Association of Asthma With Treatments and Outcomes in Children With Critical Influenza

PALISI Pediatric Intensive Care Influenza Network Investigators

doi:10.1016/j.jaip.2022.10.045

Association of Asthma With Treatments and Outcomes in Children With Critical Influenza

PALISI Pediatric Intensive Care Influenza Network Investigators

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

Background: Hospitalization for severe influenza infection in childhood may result in postdischarge sequelae. Objective: To evaluate inpatient management and postdischarge sequelae in children with critical respiratory illness owing to influenza with or without preexisting asthma. Methods: This was a prospective, observational multicenter study of children (aged 8 months to 17 years) admitted to a pediatric intensive care or high-acuity unit (in November 2019 to April 2020) for influenza. Results were stratified by preexisting asthma. Prehospital status, hospital treatments, and outcomes were collected. Surveys at approximately 90 days after discharge evaluated postdischarge health resource use, functional status, and respiratory symptoms. Results: A total of 165 children had influenza: 56 with preexisting asthma (33.9%) and 109 without it (66.1%; 41.1% and 39.4%, respectively, were fully vaccinated against influenza). Fifteen patients with preexisting asthma (26.7%) and 34 without it (31.1%) were intubated. More patients with versus without preexisting asthma received pharmacologic asthma treatments during hospitalization (76.7% vs 28.4%). Of 136 patients with 90-day survey data (82.4%; 46 with preexisting asthma [33.8%] and 90 without it [66.1%]), a similar proportion had an emergency department/urgent care visit (4.3% vs 6.6%) or hospital readmission (8.6% vs 3.3%) for a respiratory condition. Patients with preexisting asthma more frequently experienced asthma symptoms (78.2% vs 3.3%) and had respiratory specialist visits (52% vs 20%) after discharge. Of 109 patients without preexisting asthma, 10 reported receiving a new diagnosis of asthma (11.1%). Conclusions: Respiratory health resource use and symptoms are important postdischarge outcomes after influenza critical illness in children with and without preexisting asthma. Less than half of children were vaccinated for influenza, a tool that could mitigate critical illness and its sequelae.

Original language	English (US)
Pages (from-to)	836-843.e3
Journal	Journal of Allergy and Clinical Immunology: In Practice
Volume	11
Issue number	3
DOIs	https://doi.org/10.1016/j.jaip.2022.10.045
State	Published - Mar 2023

Bibliographical note

Funding Information:
This study was supported in part by the Centers for Disease Control and Prevention (A.G. Randolph and PALISI Pediatric Intensive Care Influenza Network Investigators); Eunice Kennedy Shriver National Institute of Child Health and Human Development (A.B. Maddux, No. K23 HD096018), the National Heart, Lung, and Blood Institute (J.R. Grunwell, No. K23 HL151897), the National Institute of Nursing Research (A.M. Fitzpatrick, No. K24 NR018866), and the National Institutes of Allergy and Infectious Disease (A.G. Randolph and W. Phipatanakul, No. R01 AI 154470). The Centers for Disease Control and Prevention assisted with the collection, analysis, data interpretation and editing of the manuscript for important content, and in the decision to submit the article for publication. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Publisher Copyright:
© 2022 American Academy of Allergy, Asthma & Immunology

Keywords

Acute respiratory viral infection
Asthma
Influenza
Outcomes
Pediatric intensive care unit
Reactive airway disease

PubMed: MeSH publication types

Observational Study
Multicenter Study
Journal Article
Research Support, N.I.H., Extramural

