Rhinovirus Genotypes Differ in Severe Childhood Pneumonia Patterns

A retrospective analysis of 131 children with severe human rhinovirus pneumonia found that the condition accounted for 4.59% of 2,856 cases assessed, and co-infections were detected in 126 children, or 96.18% of the cohort. The study, published as accepted research in BMC Infectious Diseases , examined the epidemiology, symptoms, imaging findings, co-pathogens, treatments and rhinovirus genotypes associated with severe disease in children. Severe human rhinovirus pneumonia was most frequent among children aged four to six years, who represented 38.17% of the 131 cases.

Investigators also observed two seasonal peaks in detection, occurring in March and November. These patterns were recorded during the study period rather than established as general seasonal trends, and the retrospective design does not show that either month or the age distribution caused severe illness. Coinfection was nearly universal in the analyzed population.

In total, the investigators identified 301 co-pathogens: 158 bacteria, 46 viruses, nine fungi and 88 instances of Mycoplasma pneumoniae . The most frequently recorded co-pathogen was M. pneumoniae , representing 29.24% of the 301 detections, followed by Streptococcus pneumoniae at 14.29%. Because some children had more than one co-pathogen, these pathogen percentages describe detections rather than mutually exclusive groups or the proportion of children individually infected with each organism.

Cough and fever were the predominant clinical manifestations, occurring in 94.66% and 81.68% of cases, respectively. Pulmonary consolidation was the most common imaging finding, identified in 93 children, or 70.99% of the cohort, while pleural thickening appeared in 65 children, or 49.62%. Comparative analysis detected no significant differences in imaging findings among children infected with rhinovirus A, B or C, indicating that the reported imaging distributions did not significantly distinguish the genotype groups in this cohort.

The clinical profiles did differ by genotype in several respects. Children with rhinovirus C were younger than those with rhinovirus A or B. Wheezing was reported in 44.83% of the HRV-C group, compared with 15.94% in the HRV-A group and 15.00% in the HRV-B group. Pediatric intensive care unit admission was also more frequent among children with HRV-C, occurring in 24.14% of that group, versus 2.90% for HRV-A and 15% for HRV-B.

By contrast, rhinovirus A infection was associated with longer durations of fever and cough. The analysis supports these as genotype-specific associations within the studied children; it does not establish that the viruses directly caused the differences in symptoms, age distribution or intensive care use. Treatment utilization was evaluated alongside the clinical comparisons, but the reported results concern differences in use rather than comparative effectiveness.

Fiberoptic bronchoscopy was performed at similar rates across all three genotype groups, with no statistically significant difference ( P = 0.7490). Intravenous immunoglobulin use did differ significantly ( p = 0.0485): it was reported in 15.00% of HRV-B cases, 1.45% of HRV-A cases and 3.45% of HRV-C cases. Overall, the findings show that severe human rhinovirus pneumonia in children commonly occurred alongside other pathogens in this cohort.

The results also indicate that rhinovirus genotypes were associated with different clinical presentations: HRV-C with younger age, more wheezing and greater likelihood of pediatric intensive care admission, and HRV-A with longer fever and cough. These findings are limited by the retrospective design and the 131-case sample, and they do not establish a causal role for any genotype or justify conclusions about treatment benefit.

Subject of Research: Clinical and virological patterns of severe human rhinovirus pneumonia in children

Article Title: Comprehensive analysis of severe human rhinovirus pneumonia in children: epidemiology, clinical features, and genotype-specific correlations

Article References: Qiu, F.-Z., Yang, C.-H., Wang, L., Wang, L., He, F., & Yang, Y. (2026). Comprehensive analysis of severe human rhinovirus pneumonia in children: epidemiology, clinical features, and genotype-specific correlations. BMC Infectious Diseases. https://doi.org/10.1186/s12879-026-14374-4

Image Credits: AI Generated

DOI: 10.1186/s12879-026-14374-4

Keywords: rhinovirus, pediatric pneumonia, viral infection, rhinovirus C, coinfection, Mycoplasma pneumoniae, respiratory viruses, clinical epidemiology, pediatric intensive care, virus genotyping, Comprehensive, analysis