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Influenza-associated Neurologic Complications in Hospitalized Pediatric Patients: A Multicenter Retrospective Study in Republic of Korea

Authors
 Gwang-Jun Choi  ;  Ji Young Park  ;  Joon-Sik Choi  ;  Sae Rom Choi  ;  Dongsub Kim  ;  Jun Hwa Lee  ;  Young-Jong Woo  ;  Jeehun Lee  ;  Yae-Jean Kim 
Citation
 PEDIATRIC INFECTIOUS DISEASE JOURNAL, Vol.40(12) : E466-E471, 2021-12 
Journal Title
PEDIATRIC INFECTIOUS DISEASE JOURNAL
ISSN
 0891-3668 
Issue Date
2021-12
MeSH
Adolescent ; Antiviral Agents / therapeutic use ; Brain Diseases / virology* ; Child ; Child, Preschool ; Female ; Hospitalization / statistics & numerical data* ; Humans ; Infant ; Influenza A Virus, H1N1 Subtype / pathogenicity ; Influenza, Human / complications* ; Influenza, Human / drug therapy ; Male ; Oseltamivir / therapeutic use ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Seizures, Febrile / virology
Abstract
Background: The rates of influenza-associated neurologic complications are variable among studies, and a difference has been observed between the Western and Asian countries. The study aims to evaluate the frequency and characteristics of influenza-associated neurologic complications.

Methods: We performed a retrospective review of hospitalized cases of influenza infection from October 2010 to April 2017 from 3 referral hospitals.

Results: A total of 1988 influenza cases were identified. Influenza-associated neurologic complications were 161 cases (8.1%); influenza virus A was detected in 113 (70.2%) cases, B in 47 (29.2%) cases and both A and B in 1 case (0.6%). Twenty-four patients (15%) had underlying neurologic diseases. The most common diagnosis was a simple febrile convulsion (44%), followed by complex febrile convulsion (29%), fever-provoked seizure under pre-existing neurologic disease or afebrile seizure (14%), encephalopathy/encephalitis (8%) and meningitis (5%). Most of the patients fully recovered (96%). Three patients (1.9%) died of myocarditis (n = 1), encephalopathy (n = 1), and simultaneous encephalitis and myocarditis (n = 1). Pre-existing neurologic disease, age groups of 6 months to 6 years and 6-12 years were a risk factor of influenza-associated neurologic complications with an adjusted odds ratio of 5.41 (95% confidence interval [CI] 3.23-9.06, P < 0.001), 12.99 (95% CI 1.77-95.19, P = 0.01) and 8.54 (95% CI 1.14-64.79, P = 0.04), respectively. There was no association between neuropsychiatric adverse events and oseltamivir prescription (P = 0.17).

Conclusions: Influenza-associated neurologic complications are not uncommon, and most patients fully recovered. The frequency of influenza-associated neurologic complications in Korean children was not significantly different from that of children in Western countries.
Full Text
https://journals.lww.com/pidj/Fulltext/2021/12000/Influenza_associated_Neurologic_Complications_in.6.aspx
DOI
10.1097/INF.0000000000003332
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Choi, Joon Sik(최준식)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/190971
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