{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T19:41:50Z","timestamp":1790106110048,"version":"4.0.1"},"reference-count":31,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T00:00:00Z","timestamp":1684972800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Aim: This study evaluated the relationship between the systemic immune\u2013inflammatory index (SII), neutrophil\u2013to\u2013lymphocyte ratio (NLR), and platelet\u2013to\u2013lymphocyte ratio (PLR) with clinical findings of respiratory syncytial virus (RSV) infection among children with a diagnosis of lower respiratory tract infection (LRTI). Methods: The study was conducted between 1 January 2020 and 1 January 2022 in a pediatric clinic. This retrospective study included 286 consecutive patients between 0 and 12 years of age, 138 of whom were RSV (+) (48.25%) and 148 of whom were RSV (\u2212) (51.75%). The detection of the RSV antigen was carried out using the chromatographic immunoassay method on nasopharyngeal swabbing samples. Results: CRP content was significantly higher in patients with RSV (+) than in children with RSV (\u2212), while NLR, PLR, and SII, as inflammatory parameters, were significantly lower. Fever, coughs, and wheezing were the most common symptoms in the RSV (+) groups (100%). RSV infections were the highest in November, October, and December, in that order. The AUC was statistically significant for parameters in all groups. AUC values were 0.841 (95%: 0.765\u20130.917) for leukocytes, 0.703 (95%: 0.618\u20130.788) for lymphocytes, 0.869 (95%: 0.800\u20130.937) for CRP, 0.706 (95%: 0.636\u20130.776) for NLR, 0.779 (95%: 0.722\u20130.836) for PLR, and 0.705 (95%: 0.633\u20130.776) for SII. CRP was found to have both high sensitivity (80.4%) and high specificity (82.4%) among all parameters. While the ROC analysis results showed similar results for children under two years old, only CRP and NLR were statistically significant in this group. Conclusion: CRP performed better than other blood parameters as a marker. The NLR, PLR, and SII index were significantly lower in LRTI patients with RSV (+) than in those with RSV (\u2212), which implies a higher grade of inflammation. If the cause of the disease can be determined by this method, disease management will be easier, and unnecessary antibiotics could be avoided.<\/jats:p>","DOI":"10.3390\/v15061245","type":"journal-article","created":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T01:52:43Z","timestamp":1685065963000},"page":"1245","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["New Generation of Systemic Inflammatory Markers for Respiratory Syncytial Virus Infection in Children"],"prefix":"10.3390","volume":"15","author":[{"given":"Omer","family":"Okuyan","sequence":"first","affiliation":[{"name":"Department of Child Health and Diseases, Medicine Hospital, Istanbul Atlas University, 34408 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuf","family":"Elgormus","sequence":"additional","affiliation":[{"name":"Department of Child Health and Diseases, Medicine Hospital, Istanbul Atlas University, 34408 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyma","family":"Dumur","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Faculty of Medicine, Istanbul Atlas University, 34408 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5925-2128","authenticated-orcid":false,"given":"Ugurcan","family":"Sayili","sequence":"additional","affiliation":[{"name":"Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, 34303 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1347-8498","authenticated-orcid":false,"given":"Hafize","family":"Uzun","sequence":"additional","affiliation":[{"name":"Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, 34303 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,25]]},"reference":[{"key":"ref_1","unstructured":"Centers for Disease Control and Prevention (CDC) (2005). Brief report: Respiratory syncytial virus activity\u2014United States, 2004\u20132005. MMWR Morb. Mortal. Wkly. Rep., 54, 1259\u20131260."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Evans, A.S., and Kaslow, R.A. (1997). Viral Infections of Humans Epidemiology and Control, Springer. [4th ed.].","DOI":"10.1007\/978-1-4899-0036-4"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1007\/s12016-013-8368-9","article-title":"Respiratory Syncytial Virus\u2014A Comprehensive Review","volume":"45","author":"Borchers","year":"2013","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1002\/jmv.24661","article-title":"Etiology, seasonality, and clinical characteristics of respiratory viruses in children with respiratory tract infections in Eastern India (Bhubaneswar, Odisha)","volume":"89","author":"Panda","year":"2016","journal-title":"J. Med. Virol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/S0140-6736(99)80040-3","article-title":"Respiratory syncytial virus infection","volume":"354","author":"Simoes","year":"1999","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1186\/s12931-015-0244-0","article-title":"Building a better neonatal mouse model to understand infant respiratory syncytial virus disease","volume":"16","author":"You","year":"2015","journal-title":"Respir. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"21519","DOI":"10.1038\/s41598-021-00927-x","article-title":"Prognostic value of neutrophil-to-lymphocyte ratio in COVID-19 compared with Influenza and respiratory syncytial virus infection","volume":"11","author":"Prozan","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Muhammad, S., Fischer, I., Naderi, S., Faghih Jouibari, M., Abdolreza, S., Karimialavijeh, E., Aslzadeh, S., Mashayekhi, M., Zojaji, M., and Kahlert, U.D. (2021). Systemic Inflammatory Index Is a Novel Predictor of Intubation Requirement and Mortality after SARS-CoV-2 Infection. Pathogens, 10.","DOI":"10.3390\/pathogens10010058"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1016\/S0140-6736(22)00478-0","article-title":"Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: A systematic analysis","volume":"399","author":"Li","year":"2022","journal-title":"Lancet"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1002\/jmv.25499","article-title":"Clinical characteristics of the lower respiratory tract infection caused by a single infection or coinfection of the human parainfluenza virus in children","volume":"91","author":"Zhong","year":"2019","journal-title":"J. Med. Virol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1086\/512615","article-title":"Severe human lower respiratory tract illness caused by respiratory syncytial virus and influenza virus is characterized by the absence of pulmonary cytotoxic lymphocyte responses","volume":"195","author":"Welliver","year":"2007","journal-title":"J. Infect. Dis."