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Observational Study
. 2023 Jul;28(29):2300056.
doi: 10.2807/1560-7917.ES.2023.28.29.2300056.

Influenza versus other respiratory viruses - assessing severity among hospitalised children, Belgium, 2011 to 2020

Natalie Fischer  1   2 , Sarah Moreels  3 , Nicolas Dauby  4   5 , Marijke Reynders  6 , Evelyn Petit  6 , Michèle Gérard  4 , Patrick Lacor  7 , Siel Daelemans  8 , Bénédicte Lissoir  9 , Xavier Holemans  10 , Koen Magerman  11   12 , Door Jouck  12 , Marc Bourgeois  13 , Bénédicte Delaere  13 , Sophie Quoilin  14 , Steven Van Gucht  1 , Isabelle Thomas  1 , Nathalie Bossuyt  14 , Cyril Barbezange  1
Affiliations
Observational Study

Influenza versus other respiratory viruses - assessing severity among hospitalised children, Belgium, 2011 to 2020

Natalie Fischer et al. Euro Surveill. 2023 Jul.

Abstract

BackgroundKnowledge on the burden attributed to influenza viruses vs other respiratory viruses in children hospitalised with severe acute respiratory infections (SARI) in Belgium is limited.AimThis observational study aimed at describing the epidemiology and assessing risk factors for severe disease.MethodsWe retrospectively analysed data from routine national sentinel SARI surveillance in Belgium. Respiratory specimens collected during winter seasons 2011 to 2020 were tested by multiplex real-time quantitative PCR (RT-qPCR) for influenza and other respiratory viruses. Demographic data and risk factors were collected through questionnaires. Patients were followed-up for complications or death during hospital stay. Analysis focused on children younger than 15 years. Binomial logistic regression was used to identify risk factors for severe disease in relation to infection status.ResultsDuring the winter seasons 2011 to 2020, 2,944 specimens met the study case definition. Complications were more common in children with underlying risk factors, especially asthma (adjusted risk ratio (aRR): 1.87; 95% confidence interval (CI): 1.46-2.30) and chronic respiratory disease (aRR: 1.88; 95% CI: 1.44-2.32), regardless of infection status and age. Children infected with non-influenza respiratory viruses had a 32% higher risk of complications (aRR: 1.32; 95% CI: 1.06-1.66) compared with children with influenza only.ConclusionMulti-virus testing in children with SARI allows a more accurate assessment of the risk of complications and attribution of burden to respiratory viruses beyond influenza. Children with asthma and respiratory disease should be prioritised for clinical care, regardless of their virological test result and age, and targeted for prevention campaigns.

Keywords: burden of disease; influenza; non-influenza respiratory virus; risk factor; severity.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Inclusion and exclusion criteria to derive the selected study population of children < 15 years hospitalised with severe acute respiratory infection, Belgium, 2011/12–2019/20 (n = 12,145)
Figure 2
Figure 2
Influenza virus types and subtypes/lineages among children < 15 years hospitalised with severe acute respiratory infection, Belgium, 2011/12–2019/20 (n = 938)
Figure 3
Figure 3
Multi-virus infection status among children < 15 years hospitalised with severe acute respiratory infections, Belgium, 2015/16a−2019/20 (n = 1,701)
See this image and copyright information in PMC

References

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