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Volume 17
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Article

Burden and Clinical Characteristics of Influenza and Its Complications in Children Across Multiple Epidemic Seasons

by
Arianna Dondi
1,2,†,
Fiorentina Guida
1,2,†,
Ludovica Trombetta
3,*,
Maddalena De Peppo Cocco
3,*,
Giulia Piccirilli
4,
Laura Andreozzi
1,
Eleonora Battelli
1,
Pasquale Castaldo
3,
Ilaria Corsini
1,
Luca Pierantoni
1,
Martina Franceschiello
4,
Liliana Gabrielli
4,
Monia Gennari
1,
Dalila Periccioli
3,
Tiziana Lazzarotto
2,4,
Daniele Zama
1,2,‡ and
Marcello Lanari
1,2,‡
1
Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, 40138 Bologna, Italy
2
Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40137 Bologna, Italy
3
Speciality School of Paediatrics, Alma Mater Studiorum, University of Bologna, 40137 Bologna, Italy
4
Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work as co-first author.
‡
These authors contributed equally to this work as co-last author.
Viruses 2025, 17(12), 1574; https://doi.org/10.3390/v17121574
Submission received: 3 November 2025 / Revised: 28 November 2025 / Accepted: 29 November 2025 / Published: 30 November 2025
(This article belongs to the Section Human Virology and Viral Diseases)
Review Reports Versions Notes

Abstract

Seasonal influenza is a major cause of morbidity and hospitalization in children, with the potential for severe complications and considerable socioeconomic impact. We conducted a retrospective observational study including 1046 children aged 0–14 years with laboratory-confirmed influenza who accessed the Paediatric Emergency Department of a tertiary center in Bologna, Italy, across three consecutive epidemic seasons (2022–2025). While the entire cohort was analysed, particular attention was given to children with severe complications requiring hospitalization, for whom more detailed clinical and laboratory data were available. Overall, 12.3% of patients required hospitalization, and 6.1% experienced complications, most frequently influenza-associated encephalopathy, lower respiratory tract infections and myositis. Influenza A predominated overall (82.0%), except for in the last season, which saw a predominance of influenza B (57.4%), closely associated with myositis and elevated creatine phosphokinase levels. Younger age was consistently associated with increased severity and hospitalization. Intensive care admissions were rare (0.8%), and no deaths were recorded. Our findings suggest that, although influenza is generally self-limiting, younger children are at higher risk of complications. These results highlight the importance of active surveillance, careful monitoring of clinical manifestations and targeted paediatric vaccination strategies to reduce the burden of seasonal influenza.
Keywords: influenza virus; paediatric; children; complications influenza virus; paediatric; children; complications

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MDPI and ACS Style

Dondi, A.; Guida, F.; