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Background <p>Influenza viruses (IFV) have major impacts on children’s health. We studied IFV A/B epidemiology and disease severity during a 17 year-long period including the 2009 H1N1 influenza pandemic and post-COVID-19 in 2021–2023.</p> Methods <p>Nasopharyngeal samples from children referred with fever or respiratory symptoms to a Norwegian hospital from 2006 to 2023 were tested with PCR for IFV A/B and 17 other pathogens. We compared IFV hospitalization rates and disease severity before and during the 2009 influenza pandemic, and before and after the COVID-19 pandemic, respectively, using age-adjusted logistic regression analyses.</p> Results <p>From 2006 to 2023, 502 children with IFV A/B were included (IFV A 74%, IFV B 26%). Two-hundred-fifty-one (50%) were hospitalized &gt; 24&#xa0;h. During the 2009 H1N1 influenza pandemic rates of hospitalization &gt; 24&#xa0;h in children ≤ 5 and &gt; 5 years of age increased from 44 to 72, and 4 to 20 per 100,000, respectively, compared to 2006–2009. The median age of IFV positive children doubled from 23 to 49 months (<i>p</i>=.006), but no other clinical changes occurred. Post-COVID-19 (2021–2023), the hospitalization rates only increased in children &gt; 5 years from 12 to 25 per 100,000, and the median age almost doubled from 33 to 62 months (<i>p</i>&lt;.001) compared to 2010–2020. Post-COVID-19, fewer children had lower respiratory tract infections (aOR 0.32, 95% CI 0.20–0.53) and severe complications (aOR 0.24, 95% CI 0.07–0.82).</p> Conclusions <p>Compared to other influenza seasons, disease severity during the 2009 H1N1 influenza pandemic was unchanged, but post-COVID-19 children referred to hospital with IFV A/B had milder disease.</p>

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Hospitalized children with influenza virus: a 17 year-long observational study including the 2009 H1N1 influenza pandemic and COVID-19 pandemic

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  • 发表日期：

    2026年2月12日

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  • Hedda Trømborg Jalving,
  • Andreas Christensen,
  • Svein Arne Nordbø,
  • Kari Risnes,
  • Henrik Døllner,
  • Inger Heimdal

摘要

Background

Influenza viruses (IFV) have major impacts on children’s health. We studied IFV A/B epidemiology and disease severity during a 17 year-long period including the 2009 H1N1 influenza pandemic and post-COVID-19 in 2021–2023.

Methods

Nasopharyngeal samples from children referred with fever or respiratory symptoms to a Norwegian hospital from 2006 to 2023 were tested with PCR for IFV A/B and 17 other pathogens. We compared IFV hospitalization rates and disease severity before and during the 2009 influenza pandemic, and before and after the COVID-19 pandemic, respectively, using age-adjusted logistic regression analyses.

Results

From 2006 to 2023, 502 children with IFV A/B were included (IFV A 74%, IFV B 26%). Two-hundred-fifty-one (50%) were hospitalized > 24 h. During the 2009 H1N1 influenza pandemic rates of hospitalization > 24 h in children ≤ 5 and > 5 years of age increased from 44 to 72, and 4 to 20 per 100,000, respectively, compared to 2006–2009. The median age of IFV positive children doubled from 23 to 49 months (p=.006), but no other clinical changes occurred. Post-COVID-19 (2021–2023), the hospitalization rates only increased in children > 5 years from 12 to 25 per 100,000, and the median age almost doubled from 33 to 62 months (p<.001) compared to 2010–2020. Post-COVID-19, fewer children had lower respiratory tract infections (aOR 0.32, 95% CI 0.20–0.53) and severe complications (aOR 0.24, 95% CI 0.07–0.82).

Conclusions

Compared to other influenza seasons, disease severity during the 2009 H1N1 influenza pandemic was unchanged, but post-COVID-19 children referred to hospital with IFV A/B had milder disease.