What is the clinical evidence from this study?

Study design: Observational. Population: Respiratory tract infection (n=3713). Intervention: Single Parechovirus A (PeV-A) detection vs. Lower respiratory tract infection / viral codetections. Primary outcome: Upper respiratory tract infection (URTI) vs lower respiratory tract infection (LRTI) (OR 11.3, 95% CI 3.1-41.3).

What question did this study set out to answer?

This research aims to understand the role of parechovirus A in respiratory tract infections among children.

April 24, 2026SHILAP Revista de lepidopterología0 citationsOpen Access

Clinical manifestations in children with parechovirus A and respiratory tract infection

LSLars Høsøien SkankeNorwegian University of Science and Technology IHInger HeimdalNorwegian University of Science and Technology HLHilde LysvandNorwegian University of Science and Technology

Key Result

Single parechovirus A detection was strongly associated with upper respiratory tract infections compared to lower respiratory tract infections in children (age-adjusted OR 11.3).

Key Points

This research aims to understand the role of parechovirus A in respiratory tract infections among children.
Analyzed clinical and virological data from hospitalized children and those attending day-care with respiratory infections.
Conducted nasopharyngeal aspirate tests for parechovirus A and other viruses using culture and PCR.
Utilized multivariable logistic regression to assess associations between parechovirus A and types of respiratory tract infections.
4.6% of hospitalized children with respiratory tract infections had single detections of parechovirus A.
Strong association found between single parechovirus A detection and upper respiratory tract infections versus lower respiratory tract infections (age-adjusted OR 11.3).
In day-care, single detections of parechovirus A were linked to pharyngitis and tonsillitis; however, it did not affect disease severity in cases with co-detections of RSV and HRV.

Study Design

Type

Observational (n=3,713)

Multicenter

Structured PICO

Does Parechovirus A infection impact clinical manifestations and disease severity in children with respiratory tract infections?

Population

Children <16 years old with respiratory tract infections (RTI) from two observational studies: a hospital study (n=3,552) and a day-care study (n=161).

Intervention

Parechovirus A (PeV-A) infection (single detection or co-detected with other viruses)

Comparator

Children with other respiratory viruses (single RSV or single HRV) or lower respiratory tract infections

Outcome

Clinical manifestations (upper vs. lower respiratory tract infection) and disease severity (severity score ≥3)

Single Parechovirus A detection is associated with mild upper respiratory tract infections like pharyngitis and tonsillitis in children, but its co-detection does not worsen disease severity in those with RSV or HRV.

Main Result

Effect estimate: OR 11.3 (95% CI 3.1-41.3)

Limitations

Observational study design is prone to selection bias and precludes assumptions about causality
Day-care study had a limited size
Both studies were performed at one center
Low number of children with single PeV-A detection
Use of a non-validated clinical severity score
Genotyping of PeV-A and bacterial cultures were not performed in the day care study
Classification of clinical findings relied on clinical judgement without objective guidelines

Abstract

Background The role of parechovirus A (PeV-A) in respiratory tract infections (RTI) in children remains unclear. Objectives and methods We used clinical and virological data from two observational studies to study PeV-A in RTIs in children: a study of children admitted to hospital with RTI, and a study of children examined for RTI while attending day care centres. All had clinical examination and one nasopharyngeal aspirate analysed for PeV-A and 18 other viruses and bacteriae by culture and PCR-tests. Results In the hospital study 4.6% (15/323) PeV-A positive RTIs were single virus detections. In 95.4% (308/323) other viruses were co-detected, including 28 with PeV-A and respiratory syncytial virus (RSV) and 77 with PeV-A and human rhinovirus (HRV). Multivariable logistic regression analysis showed strong association between single PeV-A and upper RTI (URTI) vs. lower RTI (LRTI) (age-adjusted OR 11.3, 95% CI 3.1−41.3). By retrospective evaluation of medical records, PeV-A was a likely cause of mainly pharyngitis and tonsillitis in 10/15 children with single PeV-A. In multivariable logistic regression modelling the presence of PeV-A had no impact on clinical manifestations and short-term outcomes in children with codetected RSV and HRV. In the day-care study PeV-A was detected in 30 children, among who 8/10 with single PeV-A had pharyngitis and tonsillitis. Conclusion Single PeV-A detection was associated with pharyngitis and tonsillitis among children in day-care and hospital. Most hospitalized children with PeV-A had LRTI and viral codetections, but the presence of PeV-A did not impact disease severity in those with RSV and HRV.

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