tetano
Editor, Senior Moderator
Clin Infect Dis
. 2022 Jun 19;ciac477.
doi: 10.1093/cid/ciac477. Online ahead of print.
Life-Threatening Complications of Influenza versus COVID-19 in U.S. Children
Natasha B Halasa[SUP] 1 [/SUP], Andrew J Spieker[SUP] 2 [/SUP], Cameron C Young[SUP] 3 [/SUP], Samantha M Olson[SUP] 4 [/SUP], Margaret M Newhams[SUP] 3 [/SUP], Justin Z Amarin[SUP] 1 [/SUP], Kristin L Moffitt[SUP] 5 6 [/SUP], Mari M Nakamura[SUP] 5 6 7 [/SUP], Emily R Levy[SUP] 8 [/SUP], Vijaya L Soma[SUP] 9 [/SUP], Rana Talj[SUP] 1 [/SUP], Scott L Weiss[SUP] 10 [/SUP], Julie C Fitzgerald[SUP] 10 [/SUP], Elizabeth H Mack[SUP] 11 [/SUP], Aline B Maddux[SUP] 12 [/SUP], Jennifer E Schuster[SUP] 13 [/SUP], Bria M Coates[SUP] 14 [/SUP], Mark W Hall[SUP] 15 [/SUP], Stephanie P Schwartz[SUP] 16 [/SUP], Adam J Schwarz[SUP] 17 [/SUP], Michele Kong[SUP] 18 [/SUP], Philip C Spinella[SUP] 19 [/SUP], Laura L Loftis[SUP] 20 [/SUP], Gwenn E McLaughlin[SUP] 21 [/SUP], Charlotte V Hobbs[SUP] 22 [/SUP], Courtney M Rowan[SUP] 23 [/SUP], Melania M Bembea[SUP] 24 [/SUP], Ryan A Nofziger[SUP] 25 [/SUP], Christopher J Babbitt[SUP] 26 [/SUP], Cindy Bowens[SUP] 27 [/SUP], Heidi R Flori[SUP] 28 [/SUP], Shira J Gertz[SUP] 29 [/SUP], Matt S Zinter[SUP] 30 [/SUP], John S Giuliano[SUP] 31 [/SUP], Janet R Hume[SUP] 32 [/SUP], Natalie Z Cvijanovich[SUP] 33 [/SUP], Aalok R Singh[SUP] 34 [/SUP], Hillary A Crandall[SUP] 35 [/SUP], Neal J Thomas[SUP] 36 [/SUP], Melissa L Cullimore[SUP] 37 [/SUP], Manish M Patel[SUP] 4 [/SUP], Adrienne G Randolph[SUP] 3 [/SUP], Pediatric Intensive Care Influenza; Overcoming COVID-19 Investigators
Affiliations
Abstract
Background: Clinical differences between critical illness from influenza infection versus coronavirus disease 2019 (COVID-19) have not been well characterized in pediatric patients.
Methods: We compared U.S. children (8 months to 17 years) admitted to the intensive care or high acuity unit with influenza (17 hospitals, 12/19/2019-3/9/2020) or COVID-19 (52 hospitals, 3/15/2020-12/31/2020). We compared demographics, underlying conditions, clinical presentation, severity, and outcomes. Using mixed-effects models, we assessed the odds of death or requiring life-support for influenza versus COVID-19 after adjustment for age, sex, race and Hispanic origin, and underlying conditions including obesity.
Results: Children with influenza (n = 179) were younger than those with COVID-19 (n = 381; median 5.2 vs. 13.8 years), less likely to be non-Hispanic black (14.5% vs. 27.6%) or Hispanic (24.0% vs. 36.2%), and less likely to have ≥1 underlying condition (66.4% vs. 78.5%) or be obese (21.4% vs. 42.2%). They were similarly likely to require invasive mechanical ventilation (both 30.2%), vasopressor support (19.6% and 19.9%), or extracorporeal membrane oxygenation (2.2% and 2.9%). Four children with influenza (2.2%) and 11 children with COVID-19 (2.9%) died. The odds of death or requiring life-support in children with influenza vs. COVID-19 were similar (adjusted odds ratio, 1.30 [95% CI: 0.78-2.15; P = 0.32]). Median duration of hospital stay was shorter for influenza than COVID-19 (5 versus 7 days).
Conclusions: Despite differences in demographics and clinical characteristics of children with influenza or COVID-19, the frequency of life-threatening complications was similar. Our findings highlight the importance of implementing prevention measures to reduce transmission and disease severity of influenza and COVID-19.
