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Influenza ups risk of ICU admission, bacterial pneumonia in children with SRMC

16 Sep 2019

An increase in intensive care unit (ICU) management and bacterial pneumonia development occurs in children with special risk medical conditions (SRMC), but a rise in the probability of death or need for mechanical ventilation remains inconsistent, suggests a recent study.

“Children with SRMC are over-represented in influenza hospitalizations,” the investigators said.

A systematic review was conducted to establish whether children with SRMCs experience greater complications or severity following influenza infection.

The databases of Medline and Embase were searched for pertinent articles from 1990 to March 2018. Researchers of unpublished studies containing relevant data were also contacted. Twenty-two studies of children aged ≤18 years with SRMC hospitalized with influenza were included.

Outcomes measured included pneumonia, ICU admission, mechanical ventilation, neurologic outcomes (eg, seizures, encephalopathy), death, and length of stay in hospital or ICU.

Children with SRMC, compared with their healthy peers, were at greater risk of ICU admission (pooled odds ratio [OR], 1.66, 95 percent CI, 1.25–2.21), mechanical ventilation (pooled OR, 1.53, 0.93–2.52) and death (pooled OR, 1.34, 0.74–2.41).

Children with SRMC also had higher odds of developing bacterial pneumonia (crude OR, 1.7, 1.1–2.6) or of experiencing prolonged hospital length of stay (adjusted rate ratio, 1.75, 1.44–2.11). However, the level of GRADE evidence was low for all outcomes considered in this review.

“Further research using large datasets should evaluate the impact of complications and associated morbidity from influenza in SRMC children,” the investigators said.

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Tristan Manalac, 14 May 2020
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