Influenza linked to neurologic comorbidities in children

Influenza in a paediatric population can manifest as a neurologic disease, particularly as febrile seizures, according to a study. Hospitalized children with neurologic manifestation of influenza (neuro-flu) experience several neurologic comorbidities, which suggest that this condition is driven by host-factors rather than by pathogen-factors.

This retrospective cohort study included all children with laboratory confirmed influenza who were admitted to the Soroka University Medical Center in Israel between 2016 and 2019.

A total of 951 patients were identified, of which 201 had neuro-flu and 750 with classic-flu (without neurologic manifestations).). The most common neurologic manifestations of neuro-flu were seizures: 73 simple febrile seizures, 45 atypical febrile seizures, and seven afebrile seizures.

Children with neuro-flu had significantly higher rates of neurologic comorbidities than those with classic-flu (13.0 percent vs 6.0 percent), but the former had fewer respiratory (4.5 percent vs 8.0 percent) and cardiac comorbidities (0.5 percent vs 4.5 percent).

Compared with classic-flu, neuro-flu correlated with leukocytosis (21.0 percent vs 13.0 percent; p<0.001) and lower C-reactive protein levels (2.4 vs 3.3; p=0.03).

On the other hand, children with classic-flu exhibited a more prominent respiratory disease since they had more chest radiographs performed (60.5 percent vs 45.0 percent; p<0.001), higher pneumonia rates (27.0 percent vs 12.0 percent; p<0.001), and antibiotic treatment (60.0 percent vs 42.0 percent; p<0.001).

“The relatively lower rates of pneumonia in neuro-flu suggests that these patients are admitted in the early stage of the influenza infection, which triggers the neurologic response,” the researchers said.