Influenza-associated Neurologic Complications in Hospitalized Pediatric Patients

Choi, Gyu Seong; Park, Ji Young; Choi, Joon-Sik; Choi, Sae Rom; Kim, Dongsub; Lee, Jun Hwa; Woo, Young Jong; Lee, Jeehun; Kim, Yae-Jean

doi:10.1097/inf.0000000000003332

Cited by 12 publications

(8 citation statements)

References 30 publications

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“…Severe neurologic complications of influenza, including influenza-associated encephalopathy, are thought to be caused by cytokine storm [23], and therefore, GC therapy may be helpful for preventing or treating severe neurologic complications as well as severe pulmonary complications in patients with influenza. However, recent studies failed to show significant results on the effects of NAI therapy and GC therapy on the development of influenza-associated neurologic complications [24,25]. Because neurologic complications occurred within a few days of influenza symptoms, NAI therapy and GC therapy were initiated after the development of neurologic complications in most patients [24,25].…”

Section: Discussionmentioning

confidence: 99%

“…However, recent studies failed to show significant results on the effects of NAI therapy and GC therapy on the development of influenza-associated neurologic complications [24,25]. Because neurologic complications occurred within a few days of influenza symptoms, NAI therapy and GC therapy were initiated after the development of neurologic complications in most patients [24,25]. Moreover, early steroid pulse therapy initiated within 2 days of admission did not show a significant effect in pediatric patients with influenza-associated encephalopathy [26].…”

Section: Discussionmentioning

confidence: 99%

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Effects of Antiviral Therapy and Glucocorticoid Therapy on Fever Duration in Pediatric Patients with Influenza

et al. 2021

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Background and Objectives: Considering developing resistance against neuraminidase inhibitors (NAIs) and their adverse reactions, restricted use of NAIs and use of alternative drugs should be considered for treating influenza. Although glucocorticoids (GCs) have been used for severe influenza, their effects on non-severe influenza have rarely been evaluated. This study aimed to evaluate the clinical responses to NAI therapy and GC therapy in pediatric patients with non-severe influenza. Materials and Methods: A total of 601 pediatric patients (<19 years of age) diagnosed with non-severe influenza were retrospectively recruited to evaluate the effects of NAI therapy and GC therapy. Post-admission fever duration and hospitalization duration were compared among four patient groups divided by the administered treatment: No therapy (n = 52), NAI therapy (n = 154), GC therapy (n = 123), and Both therapies (n = 272). Results: In a multivariate analysis with adjustment for confounding variables, the post-admission fever duration was not significantly different among the four patient groups. The post-admission fever duration tended to shorten with increasing age, longer pre-admission fever duration, and incidence of influenza A virus infection and lower respiratory tract infection. The type of administered treatment showed no significant effects on the post-admission fever duration in any subgroups according to patient age, pre-admission fever duration, influenza virus subtype, and clinical diagnosis. Conclusions: Symptomatic treatment rather than antiviral or GC therapy seems to be sufficient for patients with non-severe influenza, although the effects of NAI therapy and GC therapy according to their administered time and dose should be further evaluated.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effects of Antiviral Therapy and Glucocorticoid Therapy on Fever Duration in Pediatric Patients with Influenza

et al. 2021

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“…vaikų gripas komplikavosi encefalitu. Šiame tyrime dar buvo pastebėta, kad vaikams, prieš susirgimą jau turėjusiems neurologinių ligų, nustatytas didesnis su gripo infekcija susijusių neurologinių komplikacijų dažnis [16]. Kitų tyrimų duomenimis, neurologinėmis ligomis sergančių vaikų gerokai didesnė rimtų komplikacijų ir mirties rizika [17].…”

Section: Gabija Vaikšnoraitė Vilniaus Universiteto Medicinos Fakultetasunclassified

