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Abstract <p>Pertussis resurged globally, after the relaxation of COVID-19 measures, underscoring its continued relevance as a public health concern, yet data remain limited on the factors associated with severe disease in children. The present study identified risk factors for severe pertussis to improve early recognition and clinical management.</p> <p>This multicenter retrospective study analyzed the demographic, clinical, and laboratory data of the 839 children hospitalized with laboratory-confirmed pertussis across 47 centers in Türkiye (2023–2024). Severe disease was defined as the need for respiratory support or the development of encephalopathy and/or cardiovascular dysfunction. After univariate comparison, significant variables were evaluated using center-adjusted multivariable logistic regression in vaccine-eligible (&gt; 2&#xa0;months) and non-eligible (≤ 2&#xa0;months) groups.</p> <p>The patient’s median age was 2&#xa0;months (IQR 1.5–5.0), and 77.8% were younger than 6&#xa0;months. Severe disease occurred in 26.1% of cases. In univariate analysis, younger age, vaccine refusal, refugee status, feeding difficulties, apnea, respiratory distress, leukocytosis, viral co-infection, and abnormal chest X-ray findings at admission were associated with severe disease. In infants ≤ 2&#xa0;months, apnea (OR = 3.74; <i>p</i> &lt; 0.001), respiratory distress (OR = 5.48; <i>p</i> &lt; 0.001), and WBC count (OR = 1.035 per 1 × 10<sup>3</sup>/µL increase; <i>p</i> = 0.003) were independently associated with severe disease. In children &gt; 2&#xa0;months, respiratory distress (OR = 13.59; <i>p</i> &lt; 0.001) and not being up-to-date with vaccination (OR = 2.60; <i>p</i> = 0.019) were independent predictors of severe disease. Overall, 21.5% of patients required intensive care, 24.3% needed ventilation, and mortality was 2.4%.</p> <p><i>Conclusion:</i> Severe pertussis predominantly affects young infants, and apnea, respiratory distress, and leukocytosis were identified as major predictors of severe disease. Furthermore, incomplete vaccination is associated with increased disease severity.</p>

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Clinical characteristics and predictors of severe pertussis in hospitalized children after the COVID-19 period in Türkiye: a multicenter study

