Characteristics of Children With Clinically Suspected Pneumonia and Viral Infection

This prospective study sought to assess whether the clinical and radiographic characteristics of children with suspected pneumonia differed by virus. We observed that among 2115 children undergoing chest radiography for suspected pneumonia, 718 (33.9%) had viral testing performed, among which 126 (17.5%) had respiratory syncytial virus, 55 (7.6%) had influenza, and 18 (2.5%) had COVID-19 infection. Clinical and radiographic findings varied by virus. Tachypnea, retractions, rales, and viral radiographic features were more common among children with respiratory syncytial virus. Children with influenza were more likely to present with cough, and those with COVID-19 were least likely to have fever, cough, and hypoxia. No differences were observed by virus with respect to antibiotic prescription and return to daily life. Patients with COVID reported lower rates of persistent cough. These findings may be helpful to determine etiology of infection, particularly when viral testing is not available.