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Life-Threatening Complications of Influenza versus COVID-19 in U.S. Children.
Halasa, Natasha B; Spieker, Andrew J; Young, Cameron C; Olson, Samantha M; Newhams, Margaret M; Amarin, Justin Z; Moffitt, Kristin L; Nakamura, Mari M; Levy, Emily R; Soma, Vijaya L; Talj, Rana; Weiss, Scott L; Fitzgerald, Julie C; Mack, Elizabeth H; Maddux, Aline B; Schuster, Jennifer E; Coates, Bria M; Hall, Mark W; Schwartz, Stephanie P; Schwarz, Adam J; Kong, Michele; Spinella, Philip C; Loftis, Laura L; McLaughlin, Gwenn E; Hobbs, Charlotte V; Rowan, Courtney M; Bembea, Melania M; Nofziger, Ryan A; Babbitt, Christopher J; Bowens, Cindy; Flori, Heidi R; Gertz, Shira J; Zinter, Matt S; Giuliano, John S; Hume, Janet R; Cvijanovich, Natalie Z; Singh, Aalok R; Crandall, Hillary A; Thomas, Neal J; Cullimore, Melissa L; Patel, Manish M; Randolph, Adrienne G.
  • Halasa NB; Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Spieker AJ; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Young CC; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
  • Olson SM; COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, GA, USA.
  • Newhams MM; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
  • Amarin JZ; Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Moffitt KL; Division of Infectious Diseases, Boston Children's Hospital, Boston, MA, USA.
  • Nakamura MM; Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
  • Levy ER; Division of Infectious Diseases, Boston Children's Hospital, Boston, MA, USA.
  • Soma VL; Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
  • Talj R; Antimicrobial Stewardship Program, Boston Children's Hospital, Boston, MA, USA.
  • Weiss SL; Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.
  • Fitzgerald JC; Department of Pediatrics, Division of Infectious Diseases, New York University Grossman School of Medicine and Hassenfeld Children's Hospital, New York, New York, USA.
  • Mack EH; Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Maddux AB; Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
  • Schuster JE; Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
  • Coates BM; Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, SC, USA.
  • Hall MW; Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA.
  • Schwartz SP; Division of Pediatric Infectious Disease, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA.
  • Schwarz AJ; Division of Pediatric Critical Care Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
  • Kong M; Division of Critical Care Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA.
  • Spinella PC; Department of Pediatrics, Division of Critical Care, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
  • Loftis LL; Division of Critical Care Medicine, CHOC Children's Hospital,  Orange, CA, USA.
  • McLaughlin GE; Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
  • Hobbs CV; Division of Critical Care, Department of Pediatrics, Washington University School of Medicine in St Louis, St. Louis, MO, USA.
  • Rowan CM; Section of Critical Care Medicine, Department of Pediatrics, Texas Children's Hospital, Houston, TX, USA.
  • Bembea MM; Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA.
  • Nofziger RA; Department of Pediatrics, Division of Disease; Microbiology; University of Mississippi Medical Center,  Jackson, MS, USA.
  • Babbitt CJ; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, IN, USA.
  • Bowens C; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • Flori HR; Division of Critical Care Medicine, Akron Children's Hospital, Akron, OH, USA.
  • Gertz SJ; Miller Children's and Women's Hospital of Long Beach, Long Beach, CA, USA.
  • Zinter MS; Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, TX, USA.
  • Giuliano JS; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor, MI, USA.
  • Hume JR; Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ, USA.
  • Cvijanovich NZ; Department of Pediatrics, Division of Critical Care, University of California San Francisco, San Francisco, CA, USA.
  • Singh AR; Department of Pediatrics, Division of Critical Care, Yale University School of Medicine, New Haven, CT, USA.
  • Crandall HA; Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA.
  • Thomas NJ; Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA.
  • Cullimore ML; Pediatric Critical Care Division, Maria Fareri Children's Hospital at Westchester Medical Center and New York Medical College, Valhalla, NY, USA.
  • Patel MM; Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.
  • Randolph AG; Department of Pediatrics, Penn State Hershey Children's Hospital, Pennsylvania State University College of Medicine, Hershey, PA, USA.
Clin Infect Dis ; 2022 Jun 19.
Article in English | MEDLINE | ID: covidwho-2230704
ABSTRACT

BACKGROUND:

Clinical differences between critical illness from influenza infection versus coronavirus disease 2019 (COVID-19) have not been well characterized in pediatric patients.

METHODS:

We compared U.S. children (8 months to 17 years) admitted to the intensive care or high acuity unit with influenza (17 hospitals, 12/19/2019-3/9/2020) or COVID-19 (52 hospitals, 3/15/2020-12/31/2020). We compared demographics, underlying conditions, clinical presentation, severity, and outcomes. Using mixed-effects models, we assessed the odds of death or requiring life-support for influenza versus COVID-19 after adjustment for age, sex, race and Hispanic origin, and underlying conditions including obesity.

RESULTS:

Children with influenza (n = 179) were younger than those with COVID-19 (n = 381; median 5.2 vs. 13.8 years), less likely to be non-Hispanic black (14.5% vs. 27.6%) or Hispanic (24.0% vs. 36.2%), and less likely to have ≥1 underlying condition (66.4% vs. 78.5%) or be obese (21.4% vs. 42.2%). They were similarly likely to require invasive mechanical ventilation (both 30.2%), vasopressor support (19.6% and 19.9%), or extracorporeal membrane oxygenation (2.2% and 2.9%). Four children with influenza (2.2%) and 11 children with COVID-19 (2.9%) died. The odds of death or requiring life-support in children with influenza vs. COVID-19 were similar (adjusted odds ratio, 1.30 [95% CI 0.78-2.15; P = 0.32]). Median duration of hospital stay was shorter for influenza than COVID-19 (5 versus 7 days).

CONCLUSIONS:

Despite differences in demographics and clinical characteristics of children with influenza or COVID-19, the frequency of life-threatening complications was similar. Our findings highlight the importance of implementing prevention measures to reduce transmission and disease severity of influenza and COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Language: English Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Language: English Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid