Resident Children's Hospital of Michigan Detroit, Michigan, United States
Background: Sickle cell disease (SCD) encompasses a single mutation in the B globin gene leading to multiple complications including vasococclusive crisis and acute chest syndrome. Children with SCD are at a higher risk for severe outcomes when an infection is present. Influenza is a common respiratory infection in children with predominantly good outcomes. However, severe disease does occur particularly in those children with co morbidities. Studies on the impact of influenza infection on SCD are limited and the risk factors for severe outcomes in children with SCD and influenza infection are unknown. Objective: We sought to describe and compare the clinical characteristics, risk factors, and outcomes of children with influenza with and without sickle cell disease (SCD). Design/Methods: This is a retrospective cohort study of children < 18 years of age) with influenza with and without sickle cell disease (SCD) evaluated in an emergency department of a tertiary care children’s hospital from 1/1/2015-11/30/2022. We defined severe outcomes as occurrence of death due to a related cause, respiratory failure (requiring mechanical, non-invasive ventilation or >50% FiO2 or high flow nasal cannula), or shock (requiring pressors or ECMO). Information on demographics (age, sex, race), symptoms and signs at presentation, laboratory work up, radiographs, influenza results, interventions, and outcomes will be noted. Data will be described using means and medians based on normality. A t test will be used to compare means while the Chi square test will compare categorical data. Multiple logistic regression will be performed to determine the risk factors associated with severe outcomes of influenza in children with SCD. This study has been categorized as exempt by the Institutional Review Board. Study data collection and analysis will be completed by 12/23/2023. We will describe the study sample for severity of disease in the aforementioned study population and use the statistical methods described above.
