Background <p>Viral respiratory infections (VRIs) constitute a major cause of pediatric intensive care unit (PICU) admissions worldwide. Refugee children may be particularly vulnerable due to socioeconomic and nutritional disadvantages. This study compared clinical features, viral burden, and outcomes of Turkish and Syrian refugee children admitted to the PICU with PCR-confirmed VRIs.</p> Methods <p>A retrospective cohort study was conducted at Gaziantep City Hospital between January 2023 and March 2025. Children aged 1 month–18 years with PCR-confirmed respiratory viral infections requiring PICU admission were included. Demographic, clinical, laboratory, ventilatory support, and outcome variables were analyzed. Viral coinfection patterns was categorized as single, dual, or triple infection.</p> Results <p>A total of 350 children (198 Turkish, 152 Syrian) were included. Dual and triple viral coinfections were more common among Syrian invasive mechanical ventilation (IMV) patients (66.7%) than Turkish IMV patients (41.0%). Syrian children presented with significantly lower serum albumin (3.08 ± 0.26 vs. 3.42 ± 0.28&#xa0;g/dL; <i>p</i> = 0.016). Although inflammatory markers were similar, Syrian patients required slightly longer mechanical ventilation (7.8 vs. 7.1 days) and had higher mortality (6.2% vs. 1.6%), without reaching statistical significance. Length of hospital stay was longer in Syrian children (20 vs. 17 days). Multivariate logistic regression analysis identified Syrian nationality as a significant independent predictor of viral coinfection (aOR: 1.67), which was subsequently determined to be an independent risk factor for severe disease (aOR: 1.75).</p> Conclusions <p>Syrian refugee children exhibited higher viral coinfections, hypoalbuminemia, and indicators of greater disease severity. These findings highlight the impact of refugee-related vulnerabilities on critical illness and underscore the need for early diagnosis, nutritional assessment, and equitable access to healthcare.</p>

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Viral respiratory infections in the pediatric intensive care unit: a comparative study of clinical outcomes in Syrian refugees and Turkish children

  • Ibrahim Bingol,
  • Sait Ucar,
  • Merve Yavuz,
  • Hacer Ucmak,
  • Mikail Ozdemir

摘要

Background

Viral respiratory infections (VRIs) constitute a major cause of pediatric intensive care unit (PICU) admissions worldwide. Refugee children may be particularly vulnerable due to socioeconomic and nutritional disadvantages. This study compared clinical features, viral burden, and outcomes of Turkish and Syrian refugee children admitted to the PICU with PCR-confirmed VRIs.

Methods

A retrospective cohort study was conducted at Gaziantep City Hospital between January 2023 and March 2025. Children aged 1 month–18 years with PCR-confirmed respiratory viral infections requiring PICU admission were included. Demographic, clinical, laboratory, ventilatory support, and outcome variables were analyzed. Viral coinfection patterns was categorized as single, dual, or triple infection.

Results

A total of 350 children (198 Turkish, 152 Syrian) were included. Dual and triple viral coinfections were more common among Syrian invasive mechanical ventilation (IMV) patients (66.7%) than Turkish IMV patients (41.0%). Syrian children presented with significantly lower serum albumin (3.08 ± 0.26 vs. 3.42 ± 0.28 g/dL; p = 0.016). Although inflammatory markers were similar, Syrian patients required slightly longer mechanical ventilation (7.8 vs. 7.1 days) and had higher mortality (6.2% vs. 1.6%), without reaching statistical significance. Length of hospital stay was longer in Syrian children (20 vs. 17 days). Multivariate logistic regression analysis identified Syrian nationality as a significant independent predictor of viral coinfection (aOR: 1.67), which was subsequently determined to be an independent risk factor for severe disease (aOR: 1.75).

Conclusions

Syrian refugee children exhibited higher viral coinfections, hypoalbuminemia, and indicators of greater disease severity. These findings highlight the impact of refugee-related vulnerabilities on critical illness and underscore the need for early diagnosis, nutritional assessment, and equitable access to healthcare.