Community acquired pneumonia (CAP) is a major global public health concern among children, with viral pathogens playing a significant role. Despite this, national multicenter studies on viral community acquired pneumonia (VCAP) in hospitalized children remain scarce. The study employed a multicenter approach to investigate the clinical epidemiology and burden of VCAP in hospitalized children across China.

Data were extracted from the face sheets of discharge medical records (FSMRs) within the FuTang Update Medical Records (FUTURE) database, spanning 2016 to 2022. VCAP cases from 33 tertiary children's hospitals were identified and analyzed. Epidemiological characteristics, length of stay (LOS), and hospitalization costs were compared using appropriate statistical methods.

Between January 2016 to December 2022, 72,905 hospitalized cases of CAP with confirmed diagnoses of viral pathogens were documented, accounting 4.07% of all CAP cases (72,905/1791,343). Respiratory syncytial virus (RSV) was the leading cause, responsible for 57.21% of cases, followed by adenovirus, parainfluenza virus, human rhinovirus and influenza virus. The male-to-female ratio was 1.69:1, and infants under 1 year of age represented 59.84% of hospitalizations. Temporal trends showed an increase in VCAP hospitalizations from 2016 to 2019, a decline in 2020, followed by a resurgence in 2021 and 2022. Seasonally, the majority of cases occurred during winter (December to February, 41.67%), while summer (June to August) had the lowest proportion (16.80%). A total of 40 deaths were reported, representing a mortality rate of 0.05%. The median LOS was 7 days, with a median hospitalization cost of 907.38 USD.

Although the proportion of CAP cases in children with confirmed viral pathogen in China is relatively low, VCAP remains a significant health burden for children. RSV is the most prevalent viral cause of VCAP, particularly affecting infants under 1 year of age, while adenovirus is associated with the highest mortality, longest LOS, and highest hospitalization costs. VCAP cases peak during the winter months. While the prognosis is generally favorable, the disease continues to pose a considerable public health challenge.