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At the last congress of World Federation of Pediatric Intensive & Critical Care Societies (WFPICCS 2022), which took place online from July 12 to 16, researchers from Spain presented the study Influenza Virus Infection in children admitted to the Pediatric Intensive Care Unit, whose objective was to write the frequency, clinical evolution and complications of influenza in a Neonatal and Pediatric Intensive Care Unit (ICU) during five epidemic seasons. In general, the flu is benign, although it can cause serious complications on occasion.
Methodology
A retrospective observational study was performed, which included patients diagnosed with influenza admitted to the ICU between 2015 and 2022. The following data were collected: demographic variables, morbidity, virus serotype, treatments, mortality, and length of stay in the ICU.
Results
A total of 25 pediatric patients were admitted to the unit with a diagnosis of influenza. The median age of these patients was 2 years (interquartile range [IQR] 2 – 6.5) years. Fifty-two percent were male and 40% had associated morbidity.
Influenza A represented 80%, influenza B 12% and influenza A+B coinfection was equal to 8%. Bacterial coinfection was present in 20%, with the most common organisms being Streptococcus pneumoniae and Streptococcus pyogenes.
Complications such as sepsis/septic shock, bacterial pneumonia, pleural effusion, myocarditis, supraventricular tachycardia, and seizures occurred in 80% of cases; 64% received antibiotic therapy and 40% oseltamivir. The use of non-invasive mechanical ventilation (NIV) was required in 48%. Invasive mechanical ventilation (IMV) was performed in 28% and 20% received inotropic vasopressor drugs.
During the Covid-19 pandemic, there were no hospitalizations for influenza in the 2020-2021 season, with the first hospitalization taking place in March 2022. 24 influenza-free months were observed. During the study period, the mean ICU stay was two days. [IQR 2 – 6,5]. Three children died (12%).
conclusions
The researchers observed a high rate of complications and mortality, particularly during the last pre-pandemic Covid-19 season. Since then, they have reported that they have had only one mild case admitted. Thus, they believe that preventive measures against the SARS-CoV-2 virus probably contributed to reducing the transmission of influenza.
Comment
Despite being retrospective and carried out in only one center, this study shows us how serious an influenza condition can be, reinforcing the need for health professionals to educate the population on the importance of vaccination in the pediatric age group.
More from the congress:
Author:
Graduated in Medicine at Faculdade de Medicina de Valença ⦁ Medical residency in Pediatrics at Hospital Federal Cardoso Fontes ⦁ Medical residency in Pediatric Intensive Medicine at Hospital dos Servidores do Estado do Rio de Janeiro. Master in Maternal and Child Health (UFF) ⦁ Doctor in Medicine (UERJ) ⦁ Improvement in Neurointensivism (IDOR) ⦁ Physician at the Pediatric Intensive Care Unit (PICU) at the Pedro Ernesto University Hospital (HUPE) at UERJ ⦁ Assistant Professor of Pediatrics at the Medical School at Fundação Técnico-Educacional Souza Marques ⦁ Member of the Brazilian Pediatrics Research Network at IDOR in Rio de Janeiro ⦁ Followed the Pediatric and Cardiac ICU of the Hospital for Sick Children (Sick Kids) in Toronto, Canada, supervised by Dr. Peter Cox ⦁ Member of the Brazilian Society of Pediatrics (SBP) and the Associação de Medicina Intensiva Brasileira (AMIB) ⦁ Member of the sedation, analgesia and delirium committee of the AMIB and the Latin American Society of Pediatric Intensive Care (SLACIP) ⦁ Member of the board of the American Delirium Society (ADS) ⦁ Coordinator and co-founder of the Latin American Delirium Special Interest Group (LADIG) ⦁ Supporting Member of the Society for Pediatric Sedation (SPS) ⦁ Infant Sleep and Breastfeeding Consultant ⦁ Instagram: @draroberta_pediatra
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