Risk factors associated with poor outcomes in children with Severe Acute Respiratory Infection (SARI) in a state in the Brazilian Amazon

Objective: To identify independent risk factors for death, need for mechanical ventilation, and prolonged hospitalization in children with severe acute respiratory infection (SARI). Methods: Data were analyzed from the National Health Information System of a state in the Brazilian Amazon, collected between May 2020 and May 2022. Univariate and multivariate Poisson regressions were applied to estimate adjusted relative risks (RR), with significance set at p < 0.05. Model calibration and discrimination were evaluated using the Hosmer-Lemeshow and Stukel tests, as well as ROC curves. Results: A total of 226 children were included, with a mortality rate of 14.2%. Death was associated with invasive mechanical ventilation (RR = 6.81), presence of comorbidities (RR = 2.25), and respiratory syncytial virus (RSV) infection (RR = 2.38). The need for mechanical ventilation was related to ICU admission (RR = 4.14), RSV infection (RR = 1.68), and influenza H3N2 infection (RR = 1.59). Prolonged hospitalization was associated with oxygen saturation < 95% (RR = 1.47), infection by other respiratory viruses (RR = 1.86), and H3N2 infection (RR = 1.67). Conclusion: It is concluded that respiratory viruses are important independent predictors of adverse outcomes in pediatric SARI cases.