Pandemic H1N1 influenza-associated hospitalizations in children in Madrid, Spain

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Abstract

Objective To describe the epidemiological and clinical characteristics of children hospitalized with 2009 pandemic influenza (pH1N1) in Madrid, Spain. Patients/Methods We included patients less than 14years of age admitted to one of 18 hospitals in Madrid, Spain, between May 1 and November 30, 2009 and diagnosed with pH1N1 by polymerase chain reaction. A retrospective chart review was conducted and data were compared by age, presence of high-risk medical conditions, and pediatric intensive care unit (PICU) admission. Results A total of 517 pH1N1 cases were included for final analysis. One hundred and forty-two patients (27·5%) had predisposing underlying illnesses, with immunosuppression (36 children, 7%) and moderate persistent asthma (34, 6·6%) being the most common ones. Patients with underlying medical conditions had longer hospital stays [median 5, interquartile range (IQR) 3-8days, versus median 4, IQR 3-6, P<0·001] and required intensive care (20·4% versus 5·9%, P<0·001) and mechanical ventilation more frequently than previously healthy children. Globally, intensive care was required for 51 patients (10%) and invasive mechanical ventilation for 12 (2%). Pediatric intensive care unit admission was significantly associated with abnormal initial chest X-ray [Odds Ratio (OR) 3·5, 95% confidence interval (CI) 1·5-8·5], underlying neurological condition (OR 3·1, CI 1·2-7·5) and immunosuppression (OR 2·9, 1·2-6·8). Five patients (0·9%) died; two with severe neurological disease, two with leukemia, and one with a malignant solid tumor. Conclusions Children with underlying medical conditions experienced more severe pH1N1 disease. Risk factors for admission to the PICU included underlying neurological conditions, immunosuppression and abnormal initial chest X-ray. © 2011 Blackwell Publishing Ltd.

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Del Rosal, T., Baquero-Artigao, F., Calvo, C., Mellado, M. J., Molina, J. C., Santos, M. del M., … Cabezas, M. E. (2011). Pandemic H1N1 influenza-associated hospitalizations in children in Madrid, Spain. Influenza and Other Respiratory Viruses, 5(6). https://doi.org/10.1111/j.1750-2659.2011.00272.x

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