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\begin{document}

\title{Epidemiological and Clinical Characteristics of All-age Population with
Human Respiratory Syncytial Virus, Beijing, 2015--2019}



\author[1]{Ming Luo}%
\author[1]{cheng gong}%
\author[2]{yan zhang}%
\author[3]{xue wang}%
\author[4]{yang liu}%
\author[5]{qing luo}%
\author[3]{Aihua Li}%
\author[3]{Yiting WANG}%
\author[1]{Maozhong Li}%
\author[1]{mei dong}%
\author[6]{Fang Huang}%
\author[2]{Wenbo Xu}%
\affil[1]{Beijing center for disease prevention and control}%
\affil[2]{Chinese Center for Disease Control and Prevention}%
\affil[3]{Beijing Center for Disease Prevention and Control}%
\affil[4]{Tongzhou Center for Disease Prevention and Control}%
\affil[5]{Capital Medical University}%
\affil[6]{Beijing Center for Disease Prevention and Control, Beijing Preventive Medicine Research Center}%


\vspace{-1em}



  
  \date{June 15, 2024}


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\selectlanguage{english}
\begin{abstract}
Background We investigate the epidemiological and clinical
characteristics of respiratory infections with respiratory syncytial
virus (RSV) among the entire population in Beijing, China. Methods
All-age patients with respiratory infection between 2015-2019 were
enrolled from 35 sentinel hospitals in Beijing. Their respiratory
specimens were obtained for testing of 11 respiratory pathogens,
including RSV. Their demographic data and medical record were collected
in standardized forms. Results The RSV epidemic season approximately
occurred between October to March with a peak in December or January and
covered 90\% of RSV infections with RSV-A dominated in each year.
Children aged 5 years were at the highest risk of RSV infection
(52.2\%), followed by the elderly adults aged [?]60 years (25.2\%). While
the elderly patients with RSV were prone to develop dyspnea and
lymphocytopenia than other population segments. Moreover, they had an
elevated rate of hospitalization, an increased rate of ICU admission, an
extended length of hospital stay, and elevated mortality compared to the
\textless{}5 years children with RSV infection. Conclusions The young
children was the population with the highest risk for RSV infection
followed by the elderly adults. While the later easily developed a
severe infection and need full consideration when making policy.%
\end{abstract}%



\sloppy


\textbf{Introduction}

Respiratory syncytial virus (RSV) is one of the most important pathogens
leading to severe lower respiratory tract infection in children. It
causes 2.7--3.8 million hospitalizations and 94,600--149,400 deaths in
children under five years of age each year\textsuperscript{{[}1{]}}. It
can also result in severe respiratory infections in high-risk adults or
elderly healthy persons. Therefore, RSV has been raising
concern\textsuperscript{{[}2{]}} and RSV surveillance is being conducted
in many countries. The United States has included RSV in the National
Respiratory and Enteric Virus Surveillance System since
1989\textsuperscript{{[}3, 4{]}}. Japan has used the National
Epidemiological Surveillance System for Infectious Diseases to monitor
RSV since 2003\textsuperscript{{[}5{]}}. The European Union has
initiated RSV surveillance using the existing influenza surveillance
network since 2003\textsuperscript{{[}6, 7{]}}. The United States also
launched the Global Disease Detection project in 2004, which monitored
influenza virus and RSV in several countries
world\textsuperscript{{[}8{]}}. Likewise, the World Health Organization
began monitoring RSV using the global influenza network in
2017\textsuperscript{{[}9{]}}. However, so far, a nationwide RSV
surveillance network has not been established in China.

China has a heavy burden of RSV infection. Several studies have reported
that the RSV detection rate in pneumonia cases in Chinese children could
reach 17\%--33\% during the RSV epidemic season\textsuperscript{{[}10,
11{]}}. However, these studies rarely cover RSV infections in adults
(particularly in elderly persons). Given that China is the most populous
country globally and its aging population problem is becoming more
serious, we can speculate that the proportion of Chinese elderly adults
with RSV should not be small. Therefore, more attention should be paid
to RSV infections among Chinese adults, especially Chinese elderly
adults.

Up to now, there is no licensed RSV vaccine available. Palivizumab is
the only prophylaxis biological product approved by the Food and Drug
Administration in the USA for use in infants at high risk of severe RSV
infection\textsuperscript{{[}12{]}}, but it is expensive and was not
approved by the Chinese Food and Drug Administration. In addition, there
is still no specific therapy drug for RSV, and only symptomatic and
supportive treatments for RSV infection are available. Thus, it is
urgent to establish an effective RSV surveillance system that covers all
age groups (particularly the population with a high risk of severe
respiratory infection) in China, which would contribute to a better
understanding of the epidemiological and clinical characteristics of RSV
infection in different ages groups, a better controlling the RSV
epidemic and a better administration of severe RSV infection cases.

Our research team has established the Respiratory Pathogen Surveillance
System (RPSS) in Beijing since 2014, which consists of 17 Centers for
Disease Control and Prevention (CDCs) and 30 sentinel hospitals. Using
this surveillance system, we have monitored the 11 most common
respiratory pathogens, including RSV, influenza virus, and adenovirus.
In this study, we systematically investigated the prevalence of RSV in
Beijing for four consecutive years from March 2015 to February 2019, and
compared the clinical characteristics of RSV infection among people of
different age groups, with a focus on children under five years of age
and elderly adult over 60 years of age.

\textbf{Population and Methods1.1 Ethics statement}

This study was approved by the Ethics Committees at Beijing Center for
Disease Prevention and Control. Enrollees (or their guardians if
appropriate) were told the nature, purpose, procedures, and potential
health impact regarding this study, and written informed consent was
obtained from each one. Patients were required to provide consent by
themselves if their age and medical condition were appropriate.

\textbf{1.2 Study population}

The patients with acute upper respiratory tract infection (AURTI) or
community-acquired pneumonia (CAP) were enrolled with the RPSS network
every month. AURTI patients were included if they presented with fever
and/ or respiratory symptoms, e.g., cough, sputum production, and sore
throat. Pneumonia patients were included if they had evidence of CAP
according to Guidelines of Diagnosis and Treatment for
Community-Acquired Pneumonia among Adults in China (released in 2013 by
Chinese Thoracic Society, Chinese Medicine
Association)\textsuperscript{{[}13-15{]}}, and further classified as
severe community-acquired pneumonia (SCAP) and non-severe
community-acquired pneumonia (NSCAP) based on illness severity according
to the guidelines described previously\textsuperscript{{[}16{]}}.

\textbf{1.3 Specimen and data collection}

Respiratory tract samples were collected from the enrolled patients upon
hospital visit, including oropharyngeal swabs, sputum specimens,
endotracheal aspirates, or bronchoalveolar-lavage specimens. For
inpatients, only specimens obtained within 72 hours before or after
hospital admission were included. Demographic, epidemiological, and
clinical data were collected systematically using standardized forms.

\textbf{1.4 Laboratory examinations}

Total nucleic acids were extracted and tested for the respiratory
syncytial virus. Other eight respiratory viruses (influenza virus A and B
{[}FLU A, FLU B{]}, influenza virus AH1N1 2009 pandemic and AH3N2
{[}AH1N1 2009, AH3N2{]}, parainfluenza virus 1, 2, 3, 4 {[}PIV 1, 2, 3,
4{]}, adenovirus {[}AdV{]}, human rhinovirus {[}HRV{]}, human
metapneumovirus {[}HMPV{]}, human coronavirus 229E/NL63, OC43/HKU1
{[}CoV 229E/NL63, OC43/HKU1{]}, human bocavirus {[}HBoV{]}, and human
enterovirus {[}EV{]}), \emph{M. pneumoniae} (MP), and\emph{Chlamydophila
pneumoniae} (CP) were also identified according to the design of this
study using a real-time PCR-based approach (Multiplex Combined Real-time
PCR Detection Kit for Respiratory Viruses, Jiangsu Uninovo Biological
Technology Co. Ltd., China). RSV-positive samples were further
identified into RSV group A (RSV-A) and RSV group B (RSV-B) (Duplex
Real-Time PCR Kit for RSV, Beijing Kinghawk Pharmaceutical Co., Ltd.,
China).

\textbf{1.5 Statistical analysis}

Continuous variables were presented as median (interquartile range, IQR)
and compared with the Kruskal-Wallis test between different groups;
categorical variables were presented as numbers (\%), and comparisons
between different groups were done by the \selectlanguage{greek}χ\selectlanguage{ngerman}² test or Fisher's exact
test. A two-sided \selectlanguage{greek}α \selectlanguage{english}of less than 0.05 was considered statistically
significant. Statistical analysis was done using SPSS statistical
software version 19.0 (SPSS Inc., Chicago, IL, USA).

\textbf{2. Results}

\textbf{2.1 Demographic characteristics and RSV detection}

From March 1, 2015, to February 29, 2019, a total of 29,923 cases were
included in this study, of whom 8,586 (29\%) were with AURTI, 16,121
(54\%) were with non-severe community-acquired pneumonia (NSCAP), 4,139
(14\%) were with severe community-acquired pneumonia (SCAP), and 1074
(4\%) were with bronchitis (3 had missing final diagnostic information).
Male (16, 668; 56\%) and female (13,162; 44\%) patients were included in
this study (93 missing gender information). The youngest was 1 month
old, and the oldest was 104 years old with a median age of 38 years old
(120 patients missing age information).

Of all included patients, RSV was detected in 623 (2\%), including 92
(15\% of 623 RSV infections) patients with AURTI, 429 (69\%) with NSCAP,
and 92 (15\%) with SCAP (diagnostic information was not found for 10).
Among these patients with RSV, 352 (57\%) were male, 267 (43\%) were
female (4 missing gender information), the minimum age was 1 month old,
and the maximum was 101 years old with a median age of 4 years old (age
information was not found for three).

Of the 623 RSV-positive cases, 391 (62.8\%) were identified as RSV-A,
126 (20.2\%) as RSV-B, and 106 (17.0\%) were not identified
successfully.

\textbf{2.2 Epidemiological characteristics of RSV infections}

From March 2015 to February 2019, we observed a yearly RSV epidemic
around Winter as expected. RSV detection rate began to rise in October,
peaked in December or the following January, and fell to an ordinary
level in April, with about 90\% of RSV infections occurring during the
epidemic season (from October to the following March) (Fig. 1A, B). In
different years, the RSV epidemic season may advance or be delayed by
about one month. Two groups of RSV (RSV-A and RSV-B) were prevalent each
year, but RSV-A remained predominant from March 2015 to February 2019.
The proportion of RSV-A infection among total RSV-positive cases was
62.8\%. (Fig. 1C)

RSV detection rate was the highest in the 0-year-old group (9.98\%),
followed by the 1-year-old group (6.18\%), and the 2--4-years-old group
(4.92\%); it decreased significantly to a low level in 5--44 years group
(5--13 yr: 1.68\%; 14--17 yr: 0.61\%; 18--44 yr: 0.57\%), and increased
in the 45--59 years of age adults (1.15\%), and more obviously in the
elderly persons with 60 years of age or older (1.57\%) (Fig. 2A). Both
RSV-A and RSV-B were detected in all age groups, with RSV-A a dominant
proportion (Fig. 2A). For further analysis, the above mentioned nine age
groups were incorporated into four age groups as 0--4 years (subtotal of
detection rate: 6.07\%), 5--17 years (subtotal of detection rate:
1.51\%), 18--59 years (subtotal of detection rate: 0.76\%), and 60 years
or older (subtotal of detection rate: 1.57\%). The proportion of RSV
infections under five years old (52\%) among the total RSV infections
was the greatest, followed by that of the elderly adults with 60 years
of age or older (25\%); the top two groups accounted for 77\% of RSV
infections (Fig. 2B).

The RSV detection rate of pneumonia cases (NSCAP and SCAP) was higher
than that of AURTI cases by age group, which showed that RSV was more
prone to cause acute lower respiratory tract infection. However, the RSV
detection rate of NSCAP cases was slightly higher than that of SCAP
cases despite no significant difference observed. Although RSV-A and
RSV-B were both detected among each class of RSV infection in each age
group, RSV-A approximately dominated in each group (Fig. 3).

The most common co-existing pathogen identified from RSV-positive cases
was the influenza virus (10.2\%), followed by \emph{M.
pneumoniae}(4.1\%; Fig. 4).

\textbf{2.3 Clinical characteristics of RSV infections}

\textbf{2.3.1 Clinical manifestations and laboratory findings}

Among the 623 patients with RSV infection identified in this study, the
medical data of 597 were collected successfully and analyzed. The
comorbidity rate was 2.9\% in the 0--4 years old group, 0\% in 5--17
years old group, 22.4\% in 18--44 years old group, and 57.2\% in [?]60
years old group; and presented an approximately rising trend as age
increasing (p \textless{} 0.001). Among the children with 0 to 4 years
of age, the most common symptoms were cough (95.8\%), fever (87.8\%),
sputum production (61.0\%), rhinorrhea (42.9\%), nasal congestion
(33.5\%), dyspnea (12.3\%), and sore throat (11.6\%), whereas among the
adults 60 years of age or older, the most common symptoms were cough
(88.8\%), sputum production (82.9\%), fever (74.8\%), dyspnea (52.6\%),
sore throat (18.4\%), and rhinorrhea (17.1\%). Notably, almost more than
half of patients with RSV infection aged [?]60 years eventually developed
dyspnea in their clinical course (52.6\%; Table 1).

There were some differences in blood analysis observed between the
younger children and the elderly adults with RSV. The elderly patients
frequently developed lymphopenia (5.1\% for 0--4 yr, 41.5\% for [?]60 yr,
p\textless{}0.001), neutrophilia (15.1\% for 0--4 yr, 71.2\% for [?]60 yr,
p\textless{}0.001), and elevated C-reactive protein (CRP; 23.2\% for
0--4 yr, 73.6\% for [?]60 yr, p\textless{}0.001), which indicated that
there might be co-existing bacterial infection in these elderly patients
besides RSV infection. However, the younger child patients were more
likely to develop elevated aspartate aminotransferase (AST) levels
(34.9\% for 0--4 yr, 13\% for [?]60 yr, p\textless{}0.001) and/or an
elevated creatine kinase MB fraction (CKMB; 30.4\% for 0--4 yr, 2.5\%
for [?]60 yr, p\textless{}0.001), which suggested that acute heart
injuries may have occurred (Table 2).

