Early and rapid prediction of severe Human Bocavirus 1 pneumonia in children: an age-stratified Nomogram Model based on admission data.

UNLABELLED: This study aims to identify independent risk factors for severe Human Bocavirus 1(HBoV1) pneumonia in children across different age groups and to develop reliable age-stratified nomogram models based on early admission data for the rapid prediction of disease progression and severity. A total of 370 children with HBoV1 pneumonia hospitalized at Tianjin Children's Hospital from September 2022 to August 2024 were retrospectively analyzed. Patients were divided into three age groups for analysis: Group 1 (< 24 months), Group 2 (24-47 months), and Group 3 (≥ 48 months). Multivariate logistic regression was used to identify independent risk factors. Of 370 HBoV1 pneumonia cases, severe pneumonia occurred in 145 (39.2%), with the highest incidence in Group 3 (50.6%, 42/83) versus 37.7% (43/114) and 34.7% (60/173) in other groups. For Group 1, the prediction model included BMI, maximum temperature before admission, pleural thickening, CK, CKMB, and IL-6. For Group 2, the key predictors were history of eczema, pleural thickening, and N%. For Group 3, the model incorporated L%, ALB, CK, C3, and Absolute CD3 Cell Count. The areas under the ROC curve for the three age-specific models were 0.819 (95% CI: 0.7405-0.8978), 0.729 (95% CI: 0.652-0.8064), and 0.801 (95% CI: 0.7064-0.8952), respectively. The decision curve analysis curve demonstrated outstanding net benefit. The C-index values in each group were respectively 0.791, 0.727, and 0.768.

CONCLUSION

This study develops age-stratified prediction models for severe human bocavirus 1 pneumonia in children based on early admission data. Nomograms for all three age groups exhibited good calibration performance and demonstrated clinical applicability.

WHAT IS KNOWN: • Human Bocavirus 1 (HBoV1) is a significant respiratory pathogen in children, capable of causing pneumonia with varying severity, from mild to life-threatening. • Age is a key predictor of severe pneumonia in children.

WHAT IS NEW: • The clinical manifestations and laboratory findings in children with Human Bocavirus 1 pneumonia exhibit age-specific characteristics. • Based on early admission data, this study developed age-stratified prediction models for severe Human Bocavirus 1 pneumonia in children, which demonstrated good performance.