The Impact Of Meteorological And Air Pollution On Viral Infection And Disease Outcome Among Pediatric Pneumonia Patients In Chongqing,China From 2009 To 2018: A Prospective Observational Study

Background For pediatric pneumonia,the meteorological indicators had been frequently investigated for their association with viral circulation,however,not for their impact on disease severity.Methods We performed a prospective observational study in one hospital in Chongqing,China to recruit children with pneumonia from 2009?2018.Respiratory specimens were tested for 8 commonly seen respiratory viruses.Autoregressive distributed lag(ADL)model was performed to fit monthly detection rates of each virus and estimated the effects of meteorological and air pollution predictors on viral infections at population level.Random forest models were applied to predict the possibility of severe pneumonia at individual level by using host related factors,virus identified,meteorological and air pollution indicators.Results Between 2009?2018,6 611 pediatric pneumonia patients were included,with 4 846(73.3%)tested positive for at least one respiratory virus.ADL models demonstrated a decent fitting of detection rates of four viruses(R2 >0.7 for RSV,HRV,PIV,and HMPV).The RF models indicated nine meteorological and air pollution indicators at one week before disease onset were important determinants of severe pneumonia,contributing with overall efficiency of 62.53%,significantly higher than respiratory viral infections(7.36%).The model including only meteorological and air pollution and host-related factors,displayed comparable prediction efficiency with allvariables-included model.Conclusions Meteorological and air pollution predictors contributed to severe pneumonia in children,more than respiratory viruses.These meteorological data could help predict times when children would be at increased risk for sever pneumonia,and interventions such as masks,may be warranted.