Parechovirus A detection linked to pharyngitis and tonsillitis in children across hospital and day-care settings

This observational cohort study assessed the clinical manifestations and short-term outcomes of parechovirus A (PeV-A) detection in children within hospital and day-care settings. The population included 323 children in a hospital study and 30 in a day-care study, with PeV-A detection compared against other viruses and bacteria. The primary outcome focused on clinical presentation, while secondary outcomes included single virus detection, codetections, and distinctions between upper and lower respiratory tract infections.

In the hospital study, single PeV-A detection was observed in 15 of 323 respiratory tract infections (4.6%), whereas other viruses or bacteria were co-detected in 308 of 323 cases (95.4%). Codetections involving PeV-A and respiratory syncytial virus (RSV) accounted for 28 cases, while codetections with human rhinovirus (HRV) accounted for 77 cases. Among children with single PeV-A detection, the virus was a likely cause of pharyngitis and tonsillitis in 10 of 15 children. In the day-care study, PeV-A was detected in all 30 children, with pharyngitis and tonsillitis occurring in 8 of 10 children with single PeV-A.

Multivariable logistic regression analysis showed a strong association between single PeV-A and upper respiratory tract infection versus lower respiratory tract infection, with an odds ratio of 11.3 (95% CI 3.1–41.3). However, the presence of PeV-A did not impact clinical manifestations or short-term outcomes in cases with codetections of RSV and HRV. No safety data, adverse events, or tolerability information were reported for this study. A key limitation is that the role of PeV-A in respiratory tract infections in children remains unclear based on this retrospective evaluation of medical records.