{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:13:56Z","timestamp":1788779636284,"version":"build-2803163510"},"reference-count":33,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T00:00:00Z","timestamp":1788652800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FMBA","award":["125032604538-5"],"award-info":[{"award-number":["125032604538-5"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Background\/Objectives: Acute respiratory viral infections (ARVIs) are the leading cause of pediatric morbidity and exhibit considerable clinical heterogeneity. The analysis of clinical and etiological associations, as well as the identification of factors linked to severe ARVI cases, is essential for effective epidemiological surveillance. Methods: A retrospective, single-center observational study was conducted including 1362 non-COVID-19 pediatric cases of acute respiratory infections (ARIs), registered between 2021 and 2024. Viral pathogens were detected using real-time PCR for broad-spectrum screening of respiratory viruses. Results: Viral etiology was established in approximately 50% of cases. The most frequently detected pathogen was Human rhinovirus (HRV) (35.6%), followed by Respiratory syncytial virus (RSV) and Human adenovirus (HAdV). Despite its predominance, HRV did not demonstrate nosological specificity. The strongest associations with lower respiratory tract infections were identified for RSV (OR = 3.2) and Human bocavirus (HBoV; OR = 2.4), predominantly within the pneumonia category. RSV was also associated with bronchitis\/bronchiolitis (OR = 1.8). Significant associations with upper respiratory tract infections were established for Influenza viruses (OR = 10.4) and HAdV, including nasopharyngitis (OR = 3.88) and acute tonsillitis (OR = 3.9). HAdV additionally demonstrated an association with otitis media (OR = 5.1). Severe disease was registered in 52.3% of all clinical observations and occurred most frequently among young children, particularly in cases associated with respiratory syncytial virus (RSV &gt;80%), as well as with human bocavirus (HBoV) and Human metapneumovirus (HMPV) (~55\u201359%). Co-infections were not associated with increased disease severity compared with monoinfections (OR = 1.1). Conclusions: The obtained results highlight the contribution of specific etiological agents to severe respiratory infections in children. These findings support the prioritization of such pathogens in clinical diagnostics, including the design of diagnostic algorithms and the selection of patient management strategies in pediatric populations.<\/jats:p>","DOI":"10.3390\/diseases14090326","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T10:30:46Z","timestamp":1788777046000},"page":"326","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Etiology and Clinical Manifestations of Acute Respiratory Infections in Pediatric Patients: A Retrospective Study in Moscow, Russia"],"prefix":"10.3390","volume":"14","author":[{"given":"Diana A.","family":"Grigoryan","sequence":"first","affiliation":[{"name":"Federal State Budgetary Institution \u201cCentre for Strategic Planning and Management of Biomedical Health Risks\u201d of the Federal Medical Biological Agency, Moscow 119121, Russia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3948-8491","authenticated-orcid":false,"given":"Maria A.","family":"Gordukova","sequence":"additional","affiliation":[{"name":"G. Speransky Children\u2019s Hospital No. 9, Department of Health of the City of Moscow, Moscow 123317, Russia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"given":"Elena V.","family":"Galeeva","sequence":"additional","affiliation":[{"name":"G. Speransky Children\u2019s Hospital No. 9, Department of Health of the City of Moscow, Moscow 123317, Russia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Irina E.","family":"Turina","sequence":"additional","affiliation":[{"name":"N.F. Filatov Clinical Institute of Child Health, First I.M. Sechenov Moscow State Medical University (Sechenov University), Moscow 119991, Russia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1262-8518","authenticated-orcid":false,"given":"Ekaterina V.","family":"Ligskaya","sequence":"additional","affiliation":[{"name":"N.F. Filatov Clinical Institute of Child Health, First I.M. Sechenov Moscow State Medical University (Sechenov University), Moscow 119991, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0273-6700","authenticated-orcid":false,"given":"Oleg B.","family":"Kovalev","sequence":"additional","affiliation":[{"name":"G. Speransky Children\u2019s Hospital No. 9, Department of Health of the City of Moscow, Moscow 123317, Russia"},{"name":"Institute of Maternal and Child Health, Russian National Research Medical University Named After N.I. Pirogov, Moscow 117997, Russia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6301-9169","authenticated-orcid":false,"given":"Alina D.","family":"Matsvay","sequence":"additional","affiliation":[{"name":"Federal State Budgetary Institution \u201cCentre for Strategic Planning and Management of Biomedical Health Risks\u201d of the Federal Medical Biological Agency, Moscow 119121, Russia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/j.jaci.2023.08.008","article-title":"Childhood Respiratory Viral Infections and the Microbiome","volume":"152","author":"Kloepfer","year":"2023","journal-title":"J. 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