Detection and clinical analysis of human coronavirus infection in pediatric patients with acute respiratory tract infection in the Xiamen Area, China, 2022–2024

This study aimed to investigate the prevalence of human coronavirus (HCoV) infection among pediatric patients with acute respiratory tract infection (ARTI) and to analyze the associated clinical features. A total of 15,281 pediatric patients diagnosed with ARTI admitted to Xiamen Children’s Hospital between January 2022 and June 2024 were included in this study. Clinical symptoms and signs in HCoV-positive patients were analyzed and compared with those of patients with respiratory syncytial virus (RSV) infection during the same period. HCoV was detected in 147 of 15,281 patients, corresponding to a detection rate of 0.93%. Annual detection rates were 0.87% (54/6,230) in 2022, 0.82% (53/6,439) in 2023, and 1.53% (40/2,612) in 2024. Detection rates were highest in autumn and winter, peaking in November (1.89%). Of the 147 cases, 80 involved HCoV mono-infection, while 67 were co-infected with other respiratory viruses. The most common HCoV-associated clinical manifestations were cough, fever, and wheezing. The incidence of wheezing was higher in the RSV group compared to the HCoV group (p < 0.05). No statistically significant differences were observed between the two groups regarding other symptoms, complications, or the proportion of cases requiring mechanical ventilation (p > 0.05). The HCoV detection rate among pediatric patients with ARTI in Xiamen between January 2022 and June 2024 was 0.96%. The clinical manifestations and severity of HCoV-associated ARTI were comparable to those of RSV infection.