Li Pan, Liu Xinfeng, Lang Yanmei, Cui Xiaowei, Shi Yanxi
Respiratory Department, Children's Hospital of Hebei Province, Shijiazhuang, 050031, People's Republic of China.
Int J Gen Med. 2022 Oct 31;15:7995-8001. doi: 10.2147/IJGM.S385307. eCollection 2022.
Influenza B viruses are less common than influenza A viruses in most seasons and cause relatively milder forms of infection that are less studied. We witnessed a dominance of influenza B in Shijiazhuang, China, in the 2021-2022 winter season. In this study, we comparatively investigated the severe and critical influenza B in pediatric patients.
Children who were hospitalized from December 2021 to January 2022 and diagnosed with influenza B were included in this study. Those who tested positive for COVID-19 were excluded. Demographic data, clinical features, underlying medical conditions, laboratory testing results, and treatment outcomes were retrieved and analyzed retrospectively. Disease severity was classified as severe or critical according to Chinese expert consensus on diagnosis and treatment of influenza in children.
A significantly greater proportion of patients with critical influenza had extra-pulmonary complications and bacterial coinfections. Children with critical influenza B had substantially higher levels of procalcitonin and lactate dehydrogenase, a markedly higher neutrophil percentage and a significantly lower CD4+ lymphocyte percentage.
Our findings suggest that, to effectively manage critical influenza B, therapeutic regimens should consist of organ-specific supportive care, antibiotic application if bacterial coinfection is present, and anti-inflammatory and immune-boosting treatments.
在大多数季节中，乙型流感病毒比甲型流感病毒少见，且引发的感染形式相对较轻，相关研究也较少。我们发现，在2021-2022年冬季，中国石家庄地区乙型流感占主导地位。在本研究中，我们对儿科患者中的重症和危重症乙型流感进行了对比研究。
本研究纳入了2021年12月至2022年1月期间住院且诊断为乙型流感的儿童。排除新型冠状病毒肺炎检测呈阳性的儿童。回顾性收集并分析人口统计学数据、临床特征、基础疾病、实验室检测结果及治疗转归。根据中国儿童流感诊断与治疗专家共识，将疾病严重程度分为重症或危重症。
危重症流感患者出现肺外并发症和细菌合并感染的比例显著更高。危重症乙型流感患儿的降钙素原和乳酸脱氢酶水平显著更高，中性粒细胞百分比明显更高，而CD4+淋巴细胞百分比显著更低。
我们的研究结果表明，为有效管理危重症乙型流感，治疗方案应包括针对特定器官的支持治疗、出现细菌合并感染时应用抗生素，以及抗炎和免疫增强治疗。
