Factors Associated with Severe Outcomes of Various Respiratory Infections Detected by Multiplex RT-PCR Respiratory Panel 2.1 among Pediatric Patients in a Tertiary Hospital: A Retrospective Cohort

ABSTRACT Introduction: Respiratory infections are a leading cause of pediatric hospitalizations, particularly pneumonia. In Metro Manila, many cases lack identifiable causes, underscoring the need for advanced diagnostics. The RT-PCR Respiratory Panel 2.1 enables rapid pathogen detection, improving diagnosis and treatment. Examining demographic and clinical factors linked to severe outcomes provides valuable local insights. Objective: This study aimed to identify and compare respiratory pathogens detected by the RT-PCR panel and determine demographic and clinical factors associated with severe outcomes in pediatric patients at a private tertiary hospital in the Philippines. Design: A retrospective cohort study was conducted, analyzing pediatric patients (0–18 years) admitted for respiratory infections from August 2023 to August 2024. Descriptive statistics summarized patient characteristics, while regression analyses identified factors linked to mechanical ventilation, oxygen use, and prolonged hospital stays. Results: Of 118 patients, 85.6% tested positive for respiratory pathogens, predominantly viral (RSV 23.7%, human rhinovirus/enterovirus 22.9%), with cases peaking in late 2023. Most patients had elevated WBC with neutrophilic predominance. Oxygen support was required in 22.9% of cases, primarily in infants under six months with RSV, who had a four-fold increased risk. Difficulty breathing was the strongest predictor of oxygen use, while the presence of neurological conditions (e.g., cerebral palsy, seizure disorders) were significantly associated with mechanical ventilation and prolonged hospital stays. Conclusion: Seizure disorder, cerebral palsy, and younger age influenced severe outcomes. Pathogen-specific trends in demographics, clinical findings, and oxygen support needs may help guide physicians in recognizing illnesses caused by the most common viral respiratory pathogens identified by the RT-PCR Respiratory Panel 2.1. KEYWORDS: RT-PCR Respiratory Panel 2.1, respiratory pathogens, pediatric infections, pneumonia, mechanical ventilation use