CLINICAL AND IMMUNOLOGICAL FEATURES OF VIRAL RESPIRATORY INFECTIONS IN CHILDREN WITH COMORBID CONDITIONS: A LITERATURE REVIEW
Abstract
Background: Viral respiratory infections are a leading cause of pediatric hospitalization and healthcare strain worldwide. While healthy children typically experience mild or self-limiting clinical courses, patients with underlying chronic conditions face a significantly higher risk of severe lower respiratory tract disease, mechanical ventilation, and mortality.
References
1. Academic Press, Elsevier. Emerging viral respiratory pathogens in the pediatric population: A five-year global epidemiological update. J Pediatr Infect Dis. 2024;19(2):112-125. Available from: https://doi.org/10.1016/j.jpid.2024.01.005
2. Centers for Disease Control and Prevention (CDC). Respiratory virus hospitalization surveillance network (RESP-NET): Pediatric data summary and clinical guidelines for high-risk cohorts. MMWR Morb Mortal Wkly Rep. 2025;74(12):345-352.
3. Elsevier Science. Immunological dysregulation and cytokine profiles in children with metabolic comorbidities during acute viral insults. Trends Immunol. 2023;44(8):589-604. Available from: https://doi.org/10.1016/j.it.2023.06.002
4. Oxford University Press. Clinical trajectories of respiratory syncytial virus and influenza co-infections in children with pre-existing neuromuscular and pulmonary disorders. J Infect Dis. 2025;231(4):612-624. Available from: https://doi.org/10.1093/infdis/jiae104
5. Springer Nature. Pediatric COVID-19 and Multisystem Inflammatory Syndrome (MIS-C): Long-term outcomes and immunological memory in children with comorbidities. Eur J Pediatr. 2024;183(5):2105-2120. Available from: https://doi.org/10.1007/s00431-024-05480-1
6. Taylor & Francis. Bronchial asthma and viral respiratory infections in children: Mechanisms of exacerbation and therapeutic targets. Curr Med Res Opin. 2023;39(9):1245-1256. Available from: https://doi.org/10.1080/03007995.2023.2241098
7. UNICEF. Global report on child health and nutrition: Alleviating the burden of severe respiratory infections in malnourished populations. New York: UNICEF Digital Library; 2024. Report No.: UNICEF-GHN-2024-3.
8. Wiley-Blackwell. Innate immune responses and type I interferon suppression in obese pediatric patients infected with respiratory viruses. Pediatr Allergy Immunol. 2024;35(3):e14110. Available from: https://doi.org/10.1111/pai.14110
9. World Health Organization. Therapeutics and COVID-19: Living guideline for pediatric populations with severe comorbidities. Geneva: World Health Organization; 2025. Contract No.: WHO/2019-nCoV/therapeutics/pediatrics/2025.1.
10. Wolters Kluwer, Lippincott Williams & Wilkins. Laboratory markers of systemic inflammation and endothelial activation in severe pediatric viral infections. Pediatr Crit Care Med. 2025;26(2):105-116. Available from: https://doi.org/10.1097/PCC.0000000000003560
11. Springer Nature. Cardiovascular complications and hemodynamic monitoring during severe influenza and RSV infections in children with congenital heart disease. Pediatr Cardiol. 2023;44(7):1530-1544. Available from: https://doi.org/10.1007/s00246-023-03211-w
12. Elsevier Science. The role of procalcitonin and multiplex PCR panels in antimicrobial stewardship within the pediatric intensive care unit. Anaerobe. 2024;87:102830. Available from: https://doi.org/10.1016/j.anaerobe.2024.102830
13. Oxford University Press. Type 1 diabetes and acute viral respiratory infections: Risk factors for diabetic ketoacidosis and severe outcomes in youth. Diabetes Care. 2025;48(1):142-151. Available from: https://doi.org/10.2337/dc24-1105
14. Wiley-Blackwell. Monoclonal antibody prophylaxis against respiratory syncytial virus in high-risk infants: A meta-analysis of recent clinical trial data (2021-2025). Pediatr Pulmonol. 2025;60(5):1380-1395. Available from: https://doi.org/10.1002/ppul.27420
15. World Health Organization. Global influenza surveillance and response system (GISRS): Manual for molecular diagnosis and risk assessment in vulnerable populations. Geneva: World Health Organization; 2026. Report No.: WHO-GISRS-2026.2.
