Evaluation of neurological manifestations of influenza A(H1N1) in children hospitalized with suspected influenza in Qods Hospital

Document Type : Research Paper

Authors

1 Qazvin University Medical Science

2 Qazvin University of Medical Science

10.22038/mjms.2026.80182.4624

Abstract

The emergence of influenza A (H1N1) was accompanied by an increase in reports of neurological manifestations in children. This study aimed to determine the neurological manifestations of influenza A(H1N1) in hospitalized children.
Materials and methods: In this retrospective study, the statistical population, including all patients with influenza admitted to Quds Hospital between 2017 and 2019, who met the inclusion criteria of having symptoms based on influenza, and a positive PCR test, were included in the study. All the demographic and clinical information of the patients were collected and recorded in the researcher's checklist. All information was statistically analyzed using spss version 26 software.
Results: 130 patients were included in the study, of which 65.4% were boys with an average age of 51.2 months. The most common clinical symptoms were fever, cough, nausea and vomiting, and weakness and lethargy, respectively. In 4 examined children, symptoms in favor of Raise ICP were observed. 29 children had convulsions with the most manifestations in the form of generalized tonic-clonic movements, UWG, 26 of which were accompanied by fever. The most common findings in the laboratory reports were increased glucose and CRP respectively, and the presence of red blood cells and white blood cells in the cerebrospinal fluid. 4 people (3%) of the children had a reduced level of consciousness upon arrival, and unfortunately 3 children also expired.
In case of simultaneous occurrence of neurological symptoms and symptoms of respiratory infection, a diagnostic test for influenza is necessary, followed by the initiation of antiviral treatment.

Keywords

Main Subjects

References

  1. Centers for Disease Control and Prevention. Disease burden of influenza. 2020.
  2. Paksu MS, Aslan K, Kendirli T, Akyildiz BN, Yener N, Yildizdas RD, Davutoglu M, Yaman A, Isikay S, Sensoy G, Tasdemir HA. Neuroinfluenza: evaluation of seasonal influenza associated severe neurological complications in children (a multicenter study). Child's Nervous System. 2018 Feb;34:335-47.
  3. Bal A, Suri V, Mishra B, Bhalla A, Agarwal R, Abrol A, Ratho RK, Joshi K. Pathology and virology findings in cases of fatal influenza A H1N1 virus infection in 2009–2010. Histopathology. 2012 Jan;60(2):326-35.
  4. Chen Q, Li P, Li S, Xiao W, Yang S, Lu H. Brain complications with influenza infection in children. Journal of Behavioral and Brain Science. 2020 Mar 24;10(3):129-52.
  5. Wilking AN, Elliott E, Garcia MN, Murray KO, Munoz FM. Central nervous system manifestations in pediatric patients with influenza A H1N1 infection during the 2009 pandemic. Pediatric neurology. 2014 Sep 1;51(3):370-6.
  6. Frankl S, Coffin SE, Harrison JB, Swami SK, McGuire JL. Influenza-associated neurologic complications in hospitalized children. The Journal of pediatrics. 2021 Dec 1;239:24-31.
  7. Chow EJ, Doyle JD, Uyeki TM. Influenza virus-related critical illness: prevention, diagnosis, treatment. Critical Care. 2019 Dec;23:1-1.
  8. Yoganathan S, Sudhakar SV, James EJ, Thomas MM. Acute necrotising encephalopathy in a child with H1N1 influenza infection: a clinicoradiological diagnosis and follow-up. Case Reports. 2016 Jan 11;2016:bcr2015213429.
  9. Song Y, Li S, Xiao W, Shen J, Ma W, Wang Q, Yang H, Liu G, Hong Y, Li P, Yang S. Influenza-associated encephalopathy and acute necrotizing encephalopathy in children: a retrospective single-center study. Medical science monitor: international medical journal of experimental and clinical research. 2021;27:e928374-1.
  10. Levine JM, Ahsan N, Ho E, Santoro JD. Genetic acute necrotizing encephalopathy associated with RANBP2: clinical and therapeutic implications in pediatrics. Multiple Sclerosis and Related Disorders. 2020 Aug 1;43:102194.
  11. Chopra P, Bhatia RS, Chopra R. Mild encephalopathy/encephalitis with reversible splenial lesion in a patient with Salmonella typhi infection: an unusual presentation with excellent prognosis. Indian Journal of Critical Care Medicine: Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine. 2019 Dec;23(12):584.
  12. Dadak M, Pul R, Lanfermann H, Hartmann H, Hehr U, Donnerstag F, Michels D, Tryc AB. Varying patterns of CNS imaging in influenza A encephalopathy in childhood. Clinical neuroradiology. 2020 Jun;30:243-9.
  13. Wu X, Wu W, Pan W, Wu L, Liu K, Zhang HL. Acute necrotizing encephalopathy: an underrecognized clinicoradiologic disorder. Mediators of Inflammation. 2015 Oct;2015.
  14. Hindupur A, Dhandapani P, Menon T. Influenza Virus Among Children with Acute Respiratory Infections in Chennai, India. Indian Pediatrics. 2019 Jan 1;56(1):74-5.
  15. Takia L, Saini L, Keshavan S, Angurana SK, Nallasamy K, Suthar R, Verma S, Singh P, Goyal K, Ratho RK, Jayashree M. Neurological manifestations of influenza A (H1N1): clinical features, intensive care needs, and outcome. The Indian Journal of Pediatrics. 2020 Oct;87:803-9.
  16. Mastrolia MV, Rubino C, Resti M, Trapani S, Galli L. Characteristics and outcome of influenza-associated encephalopathy/encephalitis among children in a tertiary pediatric hospital in Italy, 2017–2019. BMC infectious diseases. 2019 Dec;19:1-0.
  17. Jantarabenjakul W, Paprad T, Paprad T, Anugulruengkitt S, Pancharoen C, Puthanakit T, Chomtho K. Neurological complications associated with influenza in hospitalized children. Influenza and Other Respiratory Viruses. 2023 Jan;17(1):e13075.
  18. Sánchez-Torrent L, Triviño-Rodriguez M, Suero-Toledano P, Claret-Teruel G, Muñoz-Almagro C, Martínez-Sánchez L, Jordán-García I, Garcia-Garcia JJ. Novel influenza A (H1N1) encephalitis in a 3-month-old infant. Infection. 2010 Jun;38:227-9.
  19. Robinson JL, Saux NL. Neurologic manifestations of influenza in children. Official Journal of the Association of Medical Microbiology and Infectious Disease Canada. 2020 Jan 27;5(1):1-3.
  20. Rao S, Martin J, Ahearn MA, Osborne C, Moss A, Dempsey A, Dominguez SR, Weinberg A, Messacar KB. Neurologic manifestations of influenza A (H3N2) infection in children during the 2016–2017 season. Journal of the Pediatric Infectious Diseases Society. 2020 Mar;9(1):71-4.
Medical Journal of Mashhad university of Medical Sciences
Volume 69, Issue 4
May 2026
Pages 491-500

Files

Share

How to cite

Statistics