Burden, Risk Factors, and Clinical Outcomes of Pediatric Influenza in a Population with Extremely Low Vaccine Coverage

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OBJECTIVE: Influenza is a contagious viral respiratory tract infection that causes severe illness, particularly in high-risk populations such as young children and individuals with pre-existing health conditions. The study aims to identify clinical characteristics and key risk factors associated with respiratory support and mortality in children with influenza infection. MATERIALS AND METHODS: This retrospective, multicenter study was conducted across 33 hospitals from 19 cities in Türkiye. Data from pediatric inpatients aged <18 years diagnosed with influenza between October 2023 and May 2024 were analyzed. RESULTS: Among 1032 hospitalized children infected with influenza, 394 (38.2%) required respiratory support. The respiratory support group was significantly younger, with a mean age of 3.40 ± 4.37 years, compared to 4.96 ± 4.36 years in the non-respiratory support group (P < .001). The frequency of any underlying disease was significantly higher in the respiratory support group (P < .001). Notably, conditions such as neurometabolic disorders (20.3% vs. 9.6%) and pulmonary diseases (7.1% vs. 2.8%) were more common in this group. Influenza A infection and viral coinfections, particularly with respiratory syncytial virus, increased the likelihood of mechanical ventilation and mortality. The mortality proportion of all patients with influenza infection was 1.3% and the influenza vaccine coverage was only 1.1%. CONCLUSION: These findings highlight the urgent need to incorporate influenza vaccination into the national immunization program, especially for high-risk pediatric populations.

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