Radiographic findings showed that the older the age of the patients with
RSV infection was, the larger the proportion of pneumonia (23.2\% for
0--4 yr, 59.2\% for [?]60 yr, p\textless{}0.001). Furthermore, about 50\%
of the abnormal radiographic findings involved bilateral lung in
children and adults (Table 2).

\textbf{2.3.2 Treatments and outcomes}

Approximately 65\% (390/597) of RSV infections identified in this study
were inpatients. The median time from illness onset to hospital
admission was 3.5 days (IQR 2--5 days) in 0--4 years old group, 3 days
(IQR 1--6 days) in 5--17 years old group, 2.5 days (IQR 1--6 days) in
18--44 years old group, and 3 days (IQR 1--6 days) in [?]60 years old
group with no significant difference observed. The hospitalization rates
in the four age groups were different significantly as follows: 65.5\%,
52.5\%, 48.7\%, and 78.3\% (p\textless{}0.001). As age increased, the
median length of hospital stay extended significantly as follows: 7 days
(IQR 6--9 days), 8 days (IQR 5--11 days), 10 days (IQR 7--15 days), and
12 days (IQR 8.5--16 days) (p\textless{}0.001). The rate of ICU
admission among the four age groups differed obviously as follows:
0.6\%, 0.0\%, 10.5\%, 15.1\% (p\textless{}0.001). Taken together, the
patients with [?]60 years old were all the highest in the rate of
hospitalization, the length of hospital stay, or the rate of ICU
admission among the four age groups (Table 3).

Compared with children aged 0--4 years, the rates of antibiotic use
(60.7\%, 74.4\%, p\textless{}0.001), oxygen support therapy (12.6\%,
62.5\%, p\textless{}0.001), and mechanical ventilation (8.4\%, 12.5\%,
p=0.035) among the elderly patients aged [?]60 years were all
significantly increased. However, the rates of vasoactive drug
administration, corticosteroid use, and antiviral therapy among the four
age groups were similar. Eight (8/597) patients with RSV infection were
treated with extracorporeal membrane oxygenation (ECMO), and one case, a
63-year-old man, died (Table 3).

The most frequent complications among RSV-infected patients were acute
myocardial injury in children (9\% in 0--4 yr group, 6.8\% in 5--17 yr
group), respiratory failure in adults (11.8\% in 18--59 yr group, 15.8\%
in [?]60 yr group). The RSV infections in adults with [?]60 years of age
resulted more frequently in organ failures than in the other three
younger age groups, and heart failure (13.2\%) and renal failure (5.9\%)
were also commonly observed besides respiratory failure (15.8\%). Five
adults with RSV infection (0.8\%, 5/597) developed acute respiratory
distress syndrome (ARDS), two in the 18--59 age group and three in the
[?]60 age group. (Table 3)

The median time from onset to discharge was 11 days (IQR 9--14 days) in
0--4 years old group, 13 days (IQR 10--17 days) in 5--17 years old
group, 13 days (IQR 11--18 days) in 18--44 years old group, and 16 days
(IQR 12--20 days) in [?]60 years old group, and extended significantly as
age increased (p\textless{}0.001). The mortality of 597 RSV infections
was 1.7\%. No death was observed in the patients of 0--4 years and 5--17
years of age. Two deaths in the hospital occurred in the 18--49 age
group (mortality 6.7\%) and 8 deaths in the [?]60 age group (mortality
7.8\%). From onset to death of these two age groups, the median times
were 10.5 days (IQR 2--19 days) and 15.5 days (9.3--21.8 days),
respectively (Table 3).

\textbf{3.Discussion}

Using hospital-based and multicenter surveillance for RSV infection
among the all-age population in Beijing for four years, this study
revealed the epidemiological characteristics of RSV in Beijing from 2015
to 2019: The RSV was prevalent in the all-age population in Beijing with
only one annual epidemic season. Moreover, the RSV season started in
October, ended in March of the following year with a single peak in
Winter, and covered about 90\% of RSV infections. The epidemic season's
onset and offset times in different years may advance or be delayed by
about one month. However, the offset time of the RSV epidemic season we
observed was not consistent with Yu et al.'s
report\textsuperscript{{[}17{]}}. The reason may be that they adopted
the definition of the RSV epidemic season described previously by CDC in
the U.S.\textsuperscript{{[}18{]}}, the consecutive weeks during which
the RSV detection rate per week exceeds a threshold of 10\%, which might
be appropriate for RSV infections among children but not applicable in
this study due to the inclusion of adults. Yu et al. also reported that
RSV-A and RSV-B dominated alternatively in different years in Beijing
from 2007 to 2015\textsuperscript{{[}17{]}}, but we observed that RSV-A
has remained dominant in Beijing since 2015.

