Yu Shi1, Weiming Chen2, Mei Zeng3, Guomei Shen4, Chengjun Sun5, Gongbao Liu1, Hairong Gong2, Chuanqing Wang6, Mengmeng Ge7, Jin Xu8, Libo Wang9, Aizhen Lu10, Guoping Lu11, Xiaowen Zhai12. 1. Division of Medical Administration, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, China. 2. Department of Critical Care Medicine, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, China. 3. Department of Infectious Disease, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, China. 4. Outpatient and Emergency Management Office, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, China. 5. Department of Endocrinology, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, China. 6. Department of Hospital Infection Control, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, China. 7. Department of Neonatology, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, China. 8. Department of Clinical Laboratory, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, China. 9. Department of Respiration, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, China; Department of Pediatrics, Jinshan Hospital of Fudan University, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, China. 10. Department of Respiration, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, China; Department of Pediatrics, Central Hospital of Minhang District, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, China. 11. Department of Critical Care Medicine, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, China. Electronic address: 13788904150@163.com. 12. Department of Hematology/Oncology, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, China; Hospital Administration, National Children's Medical Center, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, China. Electronic address: zhaixiaowendy@163.com.
Abstract
BACKGROUND: The incidence and mortality of influenza in children had risen, but data are limited on children with severe influenza virus infection in China. METHODS: We conducted a retrospective case-control study and collected the patients' clinical data. Clinical data including demography, clinical presentation, laboratory findings, radiologic findings, treatment and outcomes were collected. Children were clinically confirmed to have virus infection in Shanghai in three hospitals from June 2014 to June 2019. RESULTS: During the study, 36,047 children were enrolled. Among them, 118 met the criteria for severe flu. Clinical symptoms such as fever, cough, gastrointestinal symptoms, coma and epilepsy were higher in the severe group. Complications such as pneumorrhagia, heart failure, septic shock, acute renal failure and influenza-associated encephalitis were higher in the severe influenza group than the death group. The laboratory findings including decreased hemoglobin, high alanine aminotransferase, high urea nitrogen and high lactate levels were risk factors for death in children with influenza. CONCLUSION: Influenza-associated encephalopathy (IAE), acute respiratory distress syndrome (ARDS) were the common clinical manifestations and complications for the severe influenza, and delayed use of oseltamivir was found to be associated with fatality.
BACKGROUND: The incidence and mortality of influenza in children had risen, but data are limited on children with severe influenzavirus infection in China. METHODS: We conducted a retrospective case-control study and collected the patients' clinical data. Clinical data including demography, clinical presentation, laboratory findings, radiologic findings, treatment and outcomes were collected. Children were clinically confirmed to have virus infection in Shanghai in three hospitals from June 2014 to June 2019. RESULTS: During the study, 36,047 children were enrolled. Among them, 118 met the criteria for severe flu. Clinical symptoms such as fever, cough, gastrointestinal symptoms, coma and epilepsy were higher in the severe group. Complications such as pneumorrhagia, heart failure, septic shock, acute renal failure and influenza-associated encephalitis were higher in the severe influenza group than the death group. The laboratory findings including decreased hemoglobin, high alanine aminotransferase, high ureanitrogen and high lactate levels were risk factors for death in children with influenza. CONCLUSION:Influenza-associated encephalopathy (IAE), acute respiratory distress syndrome (ARDS) were the common clinical manifestations and complications for the severe influenza, and delayed use of oseltamivir was found to be associated with fatality.