Key result
Post-pandemic pediatric influenza A is linked to more severe symptoms and ~91% more frequent low WBCs.
Why the study?
Since the outbreak of COVID-19 in late 2019, transmission dynamics and clinical presentation patterns of influenza A virus have undergone changes.
Cohort (n=885)
No
Hospitalized children with influenza A exhibited more severe clinical symptoms and laboratory abnormalities, including liver enzyme elevation and myositis, after the COVID-19 pandemic compared to before and during the pandemic.
Answers are grounded in this paper and cite their sources.
May warrant heightened vigilance for severe pediatric influenza A post-pandemic; observational data leaves open mechanisms and should not yet change practice.
CONTEXT: Since the outbreak of COVID-19 in late 2019, the transmission dynamics and clinical presentation patterns of influenza A (Flu A) virus have undergone changes. OBJECTIVES: This article conducted a comparative analysis in clinical characteristics and laboratory results of pediatric patients with Flu A before, during, and after the COVID-19 pandemic. METHODS: The medical records of 885 children hospitalized with Flu A virus infection at a tertiary hospital in Guangdong Province, China, were retrospectively analyzed. Flu A was confirmed in these cases using a direct immunofluorescence antigen assay. The clinical data for this study span from January 1, 2018, to May 31, 2023. RESULTS: In our study, we observed a total of 340 cases before the COVID-19 pandemic, 196 cases during the pandemic, and 349 cases after the pandemic. Patients after the pandemic had a higher median age on admission (5.66 years, range 3.41-7.70) and exhibited more respiratory symptoms such as cough, sore throat, and nasal stuffiness. The length of hospital stay was longer, and there was a higher percentage of patients with fever duration ≥ 5 days among Flu A patients during the pandemic. Compared to before and during the COVID-19 pandemic, Flu A patients after the pandemic showed significantly reduced white blood cell (WBC) and platelet (PLT) counts (P < 0.001), along with elevated levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in laboratory indexes (P < 0.001). Furthermore, more hospitalized children after the pandemic were diagnosed with benign acute childhood myositis (BACM). CONCLUSION: Our research results indicates a significant decrease in Flu A cases during the COVID-19 pandemic, and hospitalized children with Flu A have more severe clinical symptoms after the COVID-19 pandemic. These findings have implications for public health policy and clinical management of Flu A cases. CLINICAL TRIAL NUMBER: Not applicable.
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Lin et al. (2024) conducted a cohort in Influenza A (n=885). Post-COVID-19 pandemic period vs. Pre- and during-COVID-19 pandemic periods was evaluated on Reduced white blood cell (WBC) count (p=<0.001). Hospitalized children with influenza A after the COVID-19 pandemic exhibited more severe clinical symptoms, significantly reduced white blood cell and platelet counts, and elevated liver enzymes compared to before and during the pandemic.
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