Influencing factors for severe pertussis among Chinese children: A meta-analysis

This study systematically evaluates factors influencing severe pertussis in Chinese children, providing scientific evidence for its prevention and treatment. A comprehensive search of PubMed, Embase, Web of Science, CNKI, and Wanfang identified literature on factors influencing severe pertussis in Chinese children up to September 30, 2025. We conducted a meta-analysis, and data were combined using either fixed or random models. A total of 24 studies included 839 severe pertussis cases and 4,280 non-severe cases. Severe pertussis was significantly associated with several factors, with the top five strongest associations being: lung consolidation or atelectasis (OR: 15.44; 95%CI: 9.06–26.31), three concave sign (OR: 12.91; 95%CI: 5.46–30.53), elevated C-reactive protein (OR: 5.33; 95%CI: 3.00–9.49), unvaccinated with DTP vaccine (OR: 4.00; 95%CI: 2.86–5.58), and white blood cell count (WMD: 16.42 × 109/L; 95%CI: 9.49–23.36). Early identification of these factors and timely intervention, along with strengthening vaccination efforts for children, can help effectively reduce severe cases.