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Article History

Received: 16 October 2025

Accepted: 30 April 2026

First Online: 7 May 2026

Declarations

:

: This study was conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of Tianjin Children’s Hospital (KY2020-19). Written informed consent was obtained from the parents or legal guardians of all participants.

: All procedures involving human participants were conducted according to institutional and international ethical standards.

: Consent for publication: Not applicable. No individual person’s identifiable data are included in this manuscript.

: Multiple co-infections in RSV-infected children were associated with a higher proportion of severe pneumonia and longer illness duration.

: Co-infections are common in children with respiratory syncytial virus infection, but most previous studies have focused on dual infections and provided inconsistent findings regarding clinical phenotypes and disease severity.

: This large cohort study identifies distinct clinical patterns across different co-infection types and suggests that multiple co-infections were associated with a higher proportion of severe pneumonia and prolonged illness among children hospitalized with RSV infection.

: The authors declare no competing interests.