{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T13:42:26Z","timestamp":1793367746770,"version":"4.5.0"},"reference-count":45,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T00:00:00Z","timestamp":1749859200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Council for Scientific and Technological Development (CNPQ)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Severe Acute Respiratory Syndrome (SARS) represents a significant cause of morbidity and mortality in children under one year of age, a particularly vulnerable population due to immunological and respiratory immaturity. The diverse etiology includes multiple respiratory viruses such as Respiratory Syncytial Virus (RSV), influenza, rhinovirus, and SARS-CoV-2, each with distinct potential to cause severe illness and death. Understanding the specific incidence and lethality by etiological agents in the recent Brazilian context (2024), after the COVID-19 pandemic, is essential to guide surveillance and public health strategies. This study aimed to analyze the risk of incidence and lethality by specific etiology of SARS in children under one year of age hospitalized in Brazil during the year 2024. A descriptive cross-sectional study was performed using secondary data from the 2024 Influenza Epidemiological Surveillance Information System (SIVEP-Gripe), obtained via OpenDataSUS. Reported cases of SARS hospitalized in children &lt;1 year of age in Brazil were included. Distribution by final classification and epidemiological week (EW) was analyzed; the incidence rate by Federative Unit (FU) (cases\/100,000 &lt; 1 year) with risk classification (Low\/Moderate\/High) was assessed; and, for cases with positive viral RT-PCR, the etiological frequency and virus-specific lethality rate (deaths\/total cases of etiology \u00d7100), also with risk classification, were extracted. A multivariate logistic regression model was performed for the risk factors of death. A total of 66,170 cases of SARS were reported in children under 1 year old (national incidence: 2663\/100,000), with a seasonal peak between April and May. The majority of cases were classified as \u201cSARS due to another respiratory virus\u201d (49.06%) or \u201cunspecified\u201d (37.46%). Among 36,009 cases with positive RT-PCR, RSV (50.06%) and rhinovirus (26.97%) were the most frequent. The overall lethality in RT-PCR-positive cases was 1.28%. Viruses such as parainfluenza 4 (8.57%), influenza B (2.86%), parainfluenza 3 (2.49%), and SARS-CoV-2 (2.47%) had higher lethality. The multivariate model identified parainfluenza 4 (OR = 6.806), chronic kidney disease (OR = 3.820), immunodeficiency (OR = 3.680), Down Syndrome (OR = 3.590), heart disease (OR = 3.129), neurological disease (OR = 2.250), low O2 saturation (OR = 1.758), SARS-CoV-2 (OR = 1.569) and respiratory distress (OR = 1.390) as risk factors for death. Cough (OR = 0.477) and RSV (OR = 0.736) were associated with a lower chance of death. The model had good calibration (Hosmer\u2013Lemeshow p = 0.693) and overall significance (p &lt; 0.001). SARS represented a substantial burden of hospitalizations, with marked seasonal and geographic patterns. RSV and rhinovirus were the main agents responsible for the volume of confirmed cases but had a relatively low to moderate risk of lethality. In contrast, less frequent viruses such as parainfluenza 4, influenza B, parainfluenza 3, and SARS-CoV-2 were associated with a significantly higher risk of death. These findings highlight the importance of dissociating frequency from lethality and reinforce the need to strengthen etiological surveillance, improve diagnosis, and direct preventive strategies (such as immunizations) considering the specific risk of each pathogen for this vulnerable population.