This study compared the prevalence of RSV infections among the
populations of different age groups and found that the detection rate of
RSV was highest in children under five years of age (6.07\%), followed
by people aged [?]60 years (1.57\%). Ren et al\textsuperscript{{[}19{]}}
reported that the RSV detection rate in patients aged [?]66 years was 2\%
in Beijing during 2005--2007, the same percentage Feng et
al.\textsuperscript{{[}10{]}} reported for the average of RSV detection
rates in patients aged [?]65 years from 22 provinces in China from 2009 to
2013. These two estimates are slightly higher than ours, probably due to
the inclusion of the 60--64 years of age population in our study.
However, our findings confirmed that the elderly people aged [?]60 years
were another RSV infection susceptible population, accounting for 25.2\%
of total RSV infections, besides the expected children under five years
of age, who accounted for 52.0\%. Given that China is the world's
largest population country and its population is aging, it can be
speculated that the proportion of RSV-infected patients with 60 years of
age or older will increase continuously shortly. So, the elderly
population, 60 years of age or older, should receive full consideration
when the RSV prevention and control policy is made.

This study also found that co-infection of multiple pathogens was common
in RSV-infected cases. The most frequently identified pathogens was the
influenza virus, followed by \emph{M. pneumoniae} , which might be due
to a certain overlap of the epidemic seasons of RSV, influenza virus,
and\emph{M. pneumoniae} in Beijing\textsuperscript{{[}16{]}}\emph{.}

Another contribution of this study was that we described and compared
the clinical characteristics of patients with RSV infection from
different age groups in Beijing, particularly patients 60 years or
older. We found that the many key indicators of the patients with RSV
infection among the elderly adult aged [?]60 years were significantly
higher than those among the populations of any other age group, namely,
the rate of hospitalization, the rate of ICU admission, and the rate of
death in hospital. However, the RSV detection rate of the elderly adult
aged [?]60 years was lower than that of children under five years old.

As to clinical manifestations, the most outstanding for RSV-infected
patients with [?]60 years of age was dyspnea followed by lymphocytopenia,
which was more common compared to other age groups, and occurred at a
significantly higher frequency than the RSV-infected patients under five
years of age. Regarding complications, there was an obvious difference
in the different age groups. RSV infections in elderly adults aged [?]60
years were frequently complicated by respiratory failure, heart failure,
and kidney failure compared to other populations, while acute myocardial
injury was more common in RSV infections in children under five years of
age. Notably, a total of eight RSV-infected patients with severe
pneumonia were given ECMO therapy in this study, and finally, seven
cases were cured, and one died. This favorable ratio suggests that there
may be a chance to improve the hospitalization mortality of RSV-infected
adults further and needs to be confirmed by collecting more cases.

Several studies reported the RSV infection in elderly adults focusing on
different aspects, and considered that the RSV infection led to a
heavier health burden and more severe illness in the elderly adults than
influenza\textsuperscript{{[}2, 20, 21{]}}. In this study, the hospital
length of stay of patients with RSV infection was elevated as the age of
the patients increased, the hospital length of stay in RSV-infected
patients with [?]60 years was 12 days, and was longer than that of any
other age group, but was shorter than the hospital stay of 20 days
reported by Jin et al\textsuperscript{{[}20{]}} for RSV-infected elderly
adults in South Korea. The hospitalization mortality of RSV-infected
patients aged [?]60 years is 7.8\%, which was also significantly higher
than that of children with RSV infection under five years of age (0\%),
and approximately consistent with the study of Falsey et al.
\textsuperscript{{[}2{]}} on American healthy elderly adults (mortality
of 8\% among RSV-infected patients aged [?]65 years), but lower than
Jin's\textsuperscript{{[}20{]}} study on the elderly adults in South
Korea (mortality of 12\% among RSV-infected patients aged [?]65 years).

In conclusion, The RSV season in Beijing usually began in October and
ended in March of the following year and covered approximately 90\% of
RSV infections. The RSV infection in the elderly aged [?]60 years old, the
second most susceptible population, usually developed more severe
outcomes than in children under five years of age, with dyspnea and
lymphocytopenia as important clinical characteristics.These findings can
promote the comprehensive understanding of the illness course and
contribute to the policy-making on RSV prevention and control in China,
particularly in Beijing.

\textbf{Acknowledgments}

We would like to thank all physicians from 30 sentinel hospitals in
Beijing for enrolling patients and collecting medical data and
specimens, and the staff from 16 district CDCs in Beijing for quality
control of obtained specimens and questionnaires and partial specimen
testings.

\textbf{Contributions}

LM, GC and ZY did data analysis and prepared the manuscript. HF and XWB
conducted the study design and reviewed the manuscript. LM, GC, WX, LY,
LQ, LAH, WYT, LMZ and DM tested the specimens.

