Life-Threatening Complications of Influenza vs Coronavirus Disease 2019 (COVID-19) in US Children

BACKGROUND: Clinical differences between critical illness from influenza infection vs coronavirus disease 2019 (COVID-19) have not been well characterized in pediatric patients. METHODS: We compared demographics, clinical characteristics, and outcomes of US children (aged 8 months to 17 years) admitted to the intensive care or high-acuity unit with influenza or COVID-19. Using mixed-effects models, we assessed the odds of death or requiring life support for influenza vs COVID-19 after adjustment for age, sex, race and Hispanic origin, and underlying conditions including obesity. RESULTS: Children with influenza (n = 179) were younger than those with COVID-19 (n = 381; median, 5.2 years vs 13.8 years), less likely to be non-Hispanic Black (14.5% vs 27.6%) or Hispanic (24.0% vs 36.2%), and less likely to have ≥1 underlying condition (66.4% vs 78.5%) or be obese (21.4% vs 42.2%), and a shorter hospital stay (median, 5 days vs 7 days). They were similarly likely to require invasive mechanical ventilation (both 30.2%), vasopressor support (19.6% and 19.9%), or extracorporeal membrane oxygenation (2.2% and 2.9%). Four children with influenza (2.2%) and 11 children with COVID-19 (2.9%) died. The odds of death or requiring life support in children with influenza vs COVID-19 were similar (adjusted odds ratio, 1.30; 95% confidence interval, .78-2.15; P = .32). CONCLUSIONS: Despite differences in demographics and clinical characteristics of children with influenza or COVID-19, the frequency of life-threatening complications was similar. Our findings highlight the importance of implementing prevention measures to reduce transmission and disease severity of influenza and COVID-19.

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Publication Details

Journal
UNC Libraries
Published
2025-04-16
DOI
https://doi.org/10.17615/8twe-4q21
Primary Topic
Infectious Encephalopathies and Encephalitis
Type
article
Field-Weighted Citation Impact
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article

Life-Threatening Complications of Influenza vs Coronavirus Disease 2019 (COVID-19) in US Children

Andrew J. Spieker, Jennifer E. Schuster, Janet R. Hume, Emily R. Levy et al.
UNC Libraries
Infectious Encephalopathies and Encephalitis
article

Life-Threatening Complications of Influenza vs Coronavirus Disease 2019 (COVID-19) in US Children

Andrew J. Spieker, Jennifer E. Schuster, Janet R. Hume, Emily R. Levy, Margaret M. Newhams, Bria M. Coates, Kristin Moffitt, Justin Z. Amarin, Ryan A. Nofziger, Charlotte V. Hobbs, Vijaya L Soma, Mari Nakamura, Philip Charles Spinella, Natalie Z. Cvijanovich, John S. Giuliano, Natasha Halasa, Aalok R. Singh, Laura L. Loftis, Melissa L. Cullimore, Aline B. Maddux, Melania M. Bembea, Cameron C. Young, Scott L. Weiss, Rana Talj, Overcoming COVID- Investigators, Stephanie P. Schwartz, Shira J. Gertz, Matt S. Zinter, Neal J. Thomas, Heidi R. Flori, Cindy Bowens, Adrienne G. Randolph, Elizabeth H. Mack, Michele Kong, Samantha M. Olson, Courtney Marie Rowan, Julie C. Fitzgerald, Christopher J. Babbitt, Adam J. Schwarz, Manish Patel, Hillary A Crandall, Mark W. Hall, Gwenn E. McLaughlin, Pediatric Intensive Care Influenza Investigators
article en

Abstract

BACKGROUND: Clinical differences between critical illness from influenza infection vs coronavirus disease 2019 (COVID-19) have not been well characterized in pediatric patients. METHODS: We compared demographics, clinical characteristics, and outcomes of US children (aged 8 months to 17 years) admitted to the intensive care or high-acuity unit with influenza or COVID-19. Using mixed-effects models, we assessed the odds of death or requiring life support for influenza vs COVID-19 after adjustment for age, sex, race and Hispanic origin, and underlying conditions including obesity. RESULTS: Children with influenza (n = 179) were younger than those with COVID-19 (n = 381; median, 5.2 years vs 13.8 years), less likely to be non-Hispanic Black (14.5% vs 27.6%) or Hispanic (24.0% vs 36.2%), and less likely to have ≥1 underlying condition (66.4% vs 78.5%) or be obese (21.4% vs 42.2%), and a shorter hospital stay (median, 5 days vs 7 days). They were similarly likely to require invasive mechanical ventilation (both 30.2%), vasopressor support (19.6% and 19.9%), or extracorporeal membrane oxygenation (2.2% and 2.9%). Four children with influenza (2.2%) and 11 children with COVID-19 (2.9%) died. The odds of death or requiring life support in children with influenza vs COVID-19 were similar (adjusted odds ratio, 1.30; 95% confidence interval, .78-2.15; P = .32). CONCLUSIONS: Despite differences in demographics and clinical characteristics of children with influenza or COVID-19, the frequency of life-threatening complications was similar. Our findings highlight the importance of implementing prevention measures to reduce transmission and disease severity of influenza and COVID-19.

UNC Libraries
University of North Carolina at Chapel Hill (US)
Openalex Percentile: Top 65%
Infectious Encephalopathies and Encephalitis
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