Outcomes of immunocompromised children hospitalized for Influenza, 2010-2021, the Canadian Immunization Monitoring Program Active (IMPACT)
Copyright © 2023 European Society of Clinical Microbiology and Infectious Diseases. All rights reserved..
OBJECTIVES: To evaluate immunocompromising conditions and subgroups of immunocompromise as risk factors for severe outcomes among children admitted for influenza.
METHODS: We performed active surveillance for laboratory-confirmed influenza hospitalizations among children ≤16 years old at the 12 Canadian Immunization Monitoring Program Active hospitals, during 2010-2021. Logistic regression analyses were used to compare outcomes between immunocompromised and non-immunocompromised children, and for different subgroups of immunocompromise. The primary outcome was intensive care unit (ICU) admission; the secondary outcomes were mechanical ventilation and death.
RESULTS: Among 8982 children, 892 (9.9%) were immunocompromised; these patients were older (median, 5.6 (IQR, 3.1-10.0) vs. 2.4 (1-6) years; p < 0.001) than non-immunocompromised children, had a similar frequency of comorbidities, excluding immunocompromise and/or malignancy (38% (340/892) vs. 40% (3272/8090); p 0.2), but fewer respiratory symptoms, such as respiratory distress (20% (177/892) vs. 42% (3424/8090), p < 0.001). In multivariable analyses, immunocompromise (adjusted odds ratio (aOR), 0.19; 95% CI, 0.14-0.25) and its subcategories immunodeficiency (aOR, 0.16; 95% CI, 0.10-0.23), immunosuppression (aOR, 0.17; 95% CI, 0.12-0.23), chemotherapy (aOR, 0.07; 95% CI, 0.03-0.13), and solid organ transplantation (aOR, 0.17; 95% CI, 0.06-0.37) were associated with decreased probability of ICU admission in children admitted for influenza. Immunocompromise was also associated with a decreased probability of mechanical ventilation (aOR, 0.26; 95% CI, 0.16-0.38) or death (aOR, 0.22; 95% CI, 0.03-0.72).
CONCLUSION: Immunocompromised children are overrepresented among hospitalizations for influenza, but have a decreased probability of ICU admission, mechanical ventilation, and mortality following admission. Admission bias precludes generalizability beyond the hospital setting.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
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| Enthalten in: |
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases - 29(2023), 7 vom: 15. Juli, Seite 924-932 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Schober, Tilmann [VerfasserIn] |
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| Links: |
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| Themen: |
Canada |
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| Anmerkungen: |
Date Completed 19.06.2023 Date Revised 19.06.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.cmi.2023.04.001 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM355592541 |
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| 245 | 1 | 0 | |a Outcomes of immunocompromised children hospitalized for Influenza, 2010-2021, the Canadian Immunization Monitoring Program Active (IMPACT) |
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| 500 | |a Date Completed 19.06.2023 | ||
| 500 | |a Date Revised 19.06.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 European Society of Clinical Microbiology and Infectious Diseases. All rights reserved. | ||
| 520 | |a OBJECTIVES: To evaluate immunocompromising conditions and subgroups of immunocompromise as risk factors for severe outcomes among children admitted for influenza | ||