Vaikų Gripo Komplikacijų Dažnis Ir Rizikos Veiksniai

Vaikšnoraitė

2022

Health Sciences

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Gripas yra sezoninė virusinė infekcija, kurią sukelia A ir B tipo gripo virusai. Kiekvienais metais gripu užsikrečia maždaug 10-20 proc. pasaulio gyventojų, iš jų 3–5 mln. hospitalizuojami, o 300 000 – 650 000 miršta dėl sunkios ligos eigos ir gripo sukeltų komplikacijų. Tyrimo tikslas − remiantis naujausiomis mokslinėmis publikacijomis, išanalizuoti įrodymais pagrįstąinformacijąapie vaikų gripo komplikacijų dažnį ir rizikos veiksnius bei prevenciją. Atlikta 26 publikacijų mokslinė apžvalga. Moksliniai straipsniai atrinkti naudojantis PubMed ir Google Scholar duomenų bazėmis. Straipsnių atrankos kriterijai: publikacijos anglų kalba, atitinkančios tyrimo temą.

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“…These figures represent a substantial burden, as RSV annually causes up to 3.2 million hospitalizations [ 1 , 6 , 12 , 13 , 14 ], and direct costs have to be pooled to the indirect ones associated with the long-term management of RSV infections [ 15 ]. When dealing with clinical features, with a reporting rate approaching 85% of cases, seizures have been identified as the most frequent ones, reflecting the heterogeneous nature of the RSV effects on the central nervous system (CNS), similarly to other respiratory viruses such as influenza virus adenovirus, and even SARS-CoV-2 [ 11 , 16 , 17 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Respiratory Syncytial Virus: An Uncommon Cause of Febrile Seizures—Results from a Systematic Review and Meta-Analysis

et al. 2022

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Human Respiratory Syncytial Virus (RSV) is a highly contagious viral pathogen. In infants, it is usually listed among the main causes of medical referrals and hospitalizations, particularly among newborns, and a considerable base of evidence associates RSV infections and bronchiolitis with long-term neurological sequelae. We specifically performed a systematic review and meta-analysis in order to ascertain whether RSV infections may be associated with an increased risk for febrile seizures (FS) in infected infants. According to the PRISMA statement, Pubmed, Embase, and pre-print archive medRxiv.og were searched for eligible observational studies published up to 1 July 2022. Raw data included the incidence of FS among children admitted for influenza-like illness (ILI) and/or bronchiolitis, with a confirmed diagnosis of RSV or seasonal influenza virus (SIV) infection. Data were then pooled in a random-effects model. Heterogeneity was assessed using the I2 measure, while reporting bias was assessed by means of funnel plots and regression analysis. A total of 11 studies including 6847 cases of RSV infections were retrieved, with a pooled prevalence of 29.975 cases of FS per 1000 RSV cases (I2 = 88.5%). The prevalence was not substantially greater in studies performed in pediatric intensive care units (53.817 per 1000 RSV cases vs. 23.552, p = 0.12). Higher occurrence of FS was reported from studies performed after 2010 (Risk Ratio [RR] 1.429, 95% Confidence Interval [95%CI] 1.049–1.948), and in China (RR 2.105, 95%CI 1.356–3.266) and South Africa (RR 1.722, 95%CI 1.060–2.824) than in Europe, while a lower occurrence was reported form the USA (RR 0.414, 95%CI 0.265–0.649). Eventually, FS were less likely reported from RSV cases compared to subjects affected by seasonal influenza (RR 0.402; 95%CI 0.228–0.708). Although RSV is often associated with high risk of neurological complications, substantially less cases of FS are reported than in SIV infections. However, the paucity of available studies recommends a cautious appraisal of aforementioned results.

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Influenza-associated Neurologic Complications in Hospitalized Pediatric Patients

Cited by 12 publications

References 30 publications

Effects of Antiviral Therapy and Glucocorticoid Therapy on Fever Duration in Pediatric Patients with Influenza

Effects of Antiviral Therapy and Glucocorticoid Therapy on Fever Duration in Pediatric Patients with Influenza

Vaikų Gripo Komplikacijų Dažnis Ir Rizikos Veiksniai

Respiratory Syncytial Virus: An Uncommon Cause of Febrile Seizures—Results from a Systematic Review and Meta-Analysis

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