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J Trop Pediatr . Influenza Virus Associated Pediatric Acute Respiratory Distress Syndrome: Clinical Characteristics and Outcomes

tetano

Editor, Senior Moderator
J Trop Pediatr


. 2021 Oct 6;67(5):fmab090.
doi: 10.1093/tropej/fmab090.
Influenza Virus Associated Pediatric Acute Respiratory Distress Syndrome: Clinical Characteristics and Outcomes


Nazik Yener[SUP] 1 [/SUP], Muhammed Üdürgücü[SUP] 1 [/SUP], Resul Yılmaz[SUP] 2 [/SUP], Tanıl Kendirli[SUP] 3 [/SUP], Nazan Ülgen Tekerek[SUP] 4 [/SUP], Gültaç Evren[SUP] 5 [/SUP], Hatice Feray Arı[SUP] 6 [/SUP], Dinçer Yıldızdaş[SUP] 7 [/SUP], Demet Demirkol[SUP] 8 [/SUP], Ethem Pişkin[SUP] 9 [/SUP], Muhterem Duyu[SUP] 10 [/SUP], Tahir Dalkıran[SUP] 11 [/SUP], Nihal Akçay[SUP] 12 [/SUP], Nilüfer Yalındağ Öztürk[SUP] 13 [/SUP], Osman Yeşilbaş[SUP] 14 [/SUP], Gürkan Bozan[SUP] 15 [/SUP], Anar Gurbanov[SUP] 3 [/SUP], Hatice Albayrak[SUP] 1 [/SUP]



Affiliations

Abstract

Background and objective: The aim of this multicenter retrospective study was to determine the clinical characteristics, treatment approaches and the course of pediatric acute respiratory distress syndrome (PARDS) which developed associated with the influenza virus in the 2019-20 season.
Methods: Patients included 1 month to 18 years who were diagnosed with PARDS associated with the influenza virus in the 2019-20 season.
Results: Sixty-seven patients were included in the study. The mean age of the patients was 64.16 ± 6.53 months, with 60% of the group <5 years. Influenza A was determined in 54 (80.5%) patients and Influenza B in 13 (19.5%). The majority of patients (73.1%) had a comorbidity. Fifty-eight (86.6%) patients were applied with invasive mechanical ventilation, Pediatric Acute Lung Injury Consensus Conference classification was mild in 5 (8.6%), moderate in 22 (37.9%) and severe in 31 (52.5%) patients. Ventilation was applied in the prone position to 40.3% of the patients, and in nonconventional modes to 24.1%. A total of 22 (33%) patients died, of which 4 had been previously healthy. Of the surviving 45 patients, 38 were discharged without support and 7 patients with a new morbidity.
Conclusion: Both Influenza A and Influenza B cause severe PARDS with similar characteristics and at high rates. Influenza-related PARDS cause 33% mortality and 15.5% morbidity among the study group. Healthy children, especially those aged younger than 5 years, are also at risk.

Keywords: acute respiratory distress syndrome; influenza; mechanical ventilation; morbidity; mortality; pediatric.
 
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