| 520 | |a METHODS: We performed active surveillance for laboratory-confirmed influenza hospitalizations among children ≤16 years old at the 12 Canadian Immunization Monitoring Program Active hospitals, during 2010-2021. Logistic regression analyses were used to compare outcomes between immunocompromised and non-immunocompromised children, and for different subgroups of immunocompromise. The primary outcome was intensive care unit (ICU) admission; the secondary outcomes were mechanical ventilation and death | ||
| 520 | |a RESULTS: Among 8982 children, 892 (9.9%) were immunocompromised; these patients were older (median, 5.6 (IQR, 3.1-10.0) vs. 2.4 (1-6) years; p < 0.001) than non-immunocompromised children, had a similar frequency of comorbidities, excluding immunocompromise and/or malignancy (38% (340/892) vs. 40% (3272/8090); p 0.2), but fewer respiratory symptoms, such as respiratory distress (20% (177/892) vs. 42% (3424/8090), p < 0.001). In multivariable analyses, immunocompromise (adjusted odds ratio (aOR), 0.19; 95% CI, 0.14-0.25) and its subcategories immunodeficiency (aOR, 0.16; 95% CI, 0.10-0.23), immunosuppression (aOR, 0.17; 95% CI, 0.12-0.23), chemotherapy (aOR, 0.07; 95% CI, 0.03-0.13), and solid organ transplantation (aOR, 0.17; 95% CI, 0.06-0.37) were associated with decreased probability of ICU admission in children admitted for influenza. Immunocompromise was also associated with a decreased probability of mechanical ventilation (aOR, 0.26; 95% CI, 0.16-0.38) or death (aOR, 0.22; 95% CI, 0.03-0.72) | ||
| 520 | |a CONCLUSION: Immunocompromised children are overrepresented among hospitalizations for influenza, but have a decreased probability of ICU admission, mechanical ventilation, and mortality following admission. Admission bias precludes generalizability beyond the hospital setting | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a Disease severity | |
| 650 | 4 | |a Hospitalized | |
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| 650 | 4 | |a Immunodeficiency | |
| 650 | 4 | |a Immunosuppression | |
| 650 | 4 | |a Influenza | |
| 650 | 4 | |a Intensive care | |
| 650 | 4 | |a Mortality | |
| 700 | 1 | |a Morris, Shaun K |e verfasserin |4 aut | |
| 700 | 1 | |a Bettinger, Julie A |e verfasserin |4 aut | |
| 700 | 1 | |a Bancej, Christina |e verfasserin |4 aut | |
| 700 | 1 | |a Burton, Catherine |e verfasserin |4 aut | |
| 700 | 1 | |a Foo, Cheryl |e verfasserin |4 aut | |
| 700 | 1 | |a Halperin, Scott A |e verfasserin |4 aut | |
| 700 | 1 | |a Jadavji, Taj |e verfasserin |4 aut | |
| 700 | 1 | |a Kazmi, Kescha |e verfasserin |4 aut | |
| 700 | 1 | |a Modler, Jacqueline |e verfasserin |4 aut | |
| 700 | 1 | |a Sadarangani, Manish |e verfasserin |4 aut | |
| 700 | 1 | |a Papenburg, Jesse |e verfasserin |4 aut | |
| 700 | 0 | |a Canadian Immunization Monitoring Program Active (IMPACT) Investigators |e verfasserin |4 aut | |
| 700 | 1 | |a Foo, Cheryl |e investigator |4 oth | |
| 700 | 1 | |a Bridger, Natalie |e investigator |4 oth | |
| 700 | 1 | |a Halperin, Scott A |e investigator |4 oth | |
| 700 | 1 | |a Top, Karina |e investigator |4 oth | |
| 700 | 1 | |a Thibeault, Roseline |e investigator |4 oth | |
| 700 | 1 | |a Papenburg, Jesse |e investigator |4 oth | |
| 700 | 1 | |a Lebel, Marc |e investigator |4 oth | |
| 700 | 1 | |a Le Saux, Nicole |e investigator |4 oth | |
| 700 | 1 | |a Morris, Shaun K |e investigator |4 oth | |
| 700 | 1 | |a Kazmi, Kescha |e investigator |4 oth | |
| 700 | 1 | |a Bullard, Jared |e investigator |4 oth | |
| 700 | 1 | |a Purewal, Rupeena |e investigator |4 oth | |
| 700 | 1 | |a Jadavji, Taj |e investigator |4 oth | |
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| 700 | 1 | |a Bettinger, Julie A |e investigator |4 oth | |
| 700 | 1 | |a Sauvé, Laura |e investigator |4 oth | |
| 700 | 1 | |a Sadarangani, Manish |e investigator |4 oth | |
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