},{"key":"ref_12","unstructured":"Cherry, J.D., Harrison, G.J., Kaplan, S.L., Steinbach, W.J., and Hotez, P.J. (2014). Feigin & Cherry\u2019s Textbook of Pediatric Infectious Diseases, Elsevier Saunders. [7th ed.]."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1111\/j.1442-200X.1996.tb03714.x","article-title":"White blood cell count, C-reactive protein and erythrocyte sedimentation rate in respiratory syncytial virus infection of the lower respiratory tract","volume":"38","author":"Saijo","year":"1996","journal-title":"Acta Paediatr. Jpn."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1097\/01.inf.0000258627.23337.00","article-title":"Lack of usefulness of an abnormal white blood cell count for predicting a concurrent serious bacterial infection in infants and young children hospitalized with respiratory syncytial virus lower respiratory tract infection","volume":"26","author":"Purcell","year":"2007","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.ijid.2020.05.008","article-title":"Characteristics of respiratory virus infection during the outbreak of 2019 novel coronavirus in Beijing","volume":"96","author":"Li","year":"2020","journal-title":"Int. J. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"4288","DOI":"10.4049\/jimmunol.169.8.4288","article-title":"IL-19 induces production of IL-6 and TNF-alpha and results in cell apoptosis through TNF-alpha","volume":"169","author":"Liao","year":"2002","journal-title":"J. Immunol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1007\/s00281-017-0629-x","article-title":"Pathogenic human coronavirus infections: Causes and consequences of cytokine storm and immunopathology","volume":"39","author":"Channappanavar","year":"2017","journal-title":"Semin. Immunopathol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e14834","DOI":"10.1097\/MD.0000000000014834","article-title":"Prognostic significance of blood inflammatory biomarkers NLR, PLR, and LMR in cancer-A protocol for systematic review and meta-analysis","volume":"98","author":"Kumarasamy","year":"2019","journal-title":"Medicine"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"106504","DOI":"10.1016\/j.intimp.2020.106504","article-title":"The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients","volume":"84","author":"Yang","year":"2020","journal-title":"Int. Immunopharmacol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1128\/CMR.00090-16","article-title":"The human immune response to respiratory syncytial virus infection","volume":"30","author":"Russell","year":"2017","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Liao, Y., Liu, C., He, W., and Wang, D. (2021). Study on the Value of Blood Biomarkers NLR and PLR in the Clinical Diagnosis of Influenza a Virus Infection in Children. Clin. Lab., 67.","DOI":"10.7754\/Clin.Lab.2021.210319"},{"key":"ref_22","first-page":"303","article-title":"Systemic immune inflammatory index in sepsis","volume":"33","year":"2017","journal-title":"Med. Int. M\u00e9x."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1826","DOI":"10.1017\/S1047951122001202","article-title":"Role of systemic immune-inflammatory index in early diagnosis of sepsis in newborns with CHD","volume":"32","author":"Aydogan","year":"2022","journal-title":"Cardiol. Young"},{"key":"ref_24","first-page":"566","article-title":"Evaluation of systemic immune-inflammation index efficacy in predicting complicated appendicitis in pediatric emergency department. \u00c7ocuk acilde komplike apandisiti \u00f6ng\u00f6rmede sistemik imm\u00fcn inflamasyon indeks etkinli\u011finin de\u011ferlendirilmesi","volume":"29","author":"Tekeli","year":"2023","journal-title":"Ulus Travma. Acil. Cerrahi. Derg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1080\/00325481.2022.2091373","article-title":"Utility of the systemic immune-inflammation index to predict serious bacterial infections in infants with fever without a source","volume":"134","author":"Bodur","year":"2022","journal-title":"Postgrad. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"104200","DOI":"10.1016\/j.meegid.2020.104200","article-title":"Hepatic TLR4, MBL and CRP gene expression levels are associated with chronic hepatitis C","volume":"80","author":"Amoras","year":"2020","journal-title":"Infect. Genet. Evol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1002\/jmv.25871","article-title":"C-reactive protein correlates with CT findings and predicts severe COVID19 early","volume":"92","author":"Tan","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1515\/cclm-2020-0198","article-title":"Laboratory abnormalities in patients with COVID-2019 infection","volume":"58","author":"Lippi","year":"2020","journal-title":"Clin. Chem. Lab. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1001\/jamainternmed.2020.0994","article-title":"Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China","volume":"180","author":"Wu","year":"2020","journal-title":"JAMA Intern. Med."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Papan, C., Willersinn, M., Wei\u00df, C., Karremann, M., Schroten, H., and Tenenbaum, T. (2020). Antibiotic utilization in hospitalized children under 2\u2009years of age with influenza or respiratory syncytial virus infection\u2014A comparative, retrospective analysis. BMC Infect. Dis., 20.","DOI":"10.1186\/s12879-020-05336-5"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"S378","DOI":"10.1093\/cid\/cix150","article-title":"Association of C-Reactive Protein With Bacterial and Respiratory Syncytial Virus-Associated Pneumonia Among Children Aged < 5 Years in the PERCH Study","volume":"64","author":"Higdon","year":"2017","journal-title":"Clin. Infect. Dis."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/15\/6\/1245\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:42:04Z","timestamp":1760125324000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/15\/6\/1245"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,25]]},"references-count":31,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,6]]}},"alternative-id":["v15061245"],"URL":"https:\/\/doi.org\/10.3390\/v15061245","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,25]]}}}