<\/jats:p>","DOI":"10.3390\/tropicalmed10060168","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T04:06:24Z","timestamp":1750046784000},"page":"168","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Risk of Incidence and Lethality by Etiology of Severe Acute Respiratory Syndrome in Hospitalized Children Under 1 Year of Age in Brazil in 2024: A Cross-Sectional Study"],"prefix":"10.3390","volume":"10","author":[{"given":"Tamires de Nazar\u00e9","family":"Soares","sequence":"first","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia Parasit\u00e1ria na Amaz\u00f4nia, Universidade do Estado do Par\u00e1 e Instituto Evandro Chagas (PPGBPA\/UEPA\/IEC), Belem 66087-662, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8396-3723","authenticated-orcid":false,"given":"Natasha Cristina Oliveira","family":"Andrade","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia Parasit\u00e1ria na Amaz\u00f4nia, Universidade do Estado do Par\u00e1 e Instituto Evandro Chagas (PPGBPA\/UEPA\/IEC), Belem 66087-662, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suziane do Socorro dos","family":"Santos","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia Parasit\u00e1ria na Amaz\u00f4nia, Universidade do Estado do Par\u00e1 e Instituto Evandro Chagas (PPGBPA\/UEPA\/IEC), Belem 66087-662, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela Ra\u00edssa Asevedo","family":"Dergan","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia Parasit\u00e1ria na Amaz\u00f4nia, Universidade do Estado do Par\u00e1 e Instituto Evandro Chagas (PPGBPA\/UEPA\/IEC), Belem 66087-662, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karina Faine Freitas","family":"Takeda","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Enfermagem, Universidade do Federal do Par\u00e1 (PPGENF\/UFPA), Belem 66087-662, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jully Greyce Freitas de Paula","family":"Ramalho","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Enfermagem, Universidade do Estado do Par\u00e1 e Universidade Federal do Amazonas (PPGENF\/UEPA-UFAM), Belem 66087-662, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luany Rafaele da Concei\u00e7\u00e3o","family":"Cruz","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Virologia, Instituto Evandro Chagas (PPGV\/IEC), Ananindeua 67000-000, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0623-5073","authenticated-orcid":false,"given":"Perla Katheleen Valente","family":"Corr\u00eaa","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Virologia, Instituto Evandro Chagas (PPGV\/IEC), Ananindeua 67000-000, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marli de Oliveira","family":"Almeida","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em An\u00e1lises Cl\u00ednicas, Universidade Federal do Par\u00e1 (PPGAC\/UFPA), Belem 66087-662, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce dos Santos","family":"Freitas","sequence":"additional","affiliation":[{"name":"Centro de Ci\u00eancias Biol\u00f3gicas e da Sa\u00fade, Faculdade de Enfermagem, Universidade Federal do Par\u00e1 (CCBS\/FAENF\/UFPA), Belem 66087-662, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilker Alves","family":"Silva","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Epidemiologia e Vigil\u00e2ncia em Sa\u00fade, Instituto Evandro Chagas (PPGEVS\/IEC), Ananindeua 67000-000, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2057-3474","authenticated-orcid":false,"given":"Marcos Jess\u00e9 Abrah\u00e3o","family":"Silva","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia Parasit\u00e1ria na Amaz\u00f4nia, Universidade do Estado do Par\u00e1 e Instituto Evandro Chagas (PPGBPA\/UEPA\/IEC), Belem 66087-662, Par\u00e1, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Epidemiologia e Vigil\u00e2ncia em Sa\u00fade, Instituto Evandro Chagas (PPGEVS\/IEC), Ananindeua 67000-000, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2650-2354","authenticated-orcid":false,"given":"Daniele Melo","family":"Sardinha","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia Parasit\u00e1ria na Amaz\u00f4nia, Universidade do Estado do Par\u00e1 e Instituto Evandro Chagas (PPGBPA\/UEPA\/IEC), Belem 66087-662, Par\u00e1, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Epidemiologia e Vigil\u00e2ncia em Sa\u00fade, Instituto Evandro Chagas (PPGEVS\/IEC), Ananindeua 67000-000, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luana Nepomuceno Gondim Costa","family":"Lima","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia Parasit\u00e1ria na Amaz\u00f4nia, Universidade do Estado do Par\u00e1 e Instituto Evandro Chagas (PPGBPA\/UEPA\/IEC), Belem 66087-662, Par\u00e1, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Epidemiologia e Vigil\u00e2ncia em Sa\u00fade, Instituto Evandro Chagas (PPGEVS\/IEC), Ananindeua 67000-000, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e35841","DOI":"10.1016\/j.heliyon.2024.e35841","article-title":"Global Epidemiological Trends in the Incidence and Deaths of Acute Respiratory Infections from 