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Volume 41 Issue 5
October 2026

    . doi: 10.1016/j.virs.2026.09.004
    Citation: Yuxin Shao, Xinyu Wang, Ziyi Su, Yueping Zeng, Guoshuang Feng, Zhengde Xie, Ran Wang. Epidemiological characteristics and in-hospital burden of infectious mononucleosis among hospitalized children in China, 2021-2023 .VIROLOGICA SINICA, 2026, 41(5) : 1045-1053.  http://dx.doi.org/10.1016/j.virs.2026.09.004
    shu

    2021~2023年中国住院患儿传染性单核细胞增多症的流行病学特征及住院负担

    • a. 国家儿童医学中心, 首都医科大学附属北京儿童医院, 北京市儿科研究所感染与病毒研究室, 北京 100045;

    • b. 儿童新发突发传染病防治关键技术北京市重点实验室, 儿童重大疾病研究教育部重点实验室, 国家呼吸系统疾病临床医学研究中心, 北京 100045;

    • c. 中国医学科学院儿童危重感染诊治创新单元(2019RU016), 北京 100045;

    • d. 国家儿童医学中心, 首都医科大学附属北京儿童医院大数据中心, 北京 100045;

    • e. 首都医科大学附属北京儿童医院病案管理科, 北京 100045

    • 本研究分析了2021~2023年我国儿童传染性单核细胞增多症（IM）住院病例的流行病学特征、记录的第一位次要诊断分布及住院负担。数据来源于福棠儿童医学发展研究中心病案首页数据库。纳入2021年1月1日至2023年12月31日31家三级儿童医院出院主要诊断为IM的住院病例，提取人口学特征、地理区域、居住地、入院月份、记录的首位次要诊断、住院时长和住院费用，并采用描述性统计和多变量回归模型进行分析。共纳入15239例IM住院病例，占同期全部住院病例的0.42%；男女比为1.34。4~6岁患儿占比最高，其次为1~3岁和7~12岁。城市居民病例占70.32%，住院病例主要集中在8月和9月。校正年龄组、性别、七大地理区域和月份后，2023年IM住院病例占全部住院病例的比例低于2021~2022年（调整后率比[aRR]=0.822，95%CI：0.784~0.861，P<0.001）。68.29%的IM住院病例记录有首位次要诊断，其中支气管炎/肺炎最常见，其次为肝功能异常。中位住院日为7天，中位住院费用为5,563.07元。仅15例的首位次要诊断记录为脑炎，但其造成的住院时长和住院费用最高。上述结果为我国参与研究的三级儿童医院儿童IM住院病例的流行病学模式及住院负担提供了大规模多中心描述性基线。

    Epidemiological characteristics and in-hospital burden of infectious mononucleosis among hospitalized children in China, 2021-2023

    • a. Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China;

    • b. Beijing Key Laboratory of Core Technologies for the Prevention and Treatment of Emerging Infectious Diseases in Children, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Beijing, 100045, China;

    • c. Research Unit of Critical Infection in Children, 2019RU016, Chinese Academy of Medical Sciences, Beijing, 100045, China;

    • d. Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China;

    • e. Medical Record Management Office, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China

    • This multicenter study described the epidemiological characteristics, recorded first-ranked secondary diagnoses, and in-hospital burden of pediatric infectious mononucleosis (IM) hospitalizations in China during 2021-2023. Data were obtained from the FUTURE database. We identified hospitalizations with IM as the principal discharge diagnosis from discharge-record front pages at 31 tertiary children's hospitals between January 1, 2021, and December 31, 2023, and analyzed demographic, geographic, temporal, diagnostic, length-of-stay (LOS), and expense data using descriptive statistics and multivariable regression. Among 15,239 IM hospitalizations, representing 0.42% of all hospitalizations, the male-to-female ratio was 1.34. Children aged 4-6 years comprised the largest group, followed by those aged 1-3 and 7-12 years; 70.32% were urban residents, and admissions peaked in August and September. After adjustment for age, sex, seven-category geographic area, and month, the proportion of IM hospitalizations among all hospitalizations was lower in 2023 than in 2021-2022 (adjusted rate ratio, 0.822; 95% CI, 0.784-0.861; P < 0.001). A first-ranked secondary diagnosis was recorded in 68.29% of cases; bronchitis/pneumonia was the most common category, followed by hepatic dysfunction. Median LOS was 7 days, and median hospitalization expense was CNY 5563.07. Encephalitis was recorded in only 15 cases, which had the highest observed median LOS and hospitalization expenses. These findings provide a large multicenter baseline for the epidemiological patterns and in-hospital burden of pediatric IM hospitalizations across participating tertiary children's hospitals in China and may inform future surveillance and resource planning.
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      7. Hu, H., Deng, H., Bi, J., Xu, Y., Li, S., Xie, Y., Sun, X., Wang, D., Li, X., Ouyang, W., et al., 2021. Clinical characteristics and effectiveness of antiviral agents in hospitalized children with infectious mononucleosis in China: A multicenter retrospective study. Pediatr Investig, 5, 188-194.