. 2022 Jun 19;ciac477.
doi: 10.1093/cid/ciac477. Online ahead of print.
Life-Threatening Complications of Influenza versus COVID-19 in U.S. Children
Natasha B Halasa[SUP] 1 [/SUP], Andrew J Spieker[SUP] 2 [/SUP], Cameron C Young[SUP] 3 [/SUP], Samantha M Olson[SUP] 4 [/SUP], Margaret M Newhams[SUP] 3 [/SUP], Justin Z Amarin[SUP] 1 [/SUP], Kristin L Moffitt[SUP] 5 6 [/SUP], Mari M Nakamura[SUP] 5 6 7 [/SUP], Emily R Levy[SUP] 8 [/SUP], Vijaya L Soma[SUP] 9 [/SUP], Rana Talj[SUP] 1 [/SUP], Scott L Weiss[SUP] 10 [/SUP], Julie C Fitzgerald[SUP] 10 [/SUP], Elizabeth H Mack[SUP] 11 [/SUP], Aline B Maddux[SUP] 12 [/SUP], Jennifer E Schuster[SUP] 13 [/SUP], Bria M Coates[SUP] 14 [/SUP], Mark W Hall[SUP] 15 [/SUP], Stephanie P Schwartz[SUP] 16 [/SUP], Adam J Schwarz[SUP] 17 [/SUP], Michele Kong[SUP] 18 [/SUP], Philip C Spinella[SUP] 19 [/SUP], Laura L Loftis[SUP] 20 [/SUP], Gwenn E McLaughlin[SUP] 21 [/SUP], Charlotte V Hobbs[SUP] 22 [/SUP], Courtney M Rowan[SUP] 23 [/SUP], Melania M Bembea[SUP] 24 [/SUP], Ryan A Nofziger[SUP] 25 [/SUP], Christopher J Babbitt[SUP] 26 [/SUP], Cindy Bowens[SUP] 27 [/SUP], Heidi R Flori[SUP] 28 [/SUP], Shira J Gertz[SUP] 29 [/SUP], Matt S Zinter[SUP] 30 [/SUP], John S Giuliano[SUP] 31 [/SUP], Janet R Hume[SUP] 32 [/SUP], Natalie Z Cvijanovich[SUP] 33 [/SUP], Aalok R Singh[SUP] 34 [/SUP], Hillary A Crandall[SUP] 35 [/SUP], Neal J Thomas[SUP] 36 [/SUP], Melissa L Cullimore[SUP] 37 [/SUP], Manish M Patel[SUP] 4 [/SUP], Adrienne G Randolph[SUP] 3 [/SUP], Pediatric Intensive Care Influenza; Overcoming COVID-19 Investigators
Affiliations
- PMID: 35717646
- DOI: 10.1093/cid/ciac477
Abstract
Background: Clinical differences between critical illness from influenza infection versus coronavirus disease 2019 (COVID-19) have not been well characterized in pediatric patients.
Methods: We compared U.S. children (8 months to 17 years) admitted to the intensive care or high acuity unit with influenza (17 hospitals, 12/19/2019-3/9/2020) or COVID-19 (52 hospitals, 3/15/2020-12/31/2020). We compared demographics, underlying conditions, clinical presentation, severity, and outcomes. Using mixed-effects models, we assessed the odds of death or requiring life-support for influenza versus COVID-19 after adjustment for age, sex, race and Hispanic origin, and underlying conditions including obesity.
Results: Children with influenza (n = 179) were younger than those with COVID-19 (n = 381; median 5.2 vs. 13.8 years), less likely to be non-Hispanic black (14.5% vs. 27.6%) or Hispanic (24.0% vs. 36.2%), and less likely to have ≥1 underlying condition (66.4% vs. 78.5%) or be obese (21.4% vs. 42.2%). They were similarly likely to require invasive mechanical ventilation (both 30.2%), vasopressor support (19.6% and 19.9%), or extracorporeal membrane oxygenation (2.2% and 2.9%). Four children with influenza (2.2%) and 11 children with COVID-19 (2.9%) died. The odds of death or requiring life-support in children with influenza vs. COVID-19 were similar (adjusted odds ratio, 1.30 [95% CI: 0.78-2.15; P = 0.32]). Median duration of hospital stay was shorter for influenza than COVID-19 (5 versus 7 days).
Conclusions: Despite differences in demographics and clinical characteristics of children with influenza or COVID-19, the frequency of life-threatening complications was similar. Our findings highlight the importance of implementing prevention measures to reduce transmission and disease severity of influenza and COVID-19.