Severe Neurological Complications With Influenza in Vietnamese Children

IF 4.3 4区 医学 Q1 INFECTIOUS DISEASES Influenza and Other Respiratory Viruses Pub Date : 2024-11-04 DOI:10.1111/irv.70035
Sy Duc Nguyen, Thi Huyen Trang Ngo, Thi Viet Ha Nguyen, Thien Hai Do
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Abstract

Background

Influenza is a common contagious respiratory virus that primarily causes respiratory tract infections. Neurological complications associated with influenza have also been reported, mainly in pediatric populations, and may be fatal.

Methods

A descriptive study evaluated pediatric patients who were diagnosed with severe influenza-associated neurological complications at the Tropical Pediatrics Center—Vietnam National Children's Hospital from October 2022 to February 2024.

Results

In this study involving 20 patients, 80% of children were under 5 years old; 70% of patients had a history of good health. All patients had not received an influenza vaccination within 12 months. The median time from onset to neurological symptoms was 1 day. The most common neurological complication was encephalitis (16/20 patients) with symptoms included altered consciousness and seizures. Most patients had elevated levels of ALT (60%), AST (90%), LDH (94%), and ferritin (69%) in serum. The imaging of brain damage on MRI and CT scans varied in patterns and locations. There was no difference in the timing of methylprednisolone treatment within and after 48 h. The mortality rate was 20%, with 45% of patients experiencing severe sequelae.

Conclusions

IANCs are severe with damage to both white matter and central gray matter and can occur in healthy children, emphasizing the importance of vaccination to reduce the risk.

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越南儿童患流感后出现严重神经系统并发症。
背景:流感是一种常见的传染性呼吸道病毒,主要引起呼吸道感染。与流感相关的神经系统并发症也有报道,主要发生在儿童群体中,而且可能是致命的:一项描述性研究对 2022 年 10 月至 2024 年 2 月期间在越南国立儿童医院热带儿科中心确诊为严重流感相关神经系统并发症的儿科患者进行了评估:在这项涉及20名患者的研究中,80%的儿童年龄在5岁以下;70%的患者健康状况良好。所有患者在 12 个月内都没有接种过流感疫苗。从发病到出现神经系统症状的中位时间为 1 天。最常见的神经系统并发症是脑炎(16/20 例患者),症状包括意识改变和癫痫发作。大多数患者血清中的谷丙转氨酶(60%)、谷草转氨酶(90%)、LDH(94%)和铁蛋白(69%)水平升高。核磁共振成像和 CT 扫描显示的脑损伤模式和位置各不相同。甲泼尼龙治疗时间在48小时内和48小时后没有差异。死亡率为20%,45%的患者有严重后遗症:IANC严重损害白质和中央灰质,可发生在健康儿童身上,强调了接种疫苗以降低风险的重要性。
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来源期刊
CiteScore
7.20
自引率
4.50%
发文量
120
审稿时长
6-12 weeks
期刊介绍: Influenza and Other Respiratory Viruses is the official journal of the International Society of Influenza and Other Respiratory Virus Diseases - an independent scientific professional society - dedicated to promoting the prevention, detection, treatment, and control of influenza and other respiratory virus diseases. Influenza and Other Respiratory Viruses is an Open Access journal. Copyright on any research article published by Influenza and Other Respiratory Viruses is retained by the author(s). Authors grant Wiley a license to publish the article and identify itself as the original publisher. Authors also grant any third party the right to use the article freely as long as its integrity is maintained and its original authors, citation details and publisher are identified.
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