Bacterial coinfection (OR 9.07; 95% CI 5.29-15.54) and dual influenza A and B infection (OR 2.13; 95% CI 1.47-3.09) significantly increased the risk of influenza complications in children.
Cohort (n=6,193)
Yes
Do different influenza virus types and coinfections increase the risk of complications and need for advanced therapies in children with laboratory-confirmed influenza?
In children with influenza, dual influenza A and B infection, as well as bacterial or viral coinfections, significantly increase the risk of complications and the need for advanced therapies.
Effect estimate: OR 9.07 (95% CI 5.29-15.54)
p-value: p=<0.001
BACKGROUND/PURPOSE: This study investigated the demographic characteristics and influenza complications of paediatric patients and explored the association of different influenza virus types and viral and bacterial coinfections with disease severity. METHODS: This retrospective cohort study used data collected in 2010-2016 from the Chang Gung Research Database (CGRD), the largest collection of multi-institutional electronic medical records in Taiwan. Data were retrieved for children aged 0-18 years with laboratory-confirmed influenza. We extracted and analysed the demographic characteristics and the data on clinical features, complications, microbiological information, and advanced therapies of each case. RESULTS: We identified 6193 children with laboratory-confirmed influenza, of whom 1964 (31.7%) were hospitalised. The age of patients with influenza A infection was lower than that of patients with influenza B (4.48 vs. 6.68, p < 0.001). Patients with influenza B infection had a higher incidence of myositis or rhabdomyolysis (4.4%, p < 0.001) and a higher need for advanced therapies (OR, 1.96; 95% CI, 1.32-2.9, p < 0.001). In addition to bacterial (OR, 9.07; 95% CI, 5.29-15.54, p < 0.001) and viral coinfection (OR, 7.73; 95% CI, 5.4-11.07, p < 0.001), dual influenza A and B infection was also a risk factor for influenza complications (OR, 2.13; 95% CI, 1.47-3.09, p < 0.001). CONCLUSION: Dual influenza A and B infection and bacterial coinfection can contribute to influenza complications. Early recognition of any influenza complication is critical for the timely initiation of organ-specific advanced therapies to improve influenza-associated outcomes.
Chien et al. (Mon,) conducted a cohort in Laboratory-confirmed influenza (n=6,193). Bacterial coinfection, viral coinfection, or dual influenza A and B infection was evaluated on Influenza complications (OR 9.07, 95% CI 5.29-15.54, p=<0.001). Bacterial coinfection (OR 9.07; 95% CI 5.29-15.54) and dual influenza A and B infection (OR 2.13; 95% CI 1.47-3.09) significantly increased the risk of influenza complications in children.