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Updated: Jan 20, 2026
Influenza A Virus Studies in a Mouse Model of Infection
Published on: September 7, 2017
Risk Factors for Influenza Virus Related Severe Lower Respiratory Tract Infection in Children
Aykut Eşki1, Gökçen Kartal Öztürk1, Figen Gülen1
1From the Department of Pediatric Pulmonology.
Insights
Severe influenza-related lower respiratory tract infections (LRTI) in children are linked to comorbidities and secondary bacterial infections (SBIs). These factors increase the risk of invasive mechanical ventilation (IMV) and mortality, highlighting the need for careful antiviral therapy selection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Respiratory Medicine
Background:
- Influenza virus is a common respiratory pathogen causing seasonal outbreaks.
- Influenza-related lower respiratory tract infection (LRTI) can lead to severe illness in children.
- Identifying risk factors for severe outcomes is crucial for pediatric influenza management.
Purpose of the Study:
- To identify risk groups and factors associated with severe clinical course in children with influenza-related LRTI.
- To analyze factors contributing to prolonged hospitalization, pediatric intensive care unit (PICU) admission, invasive mechanical ventilation (IMV) need, and mortality.
Main Methods:
- Retrospective study of 280 children hospitalized with influenza virus LRTI from 2008 to 2018.
- Data collected included demographics, influenza type, coinfections, secondary bacterial infections (SBIs), antiviral treatment timing, comorbidities, and clinical outcomes.
- Statistical analysis identified independent risk factors for severe outcomes.
Main Results:
- Congenital heart disease, neuromuscular disease, SBIs, and late antiviral treatment were linked to prolonged hospital stays.
- SBIs, lymphopenia, neutrophilia, immunosuppression, and human bocavirus coinfection were risk factors for IMV.
- Immunosuppression, lymphopenia, and SBIs were independent risk factors for mortality.
Conclusions:
- Comorbidities, SBIs, neutrophilia, and lymphopenia at admission predict severe influenza, including IMV need and death.
- While antivirals may reduce complications, careful patient selection is needed.
- Further prospective trials are warranted to optimize antiviral therapy in pediatric influenza.
Background:
Influenza virus is one of the most common respiratory pathogens for all age groups and may cause seasonal outbreaks. Our aim was to identify risk groups and factors associated with severe clinical course including mortality in children with influenza-related lower respiratory tract infection (LRTI).
Methods:
We conducted a retrospective study in children hospitalized with influenza virus LRTI from 2008 to 2018. Data on demographic features, influenza type, viral coinfection, primary and secondary bacterial infections (SBIs), time of onset of antiviral treatment, comorbidities, hospitalization length, pediatric intensive care unit admission/invasive mechanical ventilation (IMV) need and mortality were collected from medical records.
Results:
There were 280 patients hospitalized with LRTI and median hospitalization length was 9 days. Congenital heart disease, neuromuscular disease, SBIs and late-onset antiviral treatment were independent risk factors for prolonged hospital stay (P < 0.05). Pediatric intensive care unit admission was present in 20.4% (57) of the patients and 17.1% (48) of all patients required IMV. SBIs, lymphopenia, neutrophilia, immunosuppression and human bocavirus coinfection were independent risk factors for IMV support (P < 0.05). Eighteen patients died and immunosuppression, lymphopenia and SBIs were independent risk factors for mortality (P < 0.05).
Conclusions:
Presence of comorbidity, SBIs, neutrophilia and lymphopenia at admission identified as risk factors for severe influenza infections including need for IMV and death. Although several studies showed that antiviral treatment reduce hospitalization, complications and mortality, there is a lack of prospective trials and patients for antiviral therapy should be carefully chosen by the clinician.
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