key: cord-0704754-gno9py68
authors: Devrim, İlker; Böncüoğlu, Elif; Kıymet, Elif; Şahinkaya, Şahika; Çelebi, Miray Yılmaz; Cem, Ela; Düzgöl, Mine; Arıkan, Kamile Ötiken; Kara, Aybüke Akaslan; Devrim, Fatma; Ağın, Hasan; Bayram, Nuri
title: Comparison of the pediatric hospitalizations due to COVID‐19 and H1N1pdm09 virus infections during the pandemic period
date: 2022-01-25
journal: J Med Virol
DOI: 10.1002/jmv.27589
sha: 6b9c96763de40b00c49611400aaf976c1e03d9f9
doc_id: 704754
cord_uid: gno9py68

There are two major pandemics in the new millennium, including the pandemic of swine influenza and the COVID‐19 pandemic. These two pandemics affected children as well as the adult population. In this case‐control study, we compared children with COVID‐19 infection and those with H1N1pdm09 virus infection. We also compared the demographic factors, underlying disease, and the requirement for intensive care admission between the hospitalized children with COVID‐19 infection and children with H1N1pdm09 virus infection who were hospitalized during the 2009 H1N1 pandemic. In this study, we evaluated 103 patients with H1N1pdm09 virus infection and 392 patients with COVID‐19 infection. The age was significantly higher in the COVID‐19 patients' group compared to the pandemic influenza group (p < 0.001). The ratio of the children ≥12 years was 10.7% (n = 11) in the H1N1pdm09 virus infection and 36.2% (n = 142) in the COVID‐19 group. The rate of underlying disease was significantly higher in the patients with H1N1pdm09 virus infections (p = 0.02). The prevalence of underlying disease in patients requiring PICU hospitalization was 69.2% (n = 9/13) compared to 25.7% (n = 124/482) in patients who did not require PICU hospitalization. The rate of underlying disease was significantly higher in the PICU group regardless of COVID‐19 or H1N1pdm09 virus (p = 0.002). Our results suggest that older children were more hospitalized for COVID‐19 infections compared to pandemic influenza. In addition, regardless of the type of pandemic infection, the underlying disease is an important factor for pediatric intensive care unit admission. This finding is important for developing strategies for the protection of children with the underlying disease in the upcoming pandemics.

Influenza Reference Laboratory in the Istanbul Faculty of Medicine.

The standard operating protocol as defined by the CDC was adhered to throughout this process. 3 Diagnosis of COVID-19 was documented by quantitative real-time RT-PCR positivity. The protocol of RT-PCR was consistent with the recommendation of the World Health Organization. 4 Demographic characteristics, pre-existing comorbidities on admission, and hospitalization at the pediatric intensive care unit (PICU) were collected from the electronic database of the hospital. Of the comorbid diseases, obesity was defined as a body mass index (BMI) at or above the 95th percentile for children and teens of the same age and sex. 5 

Statistical analysis was performed using SPSS statistical software (version 22; SPSS). Categorical variables were analyzed using relative frequencies, whereas numerical variables were analyzed using median or mean values (depending on whether they had a normal distribution). Categorical variables were compared using Pearson χ 2 and Fisher's exact tests. Numerical variables were compared using the t test or the nonparametric Mann-Whitney U test. A p < 0.05 was considered to be statistically significant.

In this study, we evaluated 103 patients with H1N1pdm09 virus infection and 392 patients with COVID-19 infection. The rate of males was 57.3% (n = 59) among the patients with H1N1pdm09 virus infection and 52.8% (n = 207) with COVID-19 infections, and no significant difference was present between these two groups (p > 0.05). The median age of the patients with H1N1pdm09 virus infection was 4 years (range 1 month-18 years) and the median age of the patients with COVID-19 infection was 7 years and 10 months (range 1 month-18 years), and the age was significantly higher in the COVID-19 patients' group compared to the pandemic influenza group (p < 0.001). The χ 2 independence test revealed an association between the type of Age is reported to be an important determinant factor for hospitalization in children with influenza infection. Hospitalization due to lower respiratory tract infections was reported to be highest in those younger than 5 years. [6] [7] [8] In a recent study, Boncuoglu et al. 9 reported that nearly half of the hospitalizations due to influenza infection were in the age group younger than 2 years of age. These studies mainly focused on influenza infections, including the period after the H1N1 2009 pandemic. In their report, Çiftçi et al. 10 10 On the other hand, obesity and bronchial asthma were significant underlying diseases for severity and mortality in adult patients with COVID-19 infections. 12 In a recent study, obesity was found to be remarkable comorbidity for severity, especially in older children. 13 In a systematic review of published articles, only two reports described asthma bronchial as a risk factor for severe COVID-19 infections. 14 In addition, a recent study from Spain reported no demographic differences between asthmatic children with and without probable COVID-19 infections. 15 One study from our center reported asthma and obesity as risk factors, which was consistent with our findings. 16 In addition, a study with a high case number reported the most frequent underlying medical condition like asthma, with a frequency of 10.2%. 17 

The data that support the findings of this study are available from the corresponding author upon reasonable request.

ORCID İlker Devrim http://orcid.org/0000-0002-6053-8027

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