Dimopoulou Dimitra, Maltezou Helena C, Neofytou Ariadni, Giannouchos Theodoros, Pantelia Emmanuela, Dimitroglou Margarita, Koziaki Garyfallia, Makropoulou Maria, Tsolia Maria N
Department of Pediatrics, General Children's Hospital "Panagiotis and Aglaia Kyriakou", Athens, Greece.
Directorate for Research, Studies and Documentation, National Public Health Organization, Athens, Greece.
Eur J Pediatr. 2025 Aug 5;184(8):530. doi: 10.1007/s00431-025-06338-8.
Influenza results in high morbidity and mortality globally each year. Data on pediatric influenza in Greece after the COVID-19 pandemic are lacking. This study aims to evaluate the characteristics of outpatient and hospitalized pediatric influenza cases post COVID-19 pandemic in Greece. A retrospective observational study was conducted. Children 0-16 years old with laboratory-confirmed influenza presented to the emergency department of a children's hospital during the 2022-2023 and 2023-2024 influenza seasons were studied. A total of 976 children (mean age 7 years, males 53.9%) were enrolled, and 4.8% had a history of influenza vaccination. Compared to unvaccinated children, vaccinated patients had more comorbidities (29.8% vs. 3.3%, p < 0.001) and high-risk contacts (4.3% vs. 0.7%, p = 0.014). A total of 223 children (22.8%) were hospitalized, significantly younger than outpatients (mean age 5.7 vs. 7.4 years, p < 0.001). Younger age, presence of comorbidities, and symptoms such as vomiting, myositis, and respiratory distress were significantly associated with hospitalization (p < 0.001). Vaccination did not reduce the risk of hospitalization (OR 0.70, 95%CI 0.30-1.63, p = 0.405). Hospitalized children more frequently experienced complications (48.0% vs. 16.7%) and received antibiotics (34.2% vs. 14.4%) and oseltamivir (78.9% vs. 41.9%) (p < 0.001). Main complications among hospitalized patients included myositis (12.5%), acute otitis media (12.1%), febrile seizures (8.9%), and pneumonia (8.5%). Two unvaccinated children with comorbidities were admitted to the PICU; one died due to acute necrotizing encephalopathy.
Hospitalized children with influenza presented with serious complications. Although only 13% of them had comorbidities, nearly half experienced complications during hospitalization. The recently introduced universal immunization of children < 5 years old in Greece is expected to reduce influenza morbidity in this population.
•Influenza is an acute respiratory viral infection that has a significant impact on public health, representing a major cause of morbidity and mortality worldwide. •To date, there are no published data on children with influenza in Greece in the post-COVID-19 era.
•This study highlights the burden of influenza-associated ED visits and hospitalizations in Greece, particularly among younger children and those with comorbidities. •While influenza vaccination did not decrease the risk of hospitalization in this cohort, this most likely is attributed to the low vaccination rate and higher prevalence of comorbidities in the vaccinated group.
每年流感在全球导致高发病率和高死亡率。希腊在新冠疫情之后缺乏儿童流感的数据。本研究旨在评估希腊新冠疫情之后门诊和住院儿童流感病例的特征。进行了一项回顾性观察研究。对2022 - 2023年和2023 - 2024年流感季节期间到一家儿童医院急诊科就诊的0至16岁实验室确诊流感的儿童进行了研究。共纳入976名儿童（平均年龄7岁，男性占53.9%），4.8%有流感疫苗接种史。与未接种疫苗的儿童相比，接种疫苗的患者有更多合并症（29.8%对3.3%，p < 0.001）和高风险接触史（4.3%对0.7%，p = 0.014）。共有223名儿童（22.8%）住院，明显比门诊患者年龄小（平均年龄5.7岁对7.4岁，p < 0.001）。年龄较小、存在合并症以及呕吐、肌炎和呼吸窘迫等症状与住院显著相关（p < 0.001）。接种疫苗并未降低住院风险（比值比0.70，95%置信区间0.30 - 1.63，p = 0.405）。住院儿童更频繁地出现并发症（48.0%对16.7%），并接受抗生素治疗（34.2%对14.4%）和使用奥司他韦（78.9%对41.9%）（p < 0.001）。住院患者中的主要并发症包括肌炎（12.5%）、急性中耳炎（12.1%）、热性惊厥（8.9%）和肺炎（8.5%）。两名有合并症的未接种疫苗儿童被收入儿科重症监护病房；一名因急性坏死性脑病死亡。
住院的流感儿童出现了严重并发症。尽管其中只有13%有合并症，但近一半在住院期间出现了并发症。希腊最近对5岁以下儿童实施的普遍免疫有望降低该人群的流感发病率。
•流感是一种急性呼吸道病毒感染，对公众健康有重大影响，是全球发病和死亡的主要原因之一。•迄今为止，希腊在新冠疫情后时代尚无关于儿童流感的已发表数据。
•本研究突出了希腊流感相关急诊就诊和住院的负担，特别是在年幼儿童和有合并症的儿童中。•虽然流感疫苗接种在该队列中未降低住院风险，但这很可能归因于接种组的低疫苗接种率和较高的合并症患病率。
