Examining Flu, COVID-19 Infection Outcomes in Children
Research being presented at CHEST 2024 analyzed morbidity and outcomes of children infected with influenza, COVID-19 or both.
Children who had a co-infection of influenza and COVID-19 were less likely to be admitted to the hospital compared to children who had either infection alone, according to research data being presented at the annual meeting of the American College of Chest Physicians, CHEST 2024, held October 6 to 9 in Boston, Massachusetts.1
Examining Flu, COVID-19 Infection Outcomes in Children / Pixel-Shot - stock.adobe.com
While children have come to represent a significant population of those infected with COVID-19, research has shown that they are much less likely to experience severe outcomes, intensive care unit (ICU) admission and death compared to adults.2 This difference goes against what is usually seen with other upper respiratory infections, in which children have historically exhibited severe symptoms more than older populations.
Investigators conducted a retrospective cohort study to identify the differences in morbidity and treatment course for children infected with COVID-19, influenza, or co-infection with both. Data for respiratory infections was collected from the National Inpatient Sample database. The study included 7845 patients aged 18 years or younger who were hospitalized between January 2018 and December 2020. Of the patients, 3188 had COVID-19, 4552 had influenza, and 105 were co-infected with both.
The study found that 8.6% of patients who had a co-infection with COVID-19 and influenza were admitted to the hospital, compared to 13.2% with COVID-19 alone. However, both were higher than the 7.1% of patients infected with influenza alone. Investigators also found that 19% of co-infected patients were treated with antiviral medication, compared to 15.3% with flu and 11.3% with COVID-19.
When assessing COVID-19 infections alone, the study showed that it was associated with a less severe disease course in children. Only 0.2% of children with COVID-19 required mechanical ventilation and 3% required vasopressors. The mortality rate was 0.06% in children, compared to 2.94% in adults.
“Interestingly, children with co-infection were less likely to be admitted to the hospital compared to either infection alone, but they were also more likely to be given antiviral medication,” the authors said. “This may be explained by the in vivo interaction of both viruses on the host body and the ensuing immune response. Children in general had a favorable course of COVID-19 with shorter hospitalizations compared to adults.”
The authors of the study said the findings can help clinicians educate parents about the disease course of COVID-19, influenza or a co-infection in children. They added that more understanding of the nuances could inform age-specific treatment protocols for severe cases of the respiratory infections. Lastly, they concluded the data should be used to initiate future studies analyzing the mechanism of the immune response of the co-infected host.
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