Clinical characteristics of influenza virus infection and risk factors analysis of severe cases in children / 中国小儿急救医学

ABSTRACT

Objective:To analyze the clinical characteristics and laboratory examinations of hospitalized children with influenza, and improve medical personal awareness of severe influenza.Methods:Data of inpatients with influenza from November 2018 to February 2019 at Shenzhen Children′s Hospital was collected, and the clinical characteristics and laboratory examinations were statistical analyzed.Results:Of the 702 cases, 464(66.1%) cases were mild influenza, and 238 cases(33.9%)were severe influenza; the median age was 3.8 years, and 457(65.1%) cases were 0 to 5 years old.The number of patients with basic diseases and wheezing symptoms in the severe group was more than those in the mild group, with statistically significant differences(all P<0.05). The white blood cell count, percentage of neutrophils, neutrophils to lymphocytes ratio(NLR), C-reactive protein and procalcitonin in the severe group were higher than those in the mild group, while the percentage of lymphocytes was lower than that in the mild group(all P<0.05). Logistic multivariate regression analysis showed that underlying diseases, wheezing and NLR were risk factors for severe influenza.The area under the curve of NLR for severe influenza was 0.574, whose best cutoff value was 1.43. Conclusion:Influenza virus infection among children is mainly influenza A, and mostly affected children are under 5 years old.The blood routine of children with severe influenza mostly showes increased white blood cell, mainly neutrophils increased significantly, and increased C-reactive protein and procalcitonin.Children with underlying diseases, wheezing symptoms during the course of the disease, and elevated NLR are more likely to progress to severe cases, and NLR cannot be used as a independent predictor of severe influenza.