Neuropsychiatric Complications in Influenza: Overall Incidence Low in Children

The incidence of pediatric influenza-associated neuropsychiatric complications is low overall but significantly higher among children and adolescents with vs without underlying neurologic or psychiatric conditions, according to study results published in The Pediatric Infectious Disease Journal.

Researchers conducted a retrospective cohort study from 2016 to 2020 to assess the incidence of severe neurologic and psychiatric complications among children and adolescents (age range, 5-17 years) with influenza. The researchers calculated incidence rates (IRs) by dividing the number of complications by total influenza person-time expressed per 100,000 person-weeks.

A total of 156,611 pediatric influenza encounters were included in the analysis, representing 134,379 unique patients (median age, 9.3 years; male sex, 51%; White, 62%). Overall, 45,986 (29%) patients were adolescents (age range, 12-17 years), 22,213 (14%) had preexisting neurologic or psychiatric conditions, and 3075 (2%) had complex chronic conditions.

Influenza-associated neurologic or psychiatric complications requiring hospitalization were predominantly observed in adolescents (53%), those without underlying complex chronic conditions (80%), and those with underlying neurologic or psychiatric comorbidities (60%).

There were 68 neurologic complications reported. The rate of influenza-associated neurologic complications (per 100,000 person-weeks of influenza) was lower in the overall cohort (IR, 30.5; 95% CI, 24.0-38.6) than in patients with underlying comorbidities (IR, 1880.9; 95% CI, 971.9-3285.5). The most common neurologic complication was seizure (IR, 17.5; 95% CI, 12.8-23.9), followed by dizziness, headache, ataxia/movement disorders, sleep disorders/vision changes, and encephalitis.

Similar findings were observed for psychiatric complications, with a total of 45 reported and lower rates in the overall population (IR, 20.2; 95% CI, 15.1-27.0) than in patients with underlying psychiatric comorbidities (IR, 111.8; 95% CI, 77.9-155.5). The most and least frequently observed neurologic complications were mood disorders (IR, 17.5; 95% CI, 12.8-23.9) and self-harm events (IR, 0.9; 95% CI, 0.3-3.3), respectively.

Study limitations include the lack of information on influenza vaccination status and laboratory-confirmed infection. In addition, these findings may not be representative of other populations.

“These findings emphasize the importance of mitigating influenza through prevention and vaccination efforts to prevent potentially life-altering influenza complications,” the researchers concluded.

This article originally appeared on Infectious Disease Advisor