  • 期刊论文

  • 发表日期：

    2026年7月15日

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  • Sevliya Ocal-Demir,
  • Pınar Canizci Erdemli,
  • Esra Cakmak Taskin,
  • Ayşe Tekin Yilmaz,
  • Semra Bayturan Şen,
  • Deniz Ergün,
  • Hincal Ozbakir,
  • Berna Çetin Kahraman,
  • Canan Özlü,
  • Berker Okay,
  • Halil Uğur Hatipoğlu,
  • Suleyman Bayraktar,
  • Hatice Kubra Konca,
  • Seval Özen,
  • Pınar Bayraktar,
  • Hatice Karaoğlu Asrak,
  • Duygu Tunçel,
  • Faysal Göçeri,
  • Demet Tosun,
  • Mehmet Emin Menentoğlu,
  • Nevin Hatipoğlu,
  • Murat Sütçü,
  • Bilge Aldemir Kocabaş,
  • Muhammet Köşker,
  • Gülperi Timurtaş Dayar,
  • Seyhan Yilmaz,
  • Burcu Parlak,
  • Ceren Çetin,
  • Ayşe Karaaslan,
  • Lutfiye Sahin Keskin,
  • Nazan Dalgic,
  • Burcu Bursal,
  • Nihal Akçay,
  • Yağmur Ilgar,
  • Mustafa Gençeli,
  • Özge Metin Akcan,
  • Sevgi Pekcan,
  • Belkıs Hatice Inceli,
  • Halil Özdemir,
  • Ergin Çiftçi,
  • Merve Iseri Nepesov,
  • Erdal Sari,
  • Sevgi Yaşar Durmuş,
  • Binnaz Çelik,
  • Ayper Somer,
  • Ayşe Büyükcam,
  • Mavera Uşaklioğlu Erol,
  • Âdem Karbuz,
  • Çiğdem Kirmaci,
  • Vildan Şahin,
  • Şefika Elmas Bozdemir,
  • Ömer Furkan Kizilsoy,
  • Murat Tutanc,
  • Sevgi Aslan Tuncay,
  • Aylin Dizi Işik,
  • Melike Emiroğlu,
  • Meltem Kiymaz,
  • Zeynep Gökçe Gayretli Aydin,
  • Gülben Özgül Postuk,
  • Önder Kiliçaslan,
  • Aslıhan Sahin,
  • Guldane Dikme,
  • Edanur Yesil,
  • Merve Kiliç Çil,
  • Dicle Şener Okur,
  • Enes Sali,
  • Deniz Çakir,
  • Elif Gudeloglu,
  • Selcuk Sinanoglu,
  • Emine Hafize Erdeniz,
  • Canberk Çinar,
  • Hatice Sinav Ütkü,
  • Selim Öncel,
  • Yıldız Ekemen Keleş,
  • Damla Geçkalan,
  • Nesli Ağrali Eröz,
  • Ahu Kara Aksay,
  • Dilek Yilmaz,
  • Didem Büyüktaş Aytaç,
  • Meryem Çağla Abaci Çapar,
  • Mehlika Efendi Kocagöz,
  • Ozden Turel,
  • Ahmet Yasin Güney,
  • Gulhadiye Avcu,
  • Demet Terek,
  • Cihangül Bayhan,
  • İsmail Zafer Ecevit,
  • Manolya Kara,
  • Hülya Ercan Saricoban,
  • Ece Orbay,
  • Deniz Aygun,
  • Eda Karadag-Oncel,
  • Şilem Özdem Alataş,
  • Tuğba Kandemir Gülmez,
  • Gizem Mardinoğlu,
  • Ömer Kiliç,
  • Taylan Çelik,
  • Tolga Kasap,
  • Eda Somuncu,
  • Soner Sertan Kara,
  • Gül Arga,
  • Eda Kepenekli,
  • Gülşen Akkoç

摘要

Abstract

Pertussis resurged globally, after the relaxation of COVID-19 measures, underscoring its continued relevance as a public health concern, yet data remain limited on the factors associated with severe disease in children. The present study identified risk factors for severe pertussis to improve early recognition and clinical management.

This multicenter retrospective study analyzed the demographic, clinical, and laboratory data of the 839 children hospitalized with laboratory-confirmed pertussis across 47 centers in Türkiye (2023–2024). Severe disease was defined as the need for respiratory support or the development of encephalopathy and/or cardiovascular dysfunction. After univariate comparison, significant variables were evaluated using center-adjusted multivariable logistic regression in vaccine-eligible (> 2 months) and non-eligible (≤ 2 months) groups.

The patient’s median age was 2 months (IQR 1.5–5.0), and 77.8% were younger than 6 months. Severe disease occurred in 26.1% of cases. In univariate analysis, younger age, vaccine refusal, refugee status, feeding difficulties, apnea, respiratory distress, leukocytosis, viral co-infection, and abnormal chest X-ray findings at admission were associated with severe disease. In infants ≤ 2 months, apnea (OR = 3.74; p < 0.001), respiratory distress (OR = 5.48; p < 0.001), and WBC count (OR = 1.035 per 1 × 103/µL increase; p = 0.003) were independently associated with severe disease. In children > 2 months, respiratory distress (OR = 13.59; p < 0.001) and not being up-to-date with vaccination (OR = 2.60; p = 0.019) were independent predictors of severe disease. Overall, 21.5% of patients required intensive care, 24.3% needed ventilation, and mortality was 2.4%.

Conclusion: Severe pertussis predominantly affects young infants, and apnea, respiratory distress, and leukocytosis were identified as major predictors of severe disease. Furthermore, incomplete vaccination is associated with increased disease severity.