Exploration of clinical characteristics of influenza A virus infection in children / 中国小儿急救医学

ABSTRACT

Objective:To explore the clinical characteristics of influenza A virus infection in children, and provide evidence for early identification of severe patients.Methods:A total of 114 patients with influenza like symptoms admitted to Shanghai Children′s Medical Center from October 2017 to May 2019 were enrolled in our study.All the patients were confirmed influenza A infection by Xpert-Xpress influenza/respiratory syncytial virus detection platform.The patients were divided into mild influenza A group (47 cases) and severe influenza A group (67 cases with pneumonia). The clinical data of these patients were analyzed and compared.Results:The male to female ratio of 114 cases was 1.28∶1.The age of included patients ranged from 1 month 12 days to 12 years old, and the median age was 3.00 (4.27) years old.The most common clinical manifestations were fever, cough and wheezing, accounting for 79.82%, 68.42%, and 43.00%, respectively.The rate of mixed infection was 24.56%, and adenovirus(5.26%), respiratory syncytial virus(4.39%) as well as mycoplasma(3.51%) accounted for the top three, and the rate of mixed bacterial infection was 12.28%.The median age of the patients in the severe influenza A group was 1.00 (3.58) years, and that in the mild influenza A group was 4.00 (5.00) years, with statistical difference ( Z=-3.81, P<0.001). The mixed infection rate was 38.80% (26/67) in severe influenza A group and 4.26% (2/47) in mild influenza A group, with statistical difference ( χ2= 17.8, P<0.001). The neutrophil/lymphocyte ratio in peripheral blood was 2.64 (3.37) in severe influenza A group and 1.17 (2.02) in mild influenza A group, with statistical difference ( χ2=-2.46, P=0.01). Conclusion:Children with smaller age, mixed infection and higher neutrophil/lymphocyte ratio are easy to develop into severe cases.The detection system of Xpert-Xpress influenza / respiratory syncytial virus is a simple, rapid and accurate method for influenza detection, which provides a good basis for diagnosis and treatment.