To develop a clinical nomogram using routine blood parameters to identify the risk of prolonged fever (>1 week) in children with acute primary Epstein–Barr virus (EBV) infection.
Approach:
Study Design: A retrospective study involving 791 hospitalized children with primary EBV infection, divided into two groups based on fever duration.
Variable Selection: Univariate analysis followed by LASSO regression was used to select optimal predictors for the nomogram.
Model Construction: A multivariate logistic regression model was constructed and visualized as a nomogram, with performance quantified using AUC, calibration plots, and DCA.
Key Findings:
Prolonged fever affected 27.4% of the cohort.
Antiviral therapy was administered to all patients with prolonged fever (100%), compared to 56.1% in the short fever group (P < 0.001).
LASSO regression identified white blood cell count (WBC), neutrophil count (NEU), platelet count (PLT), and atypical lymphocyte proportion (AL) as optimal predictors.
The nomogram predicted prolonged fever with an AUC of 0.728 (95% CI: 0.689–0.768).
Interpretation:
A nomogram based on four routine blood parameters provides a method for risk stratification of children with prolonged EBV-related fever.
Limitations:
The study is retrospective and conducted at a single center.
The clinical value of the nomogram requires validation through multicenter prospective studies.
Conclusion:
The nomogram serves as an initial reference for predicting fever duration in pediatric EBV infection.
