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Published on: August 14, 2019
Outcome predictors of influenza for hospitalization and mortality in children
Yasemin Ozsurekci1, Kubra Aykac1, Fatma Bal2
1Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Insights
Children with underlying diseases are at higher risk for severe influenza, including hospitalization and intensive care unit (ICU) admission. Influenza vaccination is crucial for preventing severe outcomes, especially in young children and those with pre-existing conditions.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Influenza severity and influencing factors can vary, particularly in children due to lower seroprotection rates.
- Understanding pediatric influenza outcomes is crucial for public health strategies.
Purpose of the Study:
- To report clinical and outcome data of children diagnosed with influenza in Turkey between 2013 and 2017.
- To identify risk factors for severe influenza outcomes in pediatric populations.
Main Methods:
- Nasopharyngeal swab samples analyzed using multiplex polymerase chain reaction.
- Retrospective analysis of clinical and outcome data from 348 pediatric influenza cases.
- Multiple logistic regression used to identify predictors of hospitalization and ICU stay.
Main Results:
- Influenza A, B, and mixed infections accounted for 348 pediatric cases.
- Children under 2 years comprised 54% of intensive care unit (ICU) admissions (p=.001).
- Underlying diseases were significant predictors for hospitalization (OR=11.784) and ICU admission (OR=4.972).
- Neurological symptoms (44.4%), lymphopenia (55.6%), and thrombocytopenia (77.8%) were frequent in fatal cases.
- Underlying diseases significantly increased the risk of hospitalization and ICU admission.
Conclusions:
- Underlying diseases are a major risk factor for severe influenza outcomes in children, including hospitalization and ICU admission.
- Influenza vaccination is highly recommended for children, especially those under 2 and with underlying conditions, in regions without routine immunization.
- Vaccination can significantly reduce disease burden and prevent life-threatening complications.
Abstract:
Severity of disease caused by influenza virus and the influencing factors that may be different. Moreover, the disease course actually may not be determined specifically in children because of lower seroprotection rates of children. Herein, the results clinic and outcome data of children with influenza from Turkey were reported. We present here the results from 2013 to 2017. Nasopharyngeal swab samples of the children with influenza were investigated via multiplex polymerase chain reaction. A total of 348 children were diagnosed with influenza; 143 (41.1%) were influenza A, 85 (24.4%) were influenza B, and 120 (34.5%) were mixt infection with other respiratory viruses. Fifty-four percent of children admitted to intensive care unit (ICU) were under 2 years of age (p = .001). Having an underlying disease was detected as the main predictor for both hospitalization and ICU stay according to multiple logistic regression analysis (odds ratio [OR], 11.784: 95% confidence interval [CI], 5.212-26.643; p = .001 and OR, 4.972: 95% CI, 2.331-10.605; p = .001, respectively). Neurological symptoms most frequently seen in cases who died (44.4%; p = .02). Lymphopenia was relatively higher (55.6%) and thrombocytopenia was most frequently seen in cases who died (77.8%) with a significant ratio (p = .001). Underlying diseases was found a risk factor for influenza being hospitalized and being admitted to ICU. Children under 2 years of age and with underlying diseases should be vaccinated particularly in countries where the influenza vaccination is still not routinely implemented in the immunization schedule. Highlights Underlying diseases is a risk factor for influenza to be hospitalized and admitted to ICU. Influenza vaccination is of great importance to prevent life-threatening complications of influenza, particularly in children require ICU admission. The possibility to reduce the outpatient visit number by vaccination has a great impact on disease burden in addition to the underestimated crucial social benefits, as well.
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