To investigate the predictive value of inflammatory and nutritional indicators for severe human rhinovirus (HRV) pneumonia in children.

A total of 975 children with HRV pneumonia admitted to the Department of Respiratory Medicine of Capital Center for Chlidren's Health, Capital Medical University from January 2019 to December 2023 were divided into a mild pneumonia group (829 cases) and a severe pneumonia group (146 cases) according to the diagnostic criteria for severe pneumonia. The clinical characteristics, along with inflammatory and nutritional indicators, were compared between the two groups. Logistic regression was used to analyze the influencing factors of severe pneumonia in children with HRV, and the receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of each influencing factor.

Compared with the mild pneumonia group, the age (t = 0.535, P < 0.001), neutrophils (t = 0.261, P = 0.033), C-reactive protein (CRP) (Z = 5.293, P < 0.001), lactate dehydrogenase (LDH) (t = 0.417, P = 0.008), creatinine (t = 0.339, P < 0.001), systemic immune-inflammation index (SII) (Z = 5.569, P < 0.001), neutrophil-to-lymphocyte ratio (NLR) (Z = 6.156, P < 0.001), platelet-to-lymphocyte ratio (PLR) (t = 4.624, P < 0.001), monocyte-to-lymphocyte ratio (MLR) (Z = 2.444, P = 0.015), neutrophil-to-monocyte ratio (NMR) (Z = 2.973, P = 0.003), systemic inflammation response index (SIRI) (Z = 2.318, P = 0.020) and red cell distribution width-to-lymphocyte ratio (RLR) (Z = 2.845, P = 0.004) were higher, while the proportion of males (χ² = 0.227, P = 0.012), lymphocytes (t = 0.373, P < 0.001), red blood cells (t = 0.079, P < 0.001), albumin (t = 0.865, P < 0.001) and prognostic nutritional index (PNI) (Z = 0.317, P < 0.001) were lower in the severe pneumonia group. The univariate and multivariate logistic regression revealed that age [odds ratio (OR) = 1.204, 95% confidence interval (CI) (1.109, 1.307), P < 0.001], white blood cells [OR = 1.103, 95%CI (1.022, 1.191), P = 0.012], CRP [OR = 1.029, 95%CI (1.020, 1.039), P < 0.001], LDH [OR = 1.004, 95%CI (1.002, 1.006), P < 0.001] and SIRI [OR = 1.219, 95%CI (1.038, 1.432), P = 0.016] were risk factors influencing the occurrence of severe pneumonia in children with HRV, while the albumin [OR = 0.837, 95%CI (0.788, 0.889), P < 0.001] and PNI [OR = 0.986, 95%CI (0.978, 0.994), P < 0.001] were protective factors. The ROC curve indicated that the area under the curve (AUC) of the multi-factor combined model was the highest [AUC = 0.904, 95%CI (0.878, 0.930), P < 0.001], followed by albumin [AUC = 0.819, 95%CI (0.781, 0.857), P < 0.001] and PNI [AUC = 0.763, 95%CI (0.728, 0.798), P < 0.001].

Age, white blood cell count, CRP, LDH and SIRI are risk factors affecting the occurrence of severe pneumonia in children with HRV, while albumin and PNI are protective factors. They have the potential to be used as early warning indicators for severe pneumonia in children with HRV.