Epidemiologic and Clinical Trends of Pediatric Human Rhinovirus Infections: A 2-year Comparative Analysis From a Single Center

Background: Human rhinovirus is one of the leading causes of pediatric respiratory infections worldwide. Its circulation patterns have shown notable changes in recent years. This study aimed to compare the epidemiologic, clinical and laboratory characteristics of rhinovirus infections and coinfections in 2 consecutive periods to identify shifts in age distribution, symptom patterns, healthcare utilization and pathogen codetection among pediatric patients. Methods: A retrospective analysis was conducted at a tertiary pediatric center and included all children aged 0–18 years with laboratory-confirmed rhinovirus infection between December 2023 and October 2025. Two consecutive 11-month periods were compared: December 2023–October 2024 (Period 1) and December 2024–October 2025 (Period 2). Demographic and laboratory parameters were recorded. Results: A total of 572 children with rhinovirus-positive samples were evaluated. The number of cases increased 2.9-fold in December 2024–October 2025 (Period 2) (from 141 to 431; 0.42 vs. 1.22 cases/day), while age and sex distributions remained similar. Children under 6 years represented the most detections, and the proportions of 0–2-year-old children were similar in both periods. Fever, cough and rhinorrhea were significantly less frequent in Period 2. Chest X-ray use increased overall (34.8%–49.7%) but remained unchanged among hospitalized patients. Hospitalization rates were comparable, and antibiotic use declined (60.0%–48.9%). Multivariable analysis showed that neither hospitalization nor antibiotic exposure predicted period assignment. Coinfections increased from 3.5% to 10.2%, though severe outcomes remained rare. Conclusions: Human rhinovirus cases nearly tripled across 2 seasons, yet clinical severity did not increase. Fever, cough and rhinorrhea declined, antibiotic use decreased and hospitalization remained stable. Coinfections became more frequent but did not affect outcomes. These observations suggest that rhinovirus circulation is expanding with a shift toward milder, community-managed illness.