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Risk factors for need of mechanical ventilation in children with influenza A(H1N1)pdm09

Marcelo C Scotta1, Rita Mattiello, Paulo J C Marostica

  • 1MSc Candidate in Child and Adolescent Health, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Pediatric Infectious Disease's Specialist, Hospital da Criança Santo Antonio, Departamento de Pediatria, Porto Alegre, RS, Brazil.

Jornal De Pediatria
|July 13, 2013
PubMed

Insights

Children with chronic diseases or viral co-detection face higher risks of severe outcomes from influenza A(H1N1)pdm09. These factors are critical for identifying at-risk pediatric patients during and after the pandemic.

Area of Science:

  • Pediatric Infectious Diseases
  • Epidemiology
  • Virology

Background:

  • The influenza A(H1N1)pdm09 pandemic significantly impacted children and young adults in Brazil.
  • Post-pandemic, influenza A(H1N1)pdm09 cases increased during winter months, resembling seasonal influenza patterns.
  • Ongoing infections necessitate identifying risk factors for severe outcomes in pediatric populations.

Purpose of the Study:

  • To investigate risk factors associated with worse outcomes in children hospitalized with influenza A(H1N1)pdm09.
  • To identify predictors of severe disease, such as the need for mechanical ventilation, in pediatric patients.

Main Methods:

  • Retrospective cohort study of 120 hospitalized children (<14 years) with RT-PCR confirmed influenza A(H1N1)pdm09.
  • Data collected from six tertiary centers in Brazil during the first pandemic wave.
  • Potential predictors analyzed included age, chronic diseases, co-detections, chest radiograph findings, and oseltamivir use.

Main Results:

  • Multivariate analysis revealed chronic diseases as a significant predictor of worse outcomes (PR: 2.613, 95% CI: 1.267-5.386).
  • Viral co-detection was also statistically associated with worse outcomes (PR: 2.43, 95% CI: 1.203-4.905).
  • Both associations were statistically significant (p<0.05).

Conclusions:

  • Chronic diseases are confirmed risk factors for severe influenza A(H1N1)pdm09 outcomes in children.
  • Viral co-detection emerges as a novel risk factor for adverse outcomes in this pediatric cohort.
  • Further research is warranted to validate the association between viral co-detection and severe influenza.
Abstract

Keywords:
ChildCriançaFatores de riscoInfluenza A H1N1 subtypeInfluenza A subtipo H1N1Insuficiência respiratóriaRespiratory insufficiencyRisk factors

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