Hospital Medicine

Influenza Is Associated With Neurologic Complications in Children

Children with influenza infection often have neurologic complications, according to results of a new study.

To determine the frequency of neurologic complications from influenza in children who had been admitted to the hospital, researchers used the Pediatric Health Information System to conduct a cross-sectional study of such children who had been discharged from 49 children’s hospitals during the 2015-2020 influenza seasons.  

The neurologic complications they assessed included encephalopathy, encephalitis, aseptic meningitis, bacterial meningitis, brain abscess, febrile seizure, nonfebrile seizure, Reyes syndrome, and cerebral infarction. The outcomes they assessed included length of stay, admission to the intensive care unit (ICU), length of stay in the ICU, hospital readmission within 30 days, death, and related hospital cost.

As a result, they found that 2246 or 8% of nearly 30,000 children who had been admitted to the hospital with influenza had a neurologic complication diagnosed, most frequently febrile seizure (5%), encephalopathy (2%), and nonfebrile seizure (1%). Moreover, a greater length of stay in the hospital or ICU, a larger number of deaths, and higher hospital costs were noted in those with such complications compared with those without them.

Risk factors for neurologic complications were male sex (aOR, 1.1, 95%; CI, 1.0-1.2), Asian vs White race (aOR 1.7, 95%; CI, 1.4-2.1), and having a chronic neurologic condition (aOR 3.7, 95%; CI, 3.1-4.2).

“Neurologic complications are common in children hospitalized with influenza, especially among those with chronic neurologic conditions, and are associated with worse outcomes compared with children without neurologic complications,” the researchers concluded. “These findings emphasize the strategic importance of influenza immunization and treatment, especially in high-risk populations.”

—Ellen Kurek

Antoon JW, Hall M, Herndon A, et al. Prevalence, risk factors, and outcomes of influenza-associated neurologic complications in children. J Pediatr. 2021;239:32-38.e5.