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Severe Neurological Complications With Influenza in Vietnamese Children
Sy Duc Nguyen1,2, Thi Huyen Trang Ngo3, Thi Viet Ha Nguyen1,2
1Department of Pediatrics, Hanoi Medical University, Hanoi, Vietnam.
Insights
Severe influenza-associated neurological complications (IANCs) can affect healthy children, leading to significant mortality and sequelae. Vaccination is crucial for preventing these severe outcomes in pediatric populations.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Public Health
Background:
- Influenza virus commonly causes respiratory infections.
- Neurological complications (IANCs) are rare but serious, particularly in children.
- IANCs can be fatal and may occur even in previously healthy children.
Purpose of the Study:
- To describe the characteristics of pediatric patients with severe influenza-associated neurological complications.
- To identify risk factors and outcomes associated with IANCs in children.
Main Methods:
- A descriptive study was conducted at a Tropical Pediatrics Center.
- Evaluated pediatric patients diagnosed with severe IANCs between October 2022 and February 2024.
- Included clinical data, laboratory results, and neuroimaging findings.
Main Results:
- Eighty percent of the 20 pediatric patients were under 5 years old, and 70% had no prior health issues.
- All patients lacked recent influenza vaccination; neurological symptoms appeared a median of 1 day after onset.
- Encephalitis was the most common complication (80%), with high rates of elevated liver enzymes and ferritin; mortality was 20% with 45% experiencing severe sequelae.
Conclusions:
- Influenza-associated neurological complications are severe, affecting white and gray matter in children.
- These complications can occur in healthy children, underscoring the importance of influenza vaccination.
- Vaccination is a key preventive strategy against severe IANCs in pediatric populations.
Background:
Influenza is a common contagious respiratory virus that primarily causes respiratory tract infections. Neurological complications associated with influenza have also been reported, mainly in pediatric populations, and may be fatal.
Methods:
A descriptive study evaluated pediatric patients who were diagnosed with severe influenza-associated neurological complications at the Tropical Pediatrics Center-Vietnam National Children's Hospital from October 2022 to February 2024.
Results:
In this study involving 20 patients, 80% of children were under 5 years old; 70% of patients had a history of good health. All patients had not received an influenza vaccination within 12 months. The median time from onset to neurological symptoms was 1 day. The most common neurological complication was encephalitis (16/20 patients) with symptoms included altered consciousness and seizures. Most patients had elevated levels of ALT (60%), AST (90%), LDH (94%), and ferritin (69%) in serum. The imaging of brain damage on MRI and CT scans varied in patterns and locations. There was no difference in the timing of methylprednisolone treatment within and after 48 h. The mortality rate was 20%, with 45% of patients experiencing severe sequelae.
Conclusions:
IANCs are severe with damage to both white matter and central gray matter and can occur in healthy children, emphasizing the importance of vaccination to reduce the risk.
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