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jaip.2022.10.045

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@article{f0a6d471ddb8401c94b8c343eef31b16,

title = "Association of Asthma With Treatments and Outcomes in Children With Critical Influenza",

abstract = "Background: Hospitalization for severe influenza infection in childhood may result in postdischarge sequelae. Objective: To evaluate inpatient management and postdischarge sequelae in children with critical respiratory illness owing to influenza with or without preexisting asthma. Methods: This was a prospective, observational multicenter study of children (aged 8 months to 17 years) admitted to a pediatric intensive care or high-acuity unit (in November 2019 to April 2020) for influenza. Results were stratified by preexisting asthma. Prehospital status, hospital treatments, and outcomes were collected. Surveys at approximately 90 days after discharge evaluated postdischarge health resource use, functional status, and respiratory symptoms. Results: A total of 165 children had influenza: 56 with preexisting asthma (33.9%) and 109 without it (66.1%; 41.1% and 39.4%, respectively, were fully vaccinated against influenza). Fifteen patients with preexisting asthma (26.7%) and 34 without it (31.1%) were intubated. More patients with versus without preexisting asthma received pharmacologic asthma treatments during hospitalization (76.7% vs 28.4%). Of 136 patients with 90-day survey data (82.4%; 46 with preexisting asthma [33.8%] and 90 without it [66.1%]), a similar proportion had an emergency department/urgent care visit (4.3% vs 6.6%) or hospital readmission (8.6% vs 3.3%) for a respiratory condition. Patients with preexisting asthma more frequently experienced asthma symptoms (78.2% vs 3.3%) and had respiratory specialist visits (52% vs 20%) after discharge. Of 109 patients without preexisting asthma, 10 reported receiving a new diagnosis of asthma (11.1%). Conclusions: Respiratory health resource use and symptoms are important postdischarge outcomes after influenza critical illness in children with and without preexisting asthma. Less than half of children were vaccinated for influenza, a tool that could mitigate critical illness and its sequelae.",

keywords = "Acute respiratory viral infection, Asthma, Influenza, Outcomes, Pediatric intensive care unit, Reactive airway disease",

author = "{PALISI Pediatric Intensive Care Influenza Network Investigators} and Maddux, {Aline B.} and Grunwell, {Jocelyn R.} and Newhams, {Margaret M.} and Chen, {Sabrina R.} and Olson, {Samantha M.} and Halasa, {Natasha B.} and Weiss, {Scott L.} and Coates, {Bria M.} and Schuster, {Jennifer E.} and Hall, {Mark W.} and Nofziger, {Ryan A.} and Flori, {Heidi R.} and Gertz, {Shira J.} and Michele Kong and Sanders, {Ronald C.} and Katherine Irby and Hume, {Janet R.} and Cullimore, {Melissa L.} and Shein, {Steven L.} and Thomas, {Neal J.} and Kristen Miller and Manish Patel and Fitzpatrick, {Anne M.} and Wanda Phipatanakul and Randolph, {Adrienne G.} and Meghan Murdock and Glenda Hefley and Mourani, {Peter M.} and Van, {Kevin A.} and Rachel Mansour and Miller, {Kristen R.} and Avani Shukla and Jairo Chavez and Emily Jung and Dahmer, {Mary K.} and Chaandini Jayachandran and Lexie Goertzen and Brittany Faanes and Bledsoe, {Megan C.} and Clark, {Shannon E.} and Wellman, {Rachel L.} and Nicole Twinem and Rajashri Rasal and Maggie Flowers and Lisa Steele and Bush, {Jenny L.} and Burnett, {Ryan H.} and Debra Spear and Stewart, {Laura S.} and Lynch, {Tricia L.}",

note = "Funding Information: This study was supported in part by the Centers for Disease Control and Prevention (A.G. Randolph and PALISI Pediatric Intensive Care Influenza Network Investigators); Eunice Kennedy Shriver National Institute of Child Health and Human Development (A.B. Maddux, No. K23 HD096018), the National Heart, Lung, and Blood Institute (J.R. Grunwell, No. K23 HL151897), the National Institute of Nursing Research (A.M. Fitzpatrick, No. K24 NR018866), and the National Institutes of Allergy and Infectious Disease (A.G. Randolph and W. Phipatanakul, No. R01 AI 154470). The Centers for Disease Control and Prevention assisted with the collection, analysis, data interpretation and editing of the manuscript for important content, and in the decision to submit the article for publication. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Publisher Copyright: {\textcopyright} 2022 American Academy of Allergy, Asthma & Immunology",

