Comparison of Clinical Presentations and Disease Severity of Children
Hospitalized with Influenza A and B
Abstract
The impact of influenza B (FLUB) was relatively less researched than
influenza A (FLUA), because of its lower pandemic potential. We aimed to
compare the clinical presentations and disease severity between FLUA and
B. This study involved children hospitalized with
virologically-confirmed influenza between 2010-2020. The disease
severity was assessed according to admission to the intensive care unit
(ICU), mechanical ventilation requirement, length of hospital, and ICU
stay and death. FLUA and B were compared within predefined age groups
(0-2, 3-9, and 10-18 years) and in all age groups. Of 343 patients, FLUA
and B were detected in 260 (75.8%) and 83 (24.2%) children,
respectively. Headache and abdominal pain were more common in FLUB
(P<0.05). Children with FLUA were prescribed antibiotics and
antivirals 1.6 and 2.3-fold more than those with FLUB. From subgroup
analysis by age, patients between 3-9 with FLUB had a higher rate of
headache and abdominal pain; additionally, headache occurred in 5
(100%) children aged 10-18 years with FLUB and 10 (38.5%) with FLUA
(P<0.05). Children between 0-2 with FLUA were more often
admitted to ICU than those with FLUB (22.9% vs. 6.0%;
P<0.05). Eight patients with FLUA died, and one with FLUB
(P>0.05). The clinical presentation was similar between
FLUA and B, except for headache and abdominal pain, which were notably
more common in older patients with FLUB. Children aged 0-2 years with
FLUA had a significant risk for ICU admission. Higher levels of
awareness and attention should be paid to children under two years with
FLUA.