      8. Huang, Q.S., Wood, T., Jelley, L., Jennings, T., Jefferies, S., Daniells, K., Nesdale, A., Dowell, T., Turner, N., Campbell-Stokes, P., et al., 2021. Impact of the COVID-19 nonpharmaceutical interventions on influenza and other respiratory viral infections in New Zealand. Nat Commun, 12, 1001.

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      13. Luzuriaga, K.,Sullivan, J.L., 2010. Infectious mononucleosis. N Engl J Med, 362, 1993-2000.

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      15. Prtoric, L., Sokota, A., Karabatic Knezovic, S., Tesovic, G.,Zidovec-Lepej, S., 2025. Clinical Features and Laboratory Findings of Hospitalized Children with Infectious Mononucleosis Caused by Epstein-Barr Virus from Croatia. Pathogens, 14, 374.

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      Epidemiological characteristics and in-hospital burden of infectious mononucleosis among hospitalized children in China, 2021-2023

        Corresponding author: Zhengde Xie, xiezhengde@bch.com.cn
        Corresponding author: Ran Wang, randall@mail.ccmu.edu.cn
      • a. Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China;
      • b. Beijing Key Laboratory of Core Technologies for the Prevention and Treatment of Emerging Infectious Diseases in Children, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Beijing, 100045, China;
      • c. Research Unit of Critical Infection in Children, 2019RU016, Chinese Academy of Medical Sciences, Beijing, 100045, China;
      • d. Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China;
      • e. Medical Record Management Office, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
      • Received Date: 09 June 2026
      • Accepted Date: 04 September 2026

      Abstract: This multicenter study described the epidemiological characteristics, recorded first-ranked secondary diagnoses, and in-hospital burden of pediatric infectious mononucleosis (IM) hospitalizations in China during 2021-2023. Data were obtained from the FUTURE database. We identified hospitalizations with IM as the principal discharge diagnosis from discharge-record front pages at 31 tertiary children's hospitals between January 1, 2021, and December 31, 2023, and analyzed demographic, geographic, temporal, diagnostic, length-of-stay (LOS), and expense data using descriptive statistics and multivariable regression. Among 15,239 IM hospitalizations, representing 0.42% of all hospitalizations, the male-to-female ratio was 1.34. Children aged 4-6 years comprised the largest group, followed by those aged 1-3 and 7-12 years; 70.32% were urban residents, and admissions peaked in August and September. After adjustment for age, sex, seven-category geographic area, and month, the proportion of IM hospitalizations among all hospitalizations was lower in 2023 than in 2021-2022 (adjusted rate ratio, 0.822; 95% CI, 0.784-0.861; P < 0.001). A first-ranked secondary diagnosis was recorded in 68.29% of cases; bronchitis/pneumonia was the most common category, followed by hepatic dysfunction. Median LOS was 7 days, and median hospitalization expense was CNY 5563.07. Encephalitis was recorded in only 15 cases, which had the highest observed median LOS and hospitalization expenses. These findings provide a large multicenter baseline for the epidemiological patterns and in-hospital burden of pediatric IM hospitalizations across participating tertiary children's hospitals in China and may inform future surveillance and resource planning.

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