year = "2023",

month = mar,

doi = "10.1016/j.jaip.2022.10.045",

language = "English (US)",

volume = "11",

pages = "836--843.e3",

journal = "Journal of Allergy and Clinical Immunology: In Practice",

issn = "2213-2198",

publisher = "Elsevier",

number = "3",

}

TY - JOUR

T1 - Association of Asthma With Treatments and Outcomes in Children With Critical Influenza

AU - PALISI Pediatric Intensive Care Influenza Network Investigators

AU - Maddux, Aline B.

AU - Grunwell, Jocelyn R.

AU - Newhams, Margaret M.

AU - Chen, Sabrina R.

AU - Olson, Samantha M.

AU - Halasa, Natasha B.

AU - Weiss, Scott L.

AU - Coates, Bria M.

AU - Schuster, Jennifer E.

AU - Hall, Mark W.

AU - Nofziger, Ryan A.

AU - Flori, Heidi R.

AU - Gertz, Shira J.

AU - Kong, Michele

AU - Sanders, Ronald C.

AU - Irby, Katherine

AU - Hume, Janet R.

AU - Cullimore, Melissa L.

AU - Shein, Steven L.

AU - Thomas, Neal J.

AU - Miller, Kristen

AU - Patel, Manish

AU - Fitzpatrick, Anne M.

AU - Phipatanakul, Wanda

AU - Randolph, Adrienne G.

AU - Murdock, Meghan

AU - Hefley, Glenda

AU - Mourani, Peter M.

AU - Van, Kevin A.

AU - Mansour, Rachel

AU - Miller, Kristen R.

AU - Shukla, Avani

AU - Chavez, Jairo

AU - Jung, Emily

AU - Dahmer, Mary K.

AU - Jayachandran, Chaandini

AU - Goertzen, Lexie

AU - Faanes, Brittany

AU - Bledsoe, Megan C.

AU - Clark, Shannon E.

AU - Wellman, Rachel L.

AU - Twinem, Nicole

AU - Rasal, Rajashri

AU - Flowers, Maggie

AU - Steele, Lisa

AU - Bush, Jenny L.

AU - Burnett, Ryan H.

AU - Spear, Debra

AU - Stewart, Laura S.

AU - Lynch, Tricia L.

N1 - Funding Information: This study was supported in part by the Centers for Disease Control and Prevention (A.G. Randolph and PALISI Pediatric Intensive Care Influenza Network Investigators); Eunice Kennedy Shriver National Institute of Child Health and Human Development (A.B. Maddux, No. K23 HD096018), the National Heart, Lung, and Blood Institute (J.R. Grunwell, No. K23 HL151897), the National Institute of Nursing Research (A.M. Fitzpatrick, No. K24 NR018866), and the National Institutes of Allergy and Infectious Disease (A.G. Randolph and W. Phipatanakul, No. R01 AI 154470). The Centers for Disease Control and Prevention assisted with the collection, analysis, data interpretation and editing of the manuscript for important content, and in the decision to submit the article for publication. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Publisher Copyright: © 2022 American Academy of Allergy, Asthma & Immunology

