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J Clin Virol . Predictors of unfavorable outcome in children hospitalized with influenza and differences in clinical presentation among serotypes

tetano

Editor, Senior Moderator
J Clin Virol


. 2022 Sep 22;157:105298.
doi: 10.1016/j.jcv.2022.105298. Online ahead of print.
Predictors of unfavorable outcome in children hospitalized with influenza and differences in clinical presentation among serotypes


Ranaa Damouni Shalabi[SUP] 1 [/SUP], Imad Kassis[SUP] 2 [/SUP], Moran Szwarcwort Cohen[SUP] 3 [/SUP], Halima Dabaja-Younis[SUP] 4 [/SUP]



Affiliations

Abstract

Background: Apart from age and underlying disease, predictors of adverse outcome in children hospitalized with influenza are poorly understood.
Objectives: Our goal is to determine clinical and laboratory predictors that help identify children at increased risk for an unfavorable course and identify differences in clinical presentation between serotypes.
Study design: A retrospective, observational cohort study conducted at the Rambam Healthcare Campus in Haifa. We analyzed data from electronic records of children < 18 years with influenza A or B infection hospitalized between 2009 and 2020. Multivariate regression analyses were used to identify predictors of unfavorable outcome, defined as mortality, ICU admission, intubation, prolonged length of stay, or bacterial coinfection.
Results: A total of 1077 children were included, of whom 54% were male. The median age was 2.5 years. Influenza A was detected in 797 (74%) and influenza B in 286 (26%) of the cases. Children with influenza A were younger (OR 2.51, 95%CI 1.90-3.33), more likely to have oxygen desaturation <90% (OR 2.44, 95%CI 1.23-4.83) and an elevated CRP>5 mg/dL on admission (OR 2.67, 95% CI 1.63-4.37). In multivariate analyses, oxygen desaturation <90% and CRP > 5 mg/dL at admission had an 11.1 and 4-fold increased risk of unfavorable outcome, respectively, in addition to a 3.1 and 1.6-fold increased risk in the presence of underlying condition or influenza A serotype infection, respectively.
Conclusions: Data available on admission can help identify children hospitalized with influenza who are at increased risk for complications and unfavorable outcome, encouraging aggressive treatment and care.

Keywords: Influenza A; Influenza B; Unfavorable outcome.
 
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