital  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yidong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Hangzhou Children's Hospital  Hangzhou Zhejiang China"},{"name":"Department of Clinical Laboratory Hangzhou Ninth People's Hospital  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60206-1"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro.2017.14"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(18)30408-X"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-82660-9"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2025.1557076"},{"issue":"10","key":"e_1_2_11_7_1","first-page":"1665","article-title":"Analysis of Common Non\u2010Bacterial Pathogens in Hospitalized Children With Acute Respiratory Infections: A Multicenter Study in Four Regions of Fujian Province in 2023","volume":"59","author":"Cai L.","year":"2025","journal-title":"Zhonghua Yu Fang Yi Xue Za 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