Complications of influenza in 272 adult and pediatric patients in a German university hospital during the seasonal epidemic 2017–2018

Abstract

Summary Background The influenza season 2017–2018 of the northern hemisphere was the highest since 2001 and was caused predominantly by influenza B virus. Methods We performed a retrospective analysis of all patients in a university hospital in northern Germany with laboratory-confirmed influenza during the winter season 2017–2018 and analyzed underlying conditions, complications, and outcome. Results A total of 272 cases of influenza were diagnosed: 70 influenza A (25.7%), 201 influenza B (73.9%), and 1 co-infection. Of 182 adults, 145 were hospitalized, 73 developed pneumonia, 11 developed myocardial infarction, two a transient ischemic attack, one a stroke, and one perimyocarditis. Eleven of the 145 hospitalized adult patients (7.6%) died, ten of them because of pneumonia. All of them had preexisting diseases. Pneumonia was associated with a mortality of 13.7%. Underlying cardiac insufficiency was correlated with higher mortality (7/51 with versus 4/126 patients without cardiac insufficiency; p < 0.05). Ninety cases of influenza were diagnosed in 89 children (30 A, 60 B), one child had first influenza B, then influenza A. Twenty-eight children (31%) were hospitalized, 15 children developed one or more complications (lower respiratory tract infections, meningeal irritations, febrile seizures, otitis media, myositis). No child died. Influenza vaccination status was known in 149 adult patients, pneumonia occurred more frequently in non-vaccinated individuals (43/90; 47.8%) than in vaccinated patients (18/59; 30.5%, p < 0.05). Conclusion Patients with influenza should be monitored for secondary pneumonia and myocardial infarction, and vaccination should be enforced especially in patients with coronary heart disease and cardiac insufficiency.

A Comparative Study of Severe and Critical Influenza B in Children in the 2021–2022 Winter Season

“…23 Several recently published articles have described extra-pulmonary complications in hospitalized children with influenza B prior to the COVID-19 pandemic. [24][25][26][27] Geerdes-Fenge et al treated 17 hospitalized children with influenza B in northern Germany in the winter season of 2017-2018, and revealed that 5 (29.4%) suffered extrapulmonary complications, 24 lower than 42% (37/88) found in the present study (Table 1). A few studies focusing on neurologic involvement in hospitalized children with influenza B observed that approximately 10-15% of the patients had neurologic complications.…”

“…Influenza can cause complications outside the respiratory system in both adults and children. [21][22][23][24][25][26][27] A large series study of 2330 hospitalized pediatric patients with influenza A (H1N1 pdm09) during the 2009-2010 pandemic in the USA revealed that 709 (30.4%) children had complications affecting the digestive, neurological, musculoskeletal and cardiovascular systems. 23 Several recently published articles have described extra-pulmonary complications in hospitalized children with influenza B prior to the COVID-19 pandemic.…”

The Evolution and Complications of the Influenza During Covid-19 Pandemic

“…The virus can directly affect the middle ear or promote fluid accumulation in the middle ear with secondary bacterial infection [8]. Ear infections, pneumonia and febrile convulsions are the most common complications of influenza in children [8,10]. The study conducted by Short KR et al have shown that normal nasopharyngeal flora, in the presence of an influenza virus infection has the ability to ascend the Eustachian tube and determine middle ear inflammation [11].…”

Experience of using an interferon inducer in the prevention of influenza and acute respiratory viral infections in children

“…Опасность развития осложнений недооценивается не только пациентами, но и врачами. Так, по данным исследователей из Северной Германии осложнения возникли у 68% взрослых пациентов с гриппом А: 40,1%пневмония, 25,3% -острое повреждение почек, 9,3%сепсис, 6,4% -инфаркт миокарда и другие осложнения, погибли 9,5% пациентов, и у 31,1% педиатрических пациентов: 16,9% -инфекции нижних дыхательных путей, 10,1% -фебрильные судороги и раздражение мозговых оболочек, отит, миозит и другие осложнения [4].…”

“…2) [8]. Интерфероновый ответ организма на введение препарата характеризуется продолжительной (до 4-5 суток) циркуляцией интерферонов в кровотоке 4 .…”