Influenza-Associated Neurologic Complications in Hospitalized Children
Influenza-Associated Neurologic Complications in Hospitalized Children
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DOI：
10.1016/j.jpeds.2021.07.039
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发表时间：
2021-11-15
影响因子：
5.1
通讯作者：
McGuire, Jennifer L.
中科院分区：
文献类型：
--
作者：
Frankl, Sarah;Coffin, Susan E.;McGuire, Jennifer L.
目的明确在三级儿科医院住院的实验室确诊流感患儿中流感相关神经系统并发症的发生率和特征，并确定相关的临床、流行病学、研究设计这是一项历史性队列研究，研究对象为2010年至2017年期间住院的0. 5 - 18. 0岁儿童，确诊流感由于最近接受活病毒疫苗或最近解决的疾病而导致免疫受损或检测阳性的儿童被排除在外。流感相关的神经系统并发症被定义为新发的神经系统体征/症状，在急性流感疾病没有其他明确的病因。结果至少有1个流感相关的神经系统并发症被确定在10.8%（95%CI 9.1- 12.6%，n = 131 1217）的实验室确诊的流感住院。癫痫发作（n = 97）和脑病（n = 44）是最常见的流感相关神经系统并发症，尽管另外20例住院患者有其他流感相关神经系统并发症。有流感相关神经系统并发症的住院患者在年龄和流感类型（A/B）方面与无流感相关神经系统并发症的患者相似。有神经系统诊断的儿童（n = 326）与无神经系统诊断的儿童相比，流感相关神经系统并发症的比例更高（22.7% vs 6.4%，P <0.001）。存在既存神经系统诊断（aOR 4.6，P <0.001），缺乏季节性流感疫苗接种（aOR 1.6，P = 0.020）和年龄
Objectives To define the incidence and characteristics of influenza-associated neurologic complications in a cohort of children hospitalized at a tertiary care pediatric hospital with laboratory-confirmed influenza and to identify associated clinical, epidemiologic, and virologic factors.Study design This was an historical cohort study of children aged 0.5-18.0 years old hospitalized between 2010 and 2017 with laboratory-confirmed influenza. Children with immune compromise or a positive test due to recent receipt of live virus vaccine or recently resolved illness were excluded. Influenza-associated neurologic complications were defined as new-onset neurologic signs/symptoms during acute influenza illness without another clear etiology.Results At least 1 influenza-associated neurologic complication was identified in 10.8% (95% CI 9.1-12.6%, n = 131 of 1217) of hospitalizations with laboratory-confirmed influenza. Seizures (n = 97) and encephalopathy (n = 44) were the most commonly identified influenza-associated neurologic complications, although an additional 20 hospitalizations had other influenza-associated neurologic complications. Hospitalizations with influenzaassociated neurologic complications were similar in age and influenza type (A/B) to those without. Children with a pre-existing neurologic diagnosis (n = 326) had a greater proportion of influenza-associated neurologic complications compared with those without (22.7% vs 6.4%, P < .001). Presence of a pre-existing neurologic diagnosis (aOR 4.6, P < .001), lack of seasonal influenza vaccination (aOR 1.6, P = .020), and age