\textbf{Figure 1. RSV seasonality in Beijing.}

The average percentage of RSV-positive cases per month among the tested
cases in Beijing from March 2015 to February 2019. Gray bars denote the
tested cases per month, blue bars denote the RSV-positive cases per
month, and the brown line denotes the average percentage of RSV-positive
cases per month among the tested cases. B) Average proportion of
RSV-positive cases per month among the total RSV-positive cases in
Beijing from March 2015 to February 2019. C) RSV detection rate by month
in Beijing from March 2015 to February 2019. The bars represent the RSV
detection rate per month. Blue denotes RSV group A, orange denotes RSV
group B, gray denotes untyped RSV. RSV, respiratory syncytial virus.

\textbf{Figure 2. Distribution of RSV infections by age group in Beijing
from March 2015 to February 2019.} A) RSV detection rate by age group.
The bar represents the RSV detection rate per age group. Blue denotes
RSV group A, orange denotes RSV group B, and gray denotes untyped RSV.
RSV, respiratory syncytial virus. B) Proportion of RSV-positive cases
per new-age group (9 age groups were combined into 4 new-age groups).

\textbf{Figure 3.} \textbf{RSV detection rates andproportions of RSV
subgroups by} \textbf{age group and illness severity in Beijing from
March 2015 to February 2019.} A) RSV detection rate by age group and
illness severity. The bar represents RSV detection rate per age group
and illness severity. B) Proportion of RSV groups per age group and
illness severity. Blue denotes RSV group A, orange denotes RSV group B,
and gray denotes untyped RSV. RSV, respiratory syncytial virus. AURTI,
Acute upper respiratory tract infection. NSCAP, non-severe
community-acquired pneumonia. SCAP, severe community-acquired pneumonia.

\textbf{Figure 4. Co-existing pathogens identified in RSV-positive
cases.} The blue bars denote the positive cases of co-existing pathogens
identified in RSV-positive cases. The orange line denotes the positive
rates of co-existing pathogens identified in RSV-positive case (the data
are represented in the second Y-axis). Here, AdV denotes adenovirus, CoV
coronavirus, Flu influenza A or B virus, HMPV human metapneumovirus, HRV
human rhinovirus, PIV parainfluenza virus, RSV respiratory syncytial
virus, HBoV human bocavirus, EV enterovirus, MP \emph{M. pneumoniae} ,
and CP \emph{Chlamydophila pneumoniae} .

\textbf{Table 1 Demographic and clinical characteristics of 597 patients
infected with RSV.}\selectlanguage{english}
\begin{longtable}[]{@{}llllll@{}}
\toprule
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\par\null\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0--4 yr. n=310\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
5--17 yr. n=59\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
18--59 yr. n=76\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
[?]60 yr. n=152\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
P-value\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textbf{Demographics and clinical characteristics}\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Female\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
124 (40\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
26 (44.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
36 (47.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
70 (46.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.506\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Inpatient\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
203 (65.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
31 (52.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
37 (48.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
119 (78.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Time from illness onset to hospital admission, days\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
3.5 (2--5)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
3 (1--6)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
2.5 (1--6)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
3 (1--6)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.065\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Comorbidity\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
9 (2.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
(0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
17 (22.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
87 (57.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Asthma\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
1 (0.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
6 (7.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
7 (4.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Bronchitis/bronchiolitis\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
1 (0.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
1 (1.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
12 (7.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Chronical Obstructive Pneumonia disease\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
3 (3.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
13 (8.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Diabetes\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
1 (0.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
5 (6.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
24 (15.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Hypertension\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
2 (0.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
9 (11.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
52 (34.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Heart disease\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
4 (1.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
1 (1.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
35 (23\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Chronical renal disease\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
1 (0.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
2 (2.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
2 (1.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.143\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Chronical liver disease\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
1 (0.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.481\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Malignancy\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
2 (0.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
6 (3.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.034\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
Stroke\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
1 (1.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
16 (10.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textbf{Symptoms and signs}\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Fever (temperature [?]37.3\selectlanguage{ngerman}°C)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
267/304 (87.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
57/58 (98.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
67/75 (89.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
113/151 (74.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Temperature, \selectlanguage{ngerman}°C\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}37.3\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
37/304 (12.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
1/58 (1.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
8/75 (10.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
38/151 (25.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
37.3--37.9\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
21/304 (6.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
3/58 (5.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
4/75 (5.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
21/151 (13.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
38--38.9\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
129/304 (42.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
25/58 (43.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
41/75 (54.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
59/151 (39.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
[?]39\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
117/304 (38.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
29/58 (50\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
22/75 (29.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
33/151 (21.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Sore throat\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
36 (11.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
20 (33.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
27 (35.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
28 (18.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Cough\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
297 (95.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
52 (88.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
66 (86.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
135 (88.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.003\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Sputum production\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
189 (61\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
37 (62.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
55 (72.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
126 (82.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Hemoptysis\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
2 (0.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
2 (2.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
4 (2.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.138\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Chest pain\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1 (0.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1 (1.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
5 (6.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
7 (4.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Dyspnea\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
38 (12.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
21 (27.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
80 (52.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Nasal congestion\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
104 (33.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
18 (30.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
9 (11.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
12 (7.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Rhinorrhea\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
133 (42.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
23 (39\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
22 (28.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
26 (17.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Headache\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1 (0.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
4 (6.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
8 (10.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
7 (4.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Fatigue\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
2 (0.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
3 (5.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
11 (14.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
11 (7.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Myalgia\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
3 (3.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
5 (3.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.002\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Diarrhea\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
11 (3.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1 (1.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
4 (2.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.534\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Abdominal pain\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
6 (1.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
4 (5.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
2 (1.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.175\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Nausea or vomiting\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
14 (4.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1 (1.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
2 (2.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
4 (2.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.717\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Oliguria\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1 (0.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1 (0.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.731\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Disturbance of consciousness\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
3 (3.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
11 (7.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Abnormal respiratory rate, beats/min\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
116/237 (48.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
5/46 (10.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
6/65 (9.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
10/137 (7.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

