A Clinical Risk Score to Predict the Critical Illness in Respiratory Syncytial Virus Co- detected With Streptococcus Pneumoniae Hospitalized Children

Purpose To develop and validate a clinical score at hospital admission for predicting which patients will develop critical illness. Methods A retrospective study was conducted in the Children’s Hospital of Chongqing Medical University from January 2012 to December 2021. Epidemiological, clinical, laboratory, and imaging variables ascertained at hospital admission were screened using Least Absolute Shrinkage and Selection Operator and logistic regression to construct a predictive risk score. Accuracy of the score was measured by the area under the receiver operating characteristic curve (AUC). Data from our hospital and another hospital were used to validate the score. Results The study included 1516 patients totally, including training cohort 1039 patients，validation cohort 477 patients, and external cohort 122 patients. From 35 potential predictors, 11 variables were independent predictive factors and were included in the risk score: neonate hospitalization，chronic pulmonary disease，congenital heart disease，immune deficiency disease，anhelation，disorders of consciousness，assisted respiration，lymph decreased，RBC decreased，CRP increased，pulmonary atelectasis. The mean AUC in the training cohort was 0.853, the AUC in the validation cohort was 0.848，and the external cohort was 0.967. Conclusion In this study, the risk score based on characteristics of RSV-infected patients co-detected with S.pn at the time of admission to the hospital was developed that may help predict a patient’s risk of developing critical illness.