PY - 2023/3

Y1 - 2023/3

N2 - Background: Hospitalization for severe influenza infection in childhood may result in postdischarge sequelae. Objective: To evaluate inpatient management and postdischarge sequelae in children with critical respiratory illness owing to influenza with or without preexisting asthma. Methods: This was a prospective, observational multicenter study of children (aged 8 months to 17 years) admitted to a pediatric intensive care or high-acuity unit (in November 2019 to April 2020) for influenza. Results were stratified by preexisting asthma. Prehospital status, hospital treatments, and outcomes were collected. Surveys at approximately 90 days after discharge evaluated postdischarge health resource use, functional status, and respiratory symptoms. Results: A total of 165 children had influenza: 56 with preexisting asthma (33.9%) and 109 without it (66.1%; 41.1% and 39.4%, respectively, were fully vaccinated against influenza). Fifteen patients with preexisting asthma (26.7%) and 34 without it (31.1%) were intubated. More patients with versus without preexisting asthma received pharmacologic asthma treatments during hospitalization (76.7% vs 28.4%). Of 136 patients with 90-day survey data (82.4%; 46 with preexisting asthma [33.8%] and 90 without it [66.1%]), a similar proportion had an emergency department/urgent care visit (4.3% vs 6.6%) or hospital readmission (8.6% vs 3.3%) for a respiratory condition. Patients with preexisting asthma more frequently experienced asthma symptoms (78.2% vs 3.3%) and had respiratory specialist visits (52% vs 20%) after discharge. Of 109 patients without preexisting asthma, 10 reported receiving a new diagnosis of asthma (11.1%). Conclusions: Respiratory health resource use and symptoms are important postdischarge outcomes after influenza critical illness in children with and without preexisting asthma. Less than half of children were vaccinated for influenza, a tool that could mitigate critical illness and its sequelae.

AB - Background: Hospitalization for severe influenza infection in childhood may result in postdischarge sequelae. Objective: To evaluate inpatient management and postdischarge sequelae in children with critical respiratory illness owing to influenza with or without preexisting asthma. Methods: This was a prospective, observational multicenter study of children (aged 8 months to 17 years) admitted to a pediatric intensive care or high-acuity unit (in November 2019 to April 2020) for influenza. Results were stratified by preexisting asthma. Prehospital status, hospital treatments, and outcomes were collected. Surveys at approximately 90 days after discharge evaluated postdischarge health resource use, functional status, and respiratory symptoms. Results: A total of 165 children had influenza: 56 with preexisting asthma (33.9%) and 109 without it (66.1%; 41.1% and 39.4%, respectively, were fully vaccinated against influenza). Fifteen patients with preexisting asthma (26.7%) and 34 without it (31.1%) were intubated. More patients with versus without preexisting asthma received pharmacologic asthma treatments during hospitalization (76.7% vs 28.4%). Of 136 patients with 90-day survey data (82.4%; 46 with preexisting asthma [33.8%] and 90 without it [66.1%]), a similar proportion had an emergency department/urgent care visit (4.3% vs 6.6%) or hospital readmission (8.6% vs 3.3%) for a respiratory condition. Patients with preexisting asthma more frequently experienced asthma symptoms (78.2% vs 3.3%) and had respiratory specialist visits (52% vs 20%) after discharge. Of 109 patients without preexisting asthma, 10 reported receiving a new diagnosis of asthma (11.1%). Conclusions: Respiratory health resource use and symptoms are important postdischarge outcomes after influenza critical illness in children with and without preexisting asthma. Less than half of children were vaccinated for influenza, a tool that could mitigate critical illness and its sequelae.

KW - Acute respiratory viral infection

KW - Asthma

KW - Influenza

KW - Outcomes

KW - Pediatric intensive care unit

KW - Reactive airway disease

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UR - http://www.scopus.com/inward/citedby.url?scp=85143292970&partnerID=8YFLogxK

U2 - 10.1016/j.jaip.2022.10.045

DO - 10.1016/j.jaip.2022.10.045

M3 - Article

C2 - 36379408

AN - SCOPUS:85143292970

SN - 2213-2198

VL - 11

SP - 836-843.e3

JO - Journal of Allergy and Clinical Immunology: In Practice

JF - Journal of Allergy and Clinical Immunology: In Practice

IS - 3

ER -

Association of Asthma With Treatments and Outcomes in Children With Critical Influenza

Abstract

Bibliographical note

Keywords

PubMed: MeSH publication types

UN SDGs

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