Comparative Analysis of Outcomes of Influenza and COVID-19 Admissions Among Children With Asthma: A Nationwide Retrospective Cohort Study Using the US National Readmissions Database
Notice bibliographique
Résumé
BACKGROUND: Asthma is a common chronic respiratory disease with increasing prevalence among children over the past few decades. It can cause significant respiratory symptoms and acute exacerbations, often requiring emergency care or hospitalization. Moreover, exposure to respiratory viral infections, such as COVID-19 and influenza, can trigger severe complications in children with asthma. Despite these concerns, few studies have directly compared the in-hospital outcomes of children with asthma experiencing these infections. OBJECTIVE: This study aimed to compare the in-hospital outcomes of these infections in children with asthma from a population-based perspective. METHODS: We conducted a population-based retrospective cohort study using data from the 2020 US Nationwide Readmissions Database. Children aged 1 to 19 years with asthma who were admitted for COVID-19 or influenza were eligible for inclusion. Outcomes evaluated included in-hospital mortality, major complications, and 90-day readmission rate. Survey-weighted logistic regression models were used to compare clinical outcomes between the two infection groups, adjusting for demographic and clinical characteristics. RESULTS: A total of 1472 hospitalized children with asthma were included, of whom 405 (27.5%) were admitted for COVID-19 and 1067 (72.5%) for influenza. After adjustment, the multivariate analysis revealed that children admitted for COVID-19 had a significantly higher risk of sepsis or shock (adjusted odds ratio [aOR] 4.30, 95% CI 1.79-10.32) but a lower risk of bacterial or fungal pneumonia (aOR 0.37, 95% CI 0.23-0.61) compared with those admitted for influenza. Stratified analyses by age revealed that among children aged 1 to 5 years, the risk of 90-day readmission was significantly higher for those with COVID-19 than for those with influenza (aOR 3.02, 95% CI 1.09-8.35). No significant difference in in-hospital mortality was detected between the two infection groups in either the multivariable model or any of the age-stratified analyses. CONCLUSIONS: US children with asthma hospitalized for COVID-19 had higher risks of sepsis or shock compared to those admitted for influenza. In contrast, children admitted for influenza had a higher risk for bacterial or fungal pneumonia. After stratifying by age, children aged 1 to 5 years with COVID-19 had a significantly higher risk of 90-day readmission than those with influenza. Our findings suggest that different clinical approaches may be needed for children with asthma, depending on infection etiology and patient age.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».