Influenza Virus Associated Pediatric Acute Respiratory Distress Syndrome: Clinical Characteristics and Outcomes

Author:

Yener Nazik1,Üdürgücü Muhammed1ORCID,Yılmaz Resul2,Kendirli Tanıl3,Tekerek Nazan Ülgen4,Evren Gültaç5,Arı Hatice Feray6ORCID,Yıldızdaş Dinçer7,Demirkol Demet8,Pişkin Ethem9,Duyu Muhterem10,Dalkıran Tahir11,Akçay Nihal12,Yalındağ Öztürk Nilüfer13,Yeşilbaş Osman14,Bozan Gürkan15,Gurbanov Anar3ORCID,Albayrak Hatice1

Affiliation:

1. Division of Pediatric Critical Care, Ondokuz Mayıs University School of Medicine, Samsun, Turkey

2. Division of Pediatric Critical Care, Selcuk University School of Medicine, Samsun, Turkey

3. Division of Pediatric Critical Care, Ankara University School of Medicine, Ankara, Turkey

4. Division of Pediatric Critical Care, Akdeniz University School of Medicine, Antalya, Turkey

5. Division of Pediatric Critical Care, Dokuz Eylül University School of Medicine, Izmir, Turkey

6. Division of Pediatric Critical Care, Ege University School of Medicine, Izmir, Turkey

7. Division of Pediatric Critical Care, Cukurova University School of Medicine, Adana, Turkey

8. Division of Pediatric Critical Care, Istanbul University School of Medicine, Istanbul, Turkey

9. Division of Pediatric Critical Care, Zonguldak Karaelmas University School of Medicine, Zonguldak, Turkey

10. Division of Pediatric Critical Care, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey

11. Division of Pediatric Critical Care, Nezip Fazil State Hospital, Kahramanmaras, Turkey

12. Division of Pediatric Critical Care, İstanbul Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey

13. Division of Pediatric Critical Care, Marmara University School of Medicine, Istanbul, Turkey

14. Training and Research Hospital, Bezmialem University, Istanbul, Turkey

15. Division of Pediatric Critical Care, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey

Abstract

Abstract Background and Objective The aim of this multicenter retrospective study was to determine the clinical characteristics, treatment approaches and the course of pediatric acute respiratory distress syndrome (PARDS) which developed associated with the influenza virus in the 2019–20 season. Methods Patients included 1 month to 18 years who were diagnosed with PARDS associated with the influenza virus in the 2019–20 season. Results Sixty-seven patients were included in the study. The mean age of the patients was 64.16 ± 6.53 months, with 60% of the group <5 years. Influenza A was determined in 54 (80.5%) patients and Influenza B in 13 (19.5%). The majority of patients (73.1%) had a comorbidity. Fifty-eight (86.6%) patients were applied with invasive mechanical ventilation, Pediatric Acute Lung Injury Consensus Conference classification was mild in 5 (8.6%), moderate in 22 (37.9%) and severe in 31 (52.5%) patients. Ventilation was applied in the prone position to 40.3% of the patients, and in nonconventional modes to 24.1%. A total of 22 (33%) patients died, of which 4 had been previously healthy. Of the surviving 45 patients, 38 were discharged without support and 7 patients with a new morbidity. Conclusion Both Influenza A and Influenza B cause severe PARDS with similar characteristics and at high rates. Influenza-related PARDS cause 33% mortality and 15.5% morbidity among the study group. Healthy children, especially those aged younger than 5 years, are also at risk.

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Pediatrics, Perinatology and Child Health

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