Data are median (IQR) or n (\%). p-values were calculated by
Kruskal-Wallis test, \selectlanguage{greek}χ\selectlanguage{ngerman}² test, or Fisher's exact test, as appropriate.

\textbf{Table 2 Laboratory andradiographic findings of 597 patients
infected with RSV.}\selectlanguage{english}
\begin{longtable}[]{@{}llllll@{}}
\toprule
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0--4 yr. n=310\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
5--17 yr. n=59\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
18--59 yr. n=76\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
[?]60 yr. n=152\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
P-value\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textbf{Laboratory findings}\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
White blood cell count, \selectlanguage{ngerman}×109 per L\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
7.98 (6--10.8)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
8.0 (6.4--10.4)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
7.3 (5.5--10.0)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
7.5 (5.9--10.7)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.485\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}4\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
6/280 (2.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
/49 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
7/71 (9.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
10/145 (6.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.037\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
4--10\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
189/280 (67.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
35/49 (71.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
47/71 (66.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
92/145 (63.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
[?]10\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
85/280 (30.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
14/49 (28.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
17/71 (23.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
43/145 (29.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Lymphocyte count, \selectlanguage{ngerman}× 109 per L\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
3 (2--4.4)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
2.05 (1.225--2.875)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1.4 (0.9--2.15)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1.1 (0.7--1.7)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}1000\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
14/277 (5.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
8/48 (16.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
19/68 (27.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
54/130 (41.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Neutrophil proportion, \%\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
49 (32.0--62.5)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
64.9 (58.1--74.0)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
72.8 (57.3--83.3)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
76.5 (67.6--84.3)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}50\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
138/271 (50.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
7/49 (14.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
11/70 (15.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
5/139 (3.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
50\%--69\%\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
92/271 (33.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
24/49 (49\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
19/70 (27.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
35/139 (25.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
[?]70\%\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
41/271 (15.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
18/49 (36.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
40/70 (57.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
99/139 (71.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Platelet count, \selectlanguage{ngerman}× 109 per L\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
294 (225--368.5)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
292 (225--355.5)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
200 (166.25--260)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
197 (154--246)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}100\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
1/285 (0.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
/51 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
4/69 (5.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
10/154 (6.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Creatinine, \selectlanguage{greek}μ\selectlanguage{english}mol/L\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
22 (18.6--26.9)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
36.9 (29.7--39.8)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
60 (51--78)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
69.5 (56.5--87.6)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textgreater{}133\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
/98 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
/16 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
/25 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
7/94 (7.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.02\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Blood urea nitrogen, mmol/L\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
2.8 (2.1--3.625)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
2.7 (2.3--4)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
4.6 (2.95--6.025)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
5.1 (3.9--7.55)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
[?]7.14\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
2/101 (2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
1/15 (6.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
2/26 (7.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
27/90 (30\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Alanine aminotransferase, U/L\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
20 (14--28)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
13 (10--37.5)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
22 (11.5--36.5)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
16 (11--26)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.174\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Aspartate aminotransferase, U/L\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
34.5 (28.75--44)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
27 (20--31.5)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
24 (17--34)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
21 (17--32.75)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textgreater{}40\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
37/106 (34.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
2/17 (11.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
4/26 (15.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
12/92 (13\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Creatine kinase, U/L\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
77 (52.8--119.0)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
81 (50.0--105.3)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
78 (55.0--131.8)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
77 (45.0--134.0)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.951\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Creatine kinase MB fraction, U/L\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
21 (15.5--29)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
19.5 (14--21)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
10.5 (2.8--17.3)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
10 (5.3--14.0)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textgreater{}25\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
31/102 (30.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
3/17 (17.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
2/19 (10.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
2/79 (2.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Sodium, mmol/L\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
137.5 (136--139)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
139 (136--139.1)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
138 (135.5--142)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
138 (135--140)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.619\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Erythrocyte sedimentation rate, mm/hour\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
21 (15.5--29.3)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
42 (14--59)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
24.5 (15.8--48.8)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
35 (25--60)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.267\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
C-reactive protein, mg/L\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
8 (6--8)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
9 (8--80)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
18.55 (12.25--120.175)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
26 (8.5--81.8)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
[?]10\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
13/56 (23.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
3/7 (42.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
14/16 (87.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
39/53 (73.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Procalcitonin, ng/mL\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.15 (0.1--0.39)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.39 (0.25--0.64)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.055 (0.02--0.1675)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.09 (0.05--0.31)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.019\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
The arterial partial pressure of oxygen\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
97 (77.25--105.25)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
96 (91--98)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
82 (65--98)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
92 (74--96)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.099\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Saturation of arterial blood oxygen, \%\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
97 (92--99)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
94.5 (89--97)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
94 (88--99)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
94 (88--98)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.135\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}90\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
6/35 (17.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
2/8 (25\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
7/23 (30.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
33/105 (31.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0.346\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textbf{Radiographic findings}\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Monolateral involvement of chest radiographs\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
40 (12.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
12 (20.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
16 (21.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
46 (30.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
bilateral involvement of chest radiographs\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
32 (10.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
4 (6.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
19 (25\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
44 (28.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

Data are median (IQR) or n (\%). As appropriate, p-values were
calculated by the Kruskal-Wallis test, \selectlanguage{greek}χ\selectlanguage{ngerman}² test, or Fisher's exact test.

\textbf{Table 3. Treatments and outcomes of 597 patients infected with
RSV.}\selectlanguage{english}
\begin{longtable}[]{@{}llllll@{}}
\toprule
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0--4 yr. n=310\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
5--17 yr. n=59\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
18--59 yr. n=76\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
[?]60 yr. n=152\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
P-value\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textbf{Treatments}\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Vasoactive drug\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
6 (1.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1 (1.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1 (1.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
6 (3.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.573\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Antiviral treatment\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
19 (6.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1 (1.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
7 (9.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
7 (4.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.288\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Antibiotics\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
188 (60.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
30 (50.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
35 (46.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
113 (74.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Corticosteroids\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
61 (19.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
11 (18.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
10 (13.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
24 (15.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.509\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Oxygen therapy\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
39 (12.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
2 (3.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
27 (35.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
95 (62.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Mechanical ventilation\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
26 (8.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
6 (7.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
19 (12.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.035\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
noninvasive\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
25 (8.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
4 (5.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
7 (4.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.16\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}



\textbf{References}

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{[}7{]} Broberg EK, Waris M, Johansen K, Snacken R, Penttinen P,
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{[}8{]} Breiman RF, Van Beneden CA, Farnon EC. Surveillance for
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{[}9{]} Organization WH. WHO global respiratory syncytial virus
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{[}10{]} Feng L, Li Z, Zhao S, et al. Viral etiologies of hospitalized
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{[}11{]} Huo X, Fang B, Liu L, et al. Clinical and epidemiologic
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{[}12{]} Resch B, Egger B, Kurath-Koller S, Urlesberger B. Respiratory
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{[}14{]} Chinese pediatric society C. The Guideline on the Management of
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first). Chinese journal of pediatrics. 2013. 51(10): 745-752.

{[}15{]} Chinese pediatric society C. the Guideline on the Management of
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{[}16{]} Gong C, Zhang T, Luo M, et al. Distribution of the atypical
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{[}17{]} Yu J, Liu C, Xiao Y, et al. Respiratory Syncytial Virus
Seasonality, Beijing, China, 2007-2015. Emerg Infect Dis. 2019. 25(6):
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{[}18{]} Midgley CM, Haynes AK, Baumgardner JL, et al. Determining the
Seasonality of Respiratory Syncytial Virus in the United States: The
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{[}19{]} Ren L, Gonzalez R, Wang Z, et al. Prevalence of human
respiratory viruses in adults with acute respiratory tract infections in
Beijing, 2005-2007. Clin Microbiol Infect. 2009. 15(12): 1146-53.

{[}20{]} Yoon JG, Noh JY, Choi WS, et al. Clinical characteristics and
disease burden of respiratory syncytial virus infection among
hospitalized adults. Sci Rep. 2020. 10(1): 12106.

{[}21{]} Ackerson B, Tseng HF, Sy LS, et al. Severe Morbidity and
Mortality Associated With Respiratory Syncytial Virus Versus Influenza
Infection in Hospitalized Older Adults. Clin Infect Dis. 2019. 69(2):
197-203.\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/fig1/fig1}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/fig2/fig2}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/fig3/fig3}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/fig4/fig4}

\end{center}
\end{figure}

\selectlanguage{english}
\FloatBarrier
\end{document}

