tetano
Editor, Senior Moderator
J Allergy Clin Immunol Pract
. 2022 Nov 12;S2213-2198(22)01190-4.
doi: 10.1016/j.jaip.2022.10.045. Online ahead of print.
Association of Asthma with Treatments and Outcomes in Children with Critical Influenza
Aline B Maddux[SUP] 1 [/SUP], Jocelyn R Grunwell[SUP] 2 [/SUP], Margaret M Newhams[SUP] 3 [/SUP], Sabrina R Chen[SUP] 3 [/SUP], Samantha M Olson[SUP] 4 [/SUP], Natasha B Halasa[SUP] 5 [/SUP], Scott L Weiss[SUP] 6 [/SUP], Bria M Coates[SUP] 7 [/SUP], Jennifer E Schuster[SUP] 8 [/SUP], Mark W Hall[SUP] 9 [/SUP], Ryan A Nofziger[SUP] 10 [/SUP], Heidi R Flori[SUP] 11 [/SUP], Shira J Gertz[SUP] 12 [/SUP], Michele Kong[SUP] 13 [/SUP], Ronald C Sanders Jr[SUP] 14 [/SUP], Katherine Irby[SUP] 14 [/SUP], Janet R Hume[SUP] 15 [/SUP], Melissa L Cullimore[SUP] 16 [/SUP], Steven L Shein[SUP] 17 [/SUP], Neal J Thomas[SUP] 18 [/SUP], Kristen Miller[SUP] 1 [/SUP], Manish Patel[SUP] 4 [/SUP], Anne M Fitzpatrick[SUP] 19 [/SUP], Wanda Phipatanakul[SUP] 20 [/SUP], Adrienne G Randolph[SUP] 21 [/SUP], PALISI Pediatric Intensive Care Influenza (PICFLU) Network Investigators
Affiliations
Abstract
Background: Hospitalization for severe influenza infection in childhood may result in post-discharge sequelae.
Objective(s): To evaluate inpatient management and post-discharge sequelae in children with critical respiratory illness due to influenza with or without pre-existing asthma.
Methods: Prospective, observational multicenter study of children (8-months to 17-years-old) admitted to a pediatric intensive care or high-acuity unit (11/2019-4/2020) for influenza. Results were stratified by pre-existing asthma. Pre-hospital status, hospital treatments and outcomes were collected. Surveys at approximately 90 days post-discharge evaluated post-discharge health resource use, functional status, and respiratory symptoms.
Results: 165 children with influenza: 56 (33.9%) with and 109 (66.1%) without pre-existing asthma (41.1% and 39.4% fully vaccinated against influenza, respectively). Fifteen (26.7%) patients with and 34 (31.1%) without pre-existing asthma were intubated. More patients with versus without pre-existing asthma received pharmacologic asthma treatments during hospitalization (76.7% vs 28.4%). Of 136 (82.4%) patients with 90-day survey data (46 [33.8%] with and 90 [66.1%] without pre-existing asthma), a similar proportion had an Emergency Department/urgent care visit (4.3%, 6.6%) or hospital readmission (8.6%, 3.3%) for a respiratory condition. Patients with pre-existing asthma more frequently experienced asthma symptoms (78.2% vs 3.3%) and had respiratory specialist visits (52% vs 20%) post-discharge. Ten of 109 (11.1%) patients without pre-existing asthma reported being newly diagnosed with asthma.
Conclusions: Respiratory health resource use and symptoms are important post-discharge outcomes after influenza critical illness in children with and without pre-existing asthma. Less than half of children were vaccinated for influenza, a tool that could mitigate critical illness and its sequelae.
Keywords: acute respiratory viral infection; asthma; influenza; outcomes; pediatric intensive care unit; reactive airway disease.
. 2022 Nov 12;S2213-2198(22)01190-4.
doi: 10.1016/j.jaip.2022.10.045. Online ahead of print.
Association of Asthma with Treatments and Outcomes in Children with Critical Influenza
Aline B Maddux[SUP] 1 [/SUP], Jocelyn R Grunwell[SUP] 2 [/SUP], Margaret M Newhams[SUP] 3 [/SUP], Sabrina R Chen[SUP] 3 [/SUP], Samantha M Olson[SUP] 4 [/SUP], Natasha B Halasa[SUP] 5 [/SUP], Scott L Weiss[SUP] 6 [/SUP], Bria M Coates[SUP] 7 [/SUP], Jennifer E Schuster[SUP] 8 [/SUP], Mark W Hall[SUP] 9 [/SUP], Ryan A Nofziger[SUP] 10 [/SUP], Heidi R Flori[SUP] 11 [/SUP], Shira J Gertz[SUP] 12 [/SUP], Michele Kong[SUP] 13 [/SUP], Ronald C Sanders Jr[SUP] 14 [/SUP], Katherine Irby[SUP] 14 [/SUP], Janet R Hume[SUP] 15 [/SUP], Melissa L Cullimore[SUP] 16 [/SUP], Steven L Shein[SUP] 17 [/SUP], Neal J Thomas[SUP] 18 [/SUP], Kristen Miller[SUP] 1 [/SUP], Manish Patel[SUP] 4 [/SUP], Anne M Fitzpatrick[SUP] 19 [/SUP], Wanda Phipatanakul[SUP] 20 [/SUP], Adrienne G Randolph[SUP] 21 [/SUP], PALISI Pediatric Intensive Care Influenza (PICFLU) Network Investigators
Affiliations
- PMID: 36379408
- DOI: 10.1016/j.jaip.2022.10.045
Abstract
Background: Hospitalization for severe influenza infection in childhood may result in post-discharge sequelae.
Objective(s): To evaluate inpatient management and post-discharge sequelae in children with critical respiratory illness due to influenza with or without pre-existing asthma.
Methods: Prospective, observational multicenter study of children (8-months to 17-years-old) admitted to a pediatric intensive care or high-acuity unit (11/2019-4/2020) for influenza. Results were stratified by pre-existing asthma. Pre-hospital status, hospital treatments and outcomes were collected. Surveys at approximately 90 days post-discharge evaluated post-discharge health resource use, functional status, and respiratory symptoms.
Results: 165 children with influenza: 56 (33.9%) with and 109 (66.1%) without pre-existing asthma (41.1% and 39.4% fully vaccinated against influenza, respectively). Fifteen (26.7%) patients with and 34 (31.1%) without pre-existing asthma were intubated. More patients with versus without pre-existing asthma received pharmacologic asthma treatments during hospitalization (76.7% vs 28.4%). Of 136 (82.4%) patients with 90-day survey data (46 [33.8%] with and 90 [66.1%] without pre-existing asthma), a similar proportion had an Emergency Department/urgent care visit (4.3%, 6.6%) or hospital readmission (8.6%, 3.3%) for a respiratory condition. Patients with pre-existing asthma more frequently experienced asthma symptoms (78.2% vs 3.3%) and had respiratory specialist visits (52% vs 20%) post-discharge. Ten of 109 (11.1%) patients without pre-existing asthma reported being newly diagnosed with asthma.
Conclusions: Respiratory health resource use and symptoms are important post-discharge outcomes after influenza critical illness in children with and without pre-existing asthma. Less than half of children were vaccinated for influenza, a tool that could mitigate critical illness and its sequelae.
Keywords: acute respiratory viral infection; asthma; influenza; outcomes; pediatric intensive care unit; reactive airway disease.