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

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

doi:10.1093/cid/ciac477

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

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

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

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.

Original language	English (US)
Pages (from-to)	E280-E290
Journal	Clinical Infectious Diseases
Volume	76
Issue number	3
DOIs	https://doi.org/10.1093/cid/ciac477
State	Published - Feb 1 2023

Keywords

COVID-19
SARS-CoV-2
children
influenza
intensive care units

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases

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10.1093/cid/ciac477

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Halasa, N. B., Spieker, A. J., Young, C. C., Olson, S. M., Newhams, M. M., Amarin, J. Z., Moffitt, K. L., Nakamura, M. M., Levy, E. R., Soma, V. L., Talj, R., Weiss, S. L., Fitzgerald, J. C., Mack, E. H., Maddux, A. B., Schuster, J. E., Coates, B. M., Hall, M. W., Schwartz, S. P., ... Randolph, A. G. (2023). Life-Threatening Complications of Influenza vs Coronavirus Disease 2019 (COVID-19) in US Children. Clinical Infectious Diseases, 76(3), E280-E290. https://doi.org/10.1093/cid/ciac477

Halasa, NB, Spieker, AJ, Young, CC, Olson, SM, Newhams, MM, Amarin, JZ, Moffitt, KL, Nakamura, MM, Levy, ER, Soma, VL, Talj, R, Weiss, SL, Fitzgerald, JC, Mack, EH, Maddux, AB, Schuster, JE, Coates, BM, Hall, MW, Schwartz, SP, Schwarz, AJ, Kong, M, Spinella, PC, Loftis, LL, McLaughlin, GE, Hobbs, CV, Rowan, CM, Bembea, MM, Nofziger, RA, Babbitt, CJ, Bowens, C, Flori, HR, Gertz, SJ, Zinter, MS, Giuliano, JS, Hume, JR, Cvijanovich, NZ, Singh, AR, Crandall, HA, Thomas, NJ, Cullimore, ML, Patel, MM & Randolph, AG 2023, 'Life-Threatening Complications of Influenza vs Coronavirus Disease 2019 (COVID-19) in US Children', Clinical Infectious Diseases, vol. 76, no. 3, pp. E280-E290. https://doi.org/10.1093/cid/ciac477

@article{852476985b2145b9823ca8c7b8f8c6da,

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

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.",

keywords = "COVID-19, SARS-CoV-2, children, influenza, intensive care units",

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

year = "2023",

month = feb,

day = "1",

doi = "10.1093/cid/ciac477",

language = "English (US)",

volume = "76",

pages = "E280--E290",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

publisher = "Oxford University Press",

number = "3",

}

TY - JOUR

T1 - Life-Threatening Complications of Influenza vs Coronavirus Disease 2019 (COVID-19) in US Children

AU - Halasa, Natasha B.

AU - Spieker, Andrew J.

AU - Young, Cameron C.

AU - Olson, Samantha M.

AU - Newhams, Margaret M.

AU - Amarin, Justin Z.

AU - Moffitt, Kristin L.

AU - Nakamura, Mari M.

AU - Levy, Emily R.

AU - Soma, Vijaya L.

AU - Talj, Rana

AU - Weiss, Scott L.

AU - Fitzgerald, Julie C.

AU - Mack, Elizabeth H.

AU - Maddux, Aline B.

AU - Schuster, Jennifer E.

AU - Coates, Bria M.

AU - Hall, Mark W.

AU - Schwartz, Stephanie P.

AU - Schwarz, Adam J.

AU - Kong, Michele

AU - Spinella, Philip C.

AU - Loftis, Laura L.

AU - McLaughlin, Gwenn E.

AU - Hobbs, Charlotte V.

AU - Rowan, Courtney M.

AU - Bembea, Melania M.

AU - Nofziger, Ryan A.

AU - Babbitt, Christopher J.

AU - Bowens, Cindy

AU - Flori, Heidi R.

AU - Gertz, Shira J.

AU - Zinter, Matt S.

AU - Giuliano, John S.

AU - Hume, Janet R.

AU - Cvijanovich, Natalie Z.

AU - Singh, Aalok R.

AU - Crandall, Hillary A.

AU - Thomas, Neal J.

AU - Cullimore, Melissa L.

AU - Patel, Manish M.

AU - Randolph, Adrienne G.

PY - 2023/2/1

Y1 - 2023/2/1

N2 - 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.

AB - 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.

KW - COVID-19

KW - SARS-CoV-2

KW - children

KW - influenza

KW - intensive care units

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U2 - 10.1093/cid/ciac477

DO - 10.1093/cid/ciac477

M3 - Article

C2 - 35717646

AN - SCOPUS:85141929700

SN - 1058-4838

VL - 76

SP - E280-E290

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 3

ER -

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

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