Abstract
BackgroundDue to lack of proven therapies, we evaluated the effect of CBP on Influenza-Associated Neurological Disease in children.MethodsA single-center, retrospective, cohort study was conducted in Luoyang, Henan province, China from January 2018 to January 2020. Children (<18 years) with influenza-associated neurological disease were enrolled in the study. Children with indications for CBP and parental consent received CBP (Continuous Blood purification), while others received maximal intensive care treatment because of the absence of parental consent. The outcomes of the CBP and non-CBP groups were compared. Categorical variables were presented as percentage and compared by Chi-square test. Continuous variables were expressed as median (interquartile ranges) and compared with non-parametric independent sample test. Statistical analyses were carried out by SPSS (version 26.0) and p < 0.05 (2 tailed) was considered to be statistically significant.Results30 children with influenza-associated neurological disease were recruited to the study. 18 received CBP and the other 12 received maximal intensive care. There were no differences between CBP and non-CBP children in age, sex, body weight, type of influenza virus, neurological complications, Glasgow score, PIM-2 score and PCIS at admission (p > 0.05). The inflammatory factors (CRP, PCT and IL-6) of 30 cases were tested at admission and after 3 days of admission. In the CBP group, there was a significant decrease in IL-6 levels at 3 days of admission (p = 0.003) and a decrease in CRP and PCT levels, but no significant difference (p > 0.05). In the non-CBP group, there were no significant difference on levels of CRP, PCT and IL-6 at admission and 3-day of admission (p > 0.05). The 28-day mortality was significantly lower in the CBP group compared with the non-CBP group (11.11% vs. 50%, p = 0.034).ConclusionsCBP definitely reduces IL-6 levels significantly. We did find that the survival rate of patients in the CBP group was improved. But we don’t know if there is a relationship between the reduction of IL-6 levels and the survival rate. Trial registration: http://www.chictr.org.cn/index.aspx(ChiCTR2000031754).
Highlights
Due to lack of proven therapies, we evaluated the effect of Continuous Blood purification (CBP) on Influenza-Associated Neurological Disease in children
It is more common compared to adults, accounting for 1.7–15% of children hospitalized with influenza infection [3], and the burden of influenzaassociated neurological disease (IAND) is higher in the pediatric population
The aim of our study was to determine whether CBP has superior outcomes and prognosis in neurological complications in children with influenza compared to non-CBP
Summary
Due to lack of proven therapies, we evaluated the effect of CBP on Influenza-Associated Neurological Disease in children. Individuals in high risk groups, such as infants, can develop severe complications These complications include pneumonia, neurological complications and even multi-organ dysfunction. Pneumonia is the most common complication in children, neurological disease is one of the most severe complications [2]. It is more common compared to adults, accounting for 1.7–15% of children hospitalized with influenza infection [3], and the burden of influenzaassociated neurological disease (IAND) is higher in the pediatric population. The prognosis of influenza-associated neurological diseases has been reported to vary [5, 6], with encephalopathy and acute necrotizing encephalopathy having the poorest prognosis. CBP can remove inflammatory factors and reduce the level of inflammatory factors in the serum of sepsis patients [8]
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