1990 to 2021","volume":"10","author":"Chen","year":"2024","journal-title":"Heliyon"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Cui, C., Timbrook, T.T., Polacek, C., Heins, Z., and Rosenthal, N.A. (2024). Disease Burden and High-Risk Populations for Complications in Patients with Acute Respiratory Infections: A Scoping Review. Front. Med., 11.","DOI":"10.3389\/fmed.2024.1325236"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1038\/s41572-019-0069-0","article-title":"Acute Respiratory Distress Syndrome","volume":"5","author":"Matthay","year":"2019","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_4","first-page":"2526","article-title":"Acute Respiratory Distress Syndrome","volume":"307","author":"Ranieri","year":"2012","journal-title":"JAMA"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1056\/NEJMoa1405870","article-title":"Community-Acquired Pneumonia Requiring Hospitalization among U.S. Children","volume":"372","author":"Jain","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1016\/S0140-6736(10)60206-1","article-title":"Global Burden of Acute Lower Respiratory Infections Due to Respiratory Syncytial Virus in Young Children: A Systematic Review and Meta-Analysis","volume":"375","author":"Nair","year":"2010","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Simon, A.K., Hollander, G.A., and McMichael, A. (2015). Evolution of the Immune System in Humans from Infancy to Old Age. Proc. R. Soc. B Biol. Sci., 282.","DOI":"10.1098\/rspb.2014.3085"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Walsh, E.E., and Hall, C.B. (2015). Respiratory Syncytial Virus (RSV). Mandell, Douglas, and Bennett\u2019s Principles and Practice of Infectious Diseases, Elsevier.","DOI":"10.1016\/B978-1-4557-4801-3.00160-0"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e47","DOI":"10.1016\/S2214-109X(18)30408-X","article-title":"Global, Regional, and National Estimates of Pneumonia Morbidity and Mortality in Children Younger than 5 Years between 2000 and 2015: A Systematic Analysis","volume":"7","author":"McAllister","year":"2019","journal-title":"Lancet Glob. Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1016\/S0140-6736(17)30938-8","article-title":"Global, Regional, and National Disease Burden Estimates of Acute Lower Respiratory Infections Due to Respiratory Syncytial Virus in Young Children in 2015: A Systematic Review and Modelling Study","volume":"390","author":"Shi","year":"2017","journal-title":"Lancet"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1001\/jama.289.2.179","article-title":"Mortality Associated With Influenza and Respiratory Syncytial Virus in the United States","volume":"289","author":"Thompson","year":"2003","journal-title":"JAMA"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1056\/NEJMoa025472","article-title":"Human Metapneumovirus and Lower Respiratory Tract Disease in Otherwise Healthy Infants and Children","volume":"350","author":"Williams","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/S2352-4642(21)00134-6","article-title":"Clinical Characteristics and Risk Factors for Death among Hospitalised Children and Adolescents with COVID-19 in Brazil: An Analysis of a Nationwide Database","volume":"5","author":"Oliveira","year":"2021","journal-title":"Lancet Child Adolesc. Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1007\/s00431-009-0943-y","article-title":"Etiology of Community-Acquired Pneumonia in Hospitalized Children Based on WHO Clinical Guidelines","volume":"168","author":"Gervaix","year":"2009","journal-title":"Eur. J. Pediatr."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Bezerra, P.G.M., Britto, M.C.A., Correia, J.B., Duarte, M.D.C.M.B., Fonceca, A.M., Rose, K., Hopkins, M.J., Cuevas, L.E., and McNamara, P.S. (2011). Viral and Atypical Bacterial Detection in Acute Respiratory Infection in Children under Five Years. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0018928"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1186\/s13054-019-2491-9","article-title":"Influenza Virus-Related Critical Illness: Prevention, Diagnosis, Treatment","volume":"23","author":"Chow","year":"2019","journal-title":"Crit. Care"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1093\/cid\/ciae085","article-title":"Seasonality, Clinical Characteristics, and Outcomes of Respiratory Syncytial Virus Disease by Subtype Among Children Aged <5 Years: New Vaccine Surveillance Network, United States, 2016\u20132020","volume":"78","author":"Toepfer","year":"2024","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e1031","DOI":"10.1016\/S2214-109X(19)30264-5","article-title":"Global Patterns in Monthly Activity of Influenza Virus, Respiratory Syncytial Virus, Parainfluenza Virus, and Metapneumovirus: A Systematic Analysis","volume":"7","author":"Li","year":"2019","journal-title":"Lancet Glob. Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"020421","DOI":"10.7189\/jogh.09.020421","article-title":"Global Mortality Associated with Seasonal Influenza Epidemics: New Burden Estimates and Predictors from the GLaMOR Project","volume":"9","author":"Paget","year":"2019","journal-title":"J. Glob. Health"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1111\/resp.14818","article-title":"Seasonality of Common Respiratory Viruses: Analysis of Nationwide Time-Series Data","volume":"29","author":"An","year":"2024","journal-title":"Respirology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1038\/s41579-021-00535-6","article-title":"Transmissibility and Transmission of Respiratory Viruses","volume":"19","author":"Leung","year":"2021","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1038\/s41467-025-56776-z","article-title":"Characterising the Asynchronous Resurgence of Common Respiratory Viruses Following the COVID-19 Pandemic","volume":"16","author":"Zhao","year":"2025","journal-title":"Nat. Commun."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"4121","DOI":"10.1590\/1413-812320202510.2.26802020","article-title":"Fatores Associados \u00e0 S\u00edndrome Respirat\u00f3ria Aguda Grave Em Uma Regi\u00e3o Central Do Brasil","volume":"25","author":"Araujo","year":"2020","journal-title":"Ci\u00eanc. Sa\u00fade Coletiva"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1038\/nature14460","article-title":"Global Circulation Patterns of Seasonal Influenza Viruses Vary with Antigenic Drift","volume":"523","author":"Bedford","year":"2015","journal-title":"Nature"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Mendon\u00e7a, F.M. (2005). Clima, Tropicalidade e Sa\u00fade: Uma Perspectiva a Partir da Intensifica\u00e7\u00e3o do Aquecimento Global. Rev. Bras. De Climatol., 1.","DOI":"10.5380\/abclima.v1i1.25231"},{"key":"ref_26","unstructured":"Brasil, M.D.S. (2022). Guia de Vigil\u00e2ncia Epidemiol\u00f3gica: Emerg\u00eancia de Sa\u00fade P\u00fablica de Import\u00e2ncia Nacional Pela Doen\u00e7a Pelo Coronav\u00edrus 2019\u2014Covid-19. Secretaria de Vigil\u00e2ncia em Sa\u00fade, Minist\u00e9rio da Sa\u00fade do Brasil."},{"key":"ref_27","unstructured":"Brasil, Minist\u00e9rio daSa\u00fade (2025, April 26). Vigil\u00e2ncia de S\u00edndrome Respirat\u00f3ria Aguda Grave (SARS), Available online: https:\/\/opendatasus.saude.gov.br\/dataset\/?q=srag."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Sansone, N.M.S., Boschiero, M.N., and Marson, F.A.L. (2022). Epidemiologic Profile of Severe Acute Respiratory Infection in Brazil During the COVID-19 Pandemic: An Epidemiological Study. Front. Microbiol., 13.","DOI":"10.3389\/fmicb.2022.911036"},{"key":"ref_29","unstructured":"IBGE, Instituto Brasileiro de Geografia e Estat\u00edstica (2023, February 23). IBGE|Cidades|Brasil|Panorama, Available online: https:\/\/cidades.ibge.gov.br\/brasil\/panorama."},{"key":"ref_30","unstructured":"Brasil, Minist\u00e9rio da Sa\u00fade (2025, February 10). Ficha de Notifica\u00e7\u00e3o SIVEP-GRIPE 2022, Available online: https:\/\/prefeitura.pbh.gov.br\/sites\/default\/files\/estrutura-de-governo\/saude\/2022\/ficha_SARS_hospitalizado_19.09.2022.pdf."},{"key":"ref_31","unstructured":"Brasil, Minist\u00e9rio da Sa\u00fade (2021, September 18). RESOLU\u00c7\u00c3O No 510, DE 07 DE ABRIL DE 2016, Available online: http:\/\/conselho.saude.gov.br\/resolucoes\/2016\/Reso510.pdf."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.ijid.2023.10.023","article-title":"Epidemiology of Respiratory Viruses among Children during the SARS-CoV-2 Pandemic: A Systematic Review and Meta-Analysis","volume":"138","author":"Dallmeyer","year":"2024","journal-title":"Int. J. Infect. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1002\/ppul.26315","article-title":"How Has the SARS-CoV-2 Pandemic Changed the Epidemiology and Management of Acute Bronchiolitis?","volume":"58","author":"Brisca","year":"2023","journal-title":"Pediatr. Pulmonol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e13102","DOI":"10.1111\/irv.13102","article-title":"Acute Respiratory Infection Emergency Access in a Tertiary Care Children Hospital in Italy, Prior and after the SARS-CoV-2 Emergence","volume":"17","author":"Rizzo","year":"2023","journal-title":"Influenza Other Respir. Viruses"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/S1526-0542(12)00095-4","article-title":"The Risk of Mortality among Young Children Hospitalized for Severe Respiratory Syncytial Virus Infection","volume":"13","author":"Szabo","year":"2013","journal-title":"Paediatr. Respir. Rev."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"S10","DOI":"10.1093\/infdis\/jiaa751","article-title":"Risk Factors for Poor Outcome or Death in Young Children With Respiratory Syncytial Virus\u2013Associated Acute Lower Respiratory Tract Infection: A Systematic Review and Meta-Analysis","volume":"226","author":"Shi","year":"2022","journal-title":"J. Infect. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e2023064326","DOI":"10.1542\/peds.2023-064326","article-title":"Outcomes of SARS-CoV-2 and Seasonal Viruses Among Children Hospitalized in Brazil","volume":"153","author":"Dias","year":"2024","journal-title":"Pediatrics"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e2273","DOI":"10.6061\/clinics\/2020\/e2273","article-title":"Differences among Severe Cases of Sars-CoV-2, Influenza, and Other Respiratory Viral Infections in Pediatric Patients: Symptoms, Outcomes and Preexisting Comorbidities","volume":"75","author":"Sousa","year":"2020","journal-title":"Clinics"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"101287","DOI":"10.1016\/j.eclinm.2022.101287","article-title":"Which Children and Young People Are at Higher Risk of Severe Disease and Death after Hospitalisation with SARS-CoV-2 Infection in Children and Young People: A Systematic Review and Individual Patient Meta-Analysis","volume":"44","author":"Harwood","year":"2022","journal-title":"eClinicalMedicine"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e1077","DOI":"10.1016\/S2214-109X(21)00218-7","article-title":"Global Burden of Acute Lower Respiratory Infection Associated with Human Parainfluenza Virus in Children Younger than 5 Years for 2018: A Systematic Review and Meta-Analysis","volume":"9","author":"Wang","year":"2021","journal-title":"Lancet Glob. Health"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1016\/j.jpeds.2008.11.034","article-title":"Parainfluenza Virus Infection of Young Children: Estimates of the Population-Based Burden of Hospitalization","volume":"154","author":"Weinberg","year":"2009","journal-title":"J. Pediatr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e20172918","DOI":"10.1542\/peds.2017-2918","article-title":"Influenza-Associated Pediatric Deaths in the United States, 2010\u20132016","volume":"141","author":"Shang","year":"2018","journal-title":"Pediatrics"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1097\/01.inf.0000226912.88900.a3","article-title":"Role of Respiratory Viruses in Acute Upper and Lower Respiratory Tract Illness in the First Year of Life","volume":"25","author":"Kusel","year":"2006","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_44","unstructured":"Fiocruz, Funda\u00e7\u00e3o Oswaldo Cruz (2025, April 20). InfoGripe: Incid\u00eancia e Mortalidade de VSR Em Crian\u00e7as Pequenas Se Mant\u00eam Altas. Available online: https:\/\/fiocruz.br\/noticia\/2024\/07\/infogripe-incidencia-e-mortalidade-de-vsr-em-criancas-pequenas-se-mantem-altas."},{"key":"ref_45","unstructured":"Brasil, Minist\u00e9rio da Sa\u00fade (2025, April 20). Sa\u00fade Incorpora Vacina Para Proteger Gestantes e Beb\u00eas Do V\u00edrus Sincicial Respirat\u00f3rio, Available online: https:\/\/www.gov.br\/saude\/pt-br\/assuntos\/noticias\/2025\/fevereiro\/saude-incorpora-vacina-para-proteger-gestantes-e-bebes-do-virus-sincicial-respiratorio."}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/10\/6\/168\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:52:12Z","timestamp":1760032332000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/10\/6\/168"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,14]]},"references-count":45,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["tropicalmed10060168"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed10060168","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,14]]}}}