(1) Background: Respiratory virus infections, including Coronavirus disease 2019 (COVID-19), seasonal influenza (FLU), and respiratory syncytial virus (RSV) as prominent examples, can severely affect both children and adults. This study aimed to investigate the clinical characteristics of respiratory viral infections in pediatric and adult populations and to identify determinants influencing patient hospitalization. (2) Methods: This retrospective study analyzed the electronic medical records of patients admitted to a regional hospital’s emergency department from 1 January 2015 to 31 December 2022, to investigate the clinical characteristics and hospitalization risk factors associated with these three viruses. (3) Results: Infants aged 1 to 11 months were most affected by COVID-19 and RSV, whereas FLU more commonly infected children aged 3 to 5 years. Key factors influencing hospitalization included age and abnormal chest X-ray findings, with higher risks observed in younger children and adults over 65. Notably, the presence of abnormal chest x-ray findings significantly increased the hospitalization risk by 1.9 times [1.5–2.4] in children and 21.4 times [2.4–189.0] in adults. (4) Conclusions: This analysis underscores the impact of COVID-19, FLU, and RSV on hospitalization risk, offering insights for managing these respiratory viral infections (RVIs). Age-related risk differences highlight the necessity for tailored strategies, improving understanding of and treatment development for RVIs.

Kim CS, et al. J Korean Med Sci. 1992 Dec;7(4):325-332. http://dx.doi.org/10.3346/jkms.1992.7.4.325

Background/Objectives: With the advent of the field of pediatric emergency medicine, studies on the differences in treatment patterns between pediatricians and emergency medicine (EM) physicians in various pediatric conditions have been accumulating. This study aimed to compare croup (acute laryngotracheobronchitis) management patterns between pediatricians and EM physicians to enhance pediatric emergency care and inform the training of future specialists. Methods: A retrospective review of medical records was conducted for 1676 previously healthy children diagnosed with croup who visited a single pediatric emergency department (PED) of a tertiary university-affiliated hospital in South Korea, from March 2019 to February 2023. Patient characteristics, management patterns, and the impact of physician specialty on emergency care were analyzed. Results: EM physicians used injected dexamethasone monotherapy in 30.54% of the cases, more frequently than the 3.57% among pediatricians. In contrast, pediatricians used a combination of nebulized epinephrine and dexamethasone in 88.29% of the cases, compared with 67.71% for EM physicians. The appropriate use of nebulized epinephrine based on the Westley Croup Score was significantly higher in the EM physician group (77.64% vs. 57.89%, p < 0.001). Pediatricians also prescribed oral antibiotics and corticosteroids more frequently (25.13% vs. 3.13% and 81.54% vs. 22.69%, respectively; p < 0.001 for both). Despite these differences, there were no significant disparities in PED length of stay or 48 h revisit rates. Conclusions: EM physicians adhered more closely to currently accepted management algorithms for croup management. These findings underscore the need for standardized, evidence-based pediatric emergency care and provide valuable insights for training programs in this field.

Background/Objectives: Pediatric foreign body (FB) ingestion is a common clinical problem that frequently necessitates time-sensitive decisions regarding esophagogastroduodenoscopy (EGDS). Although established high-risk criteria guide the indication for EGDS, coins—despite their high prevalence—are not uniformly classified as high-risk FBs. In this study, we aimed to delineate epidemiology and endoscopic outcomes and to identify predictors of EGDS. Methods: We retrospectively reviewed cases of children younger than 15 years presenting to an urban emergency department (ED) with suspected or confirmed FB ingestion between 2014 and 2020. After applying exclusion criteria, 757 patients remained for analysis. Data abstracted included demographic characteristics, presenting symptoms, type and location of FB, ED length of stay (EDLOS), and whether EGDS was performed along with its outcomes. Multivariable logistic regression was used to identify predictors of EGDS, including age group, sex, symptom presence, established high-risk criteria, and type of FB (coin, button battery, magnet). Results: Among 757 children (median age 17.0 months; 54.0% male), 55.2% were asymptomatic. EGDS was performed in 47 of the 757 children (6.2%), with a success rate of 74.5% (35/47). Among EGDS cases, the most common foreign bodies were coins (29.8%), button batteries (27.7%), and magnets (17.0%). In multivariable models, established high-risk criteria were the dominant determinant of EGDS (adjusted OR ≈ 179.4; 95% CI, 29.9–1075.8; p < 0.001). Compared with button batteries, coin ingestion was independently associated with EGDS (adjusted OR ≈ 7.26; 95% CI, 1.07–49.31; p = 0.042). Conclusions: Established high-risk criteria were the primary determinant of EGDS, and coin ingestion showed a possible independent association with EGDS; these findings suggest that coin ingestion may warrant consideration as a potential high-risk factor when determining whether endoscopy is indicated.

Background/Objectives: Influenza poses significant risks in children, causing complications like febrile seizures and hospitalizations. Antiviral treatments include oseltamivir and peramivir, both FDA-approved neuraminidase inhibitors. This study aims to compare the effectiveness of intravenous peramivir and oral oseltamivir in pediatric patients presenting to an emergency department, with a primary focus on the revisit rate within 72 h post-treatment. Methods: A retrospective study analyzed 1327 children aged 1–15 years diagnosed with influenza A or B between 1 January 2019 and 29 February 2020, at a single urban hospital. Patients were divided into oseltamivir (n = 1243) and peramivir (n = 84) groups. Data included demographics, clinical symptoms, emergency department stays, and revisit rates. Fisher’s exact test was used for analysis, with p-values < 0.05 considered significant. Results: A total of 1327 pediatric patients were included, with 1243 receiving oseltamivir and 84 receiving peramivir. Patients in the peramivir group were older (median age 5.88 years vs. 4.54 years, p = 0.002) and had higher rates of gastrointestinal symptoms. The emergency department length of stay was significantly longer in the peramivir group (167 min vs. 63 min, p < 0.001). The revisit rate within 3 days was 5.63% for oseltamivir and 9.52% for peramivir, with no statistically significant difference (p = 0.22). Conclusions: Peramivir presents as an effective alternative treatment for influenza in children, particularly in situations where oral administration is not feasible due to gastrointestinal intolerance, highlighting the importance of an alternative route of antiviral administration.

Yoon HK, et al. J Korean Radiol Soc. 2001 Apr;44(4):433-440. http://dx.doi.org/10.3348/jkrs.2001.44.4.433