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. 2025 May 28;17(6):771.
doi: 10.3390/v17060771.

Impact of Influenza on Children in a Referral Hospital in Mexico City: Clinical Burden and Predictors of Mechanical Ventilation

Rodolfo Norberto Jiménez-Juárez  1 , Sarbelio Moreno-Espinosa  2 , Alfonso Reyes-Lopez  3 , Israel Parra-Ortega  4 , Almudena Laris-Gonzalez  1 , Daniela De la Rosa-Zamboni  5 , Paola Guerra-de-Blas  6   7 , Ana Estela Gamiño-Arroyo  1   8
Affiliations

Impact of Influenza on Children in a Referral Hospital in Mexico City: Clinical Burden and Predictors of Mechanical Ventilation

Rodolfo Norberto Jiménez-Juárez et al. Viruses. .

Abstract

Influenza is a highly transmissible seasonal disease that significantly impacts public health worldwide, causing lower respiratory tract infections, numerous hospitalizations, and prolonged stays. However, data on its clinical burden in children in Latin America remain limited. This retrospective cohort study analyzed the demographic and clinical characteristics of children hospitalized with influenza in Latin America, stratified by age, and identified factors associated with mechanical ventilation. Medical records of children with severe acute respiratory infection associated with influenza were reviewed. Statistical analyses included chi square and Wilcoxon tests to compare groups, and Cox regression to identify predictors of mechanical ventilation. Among 212 cases, 46% of admissions were in school-age children; 93.4% had comorbidities. Influenza AH1N1 was more frequent in children <5 years and influenza H3N2 in children >5 years of age. The mechanical ventilation rate per age group was 24.1% among those <1 year, 29.8% in 1-4 years of age, 4.9% in 5-9 years of age, and 26.3% in children 10-18 years of age. Hypotension, paradoxical breathing, and nosocomial infection were identified as predictors for mechanical ventilation. These findings enhance the understanding of influenza's clinical impact on pediatric populations, particularly in predicting severe outcomes requiring intensive care, and aid in developing strategies to mitigate its effects.

Keywords: Mexico; SARI; influenza; mechanical ventilation; risk factors; school-age children.

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Conflict of interest statement

R.N.J.J.: Received the Sanofi Pasteur Grant number FLU00074. Receives Honoraria for lectures of Sanofi Pasteur; S.M.E.: Receives Honoraria for lectures of Sanofi Pasteur; A.L.G.: Receives Honoraria for lectures of Sanofi Pasteur. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Study flow chart. Diagram for subject selection.
Figure 2
Figure 2
Seasonality of admissions for influenza 2013–2018 at the Federico Gómez Children’s Hospital of Mexico. Seasons 2016–2017 and 2017–2018 cocirculated influenza B lineages Yamagata and Victoria. Peaks of influenza activity found in January.
Figure 3
Figure 3
Length of stay per age group. (A) Length to stay for all hospitalizations; (B) length to stay for PICU.
Figure 4
Figure 4
Kaplan–Meir curves for mechanical ventilation. (A) Free days of mechanical ventilation for all cohorts; (B) free days of mechanical ventilation per age groups.
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