Impact of Influenza on Children in a Referral Hospital in Mexico City: Clinical Burden and Predictors of Mechanical Ventilation

TL;DR

This study examines how influenza affects children in Mexico City, identifying risk factors for needing mechanical ventilation.

Contribution

The study provides new insights into influenza's clinical burden and predictors of mechanical ventilation in children in Latin America.

Findings

Influenza AH1N1 was more common in children under 5 years, while H3N2 was more frequent in children over 5 years.

Hypotension, paradoxical breathing, and nosocomial infection were significant predictors of mechanical ventilation.

School-age children made up 46% of admissions, and 93.4% of hospitalized children had comorbidities.

Abstract

Influenza is a highly transmissible seasonal disease that significantly impacts public health worldwide, causing lower respiratory tract infections, numerous hospitalizations, and prolonged stays. However, data on its clinical burden in children in Latin America remain limited. This retrospective cohort study analyzed the demographic and clinical characteristics of children hospitalized with influenza in Latin America, stratified by age, and identified factors associated with mechanical ventilation. Medical records of children with severe acute respiratory infection associated with influenza were reviewed. Statistical analyses included chi square and Wilcoxon tests to compare groups, and Cox regression to identify predictors of mechanical ventilation. Among 212 cases, 46% of admissions were in school-age children; 93.4% had comorbidities. Influenza AH1N1 was more frequent in children <5 years and influenza H3N2 in children >5 years of age. The mechanical ventilation rate per age group was 24.1% among those <1 year, 29.8% in 1–4 years of age, 4.9% in 5–9 years of age, and 26.3% in children 10–18 years of age. Hypotension, paradoxical breathing, and nosocomial infection were identified as predictors for mechanical ventilation. These findings enhance the understanding of influenza’s clinical impact on pediatric populations, particularly in predicting severe outcomes requiring intensive care, and aid in developing strategies to mitigate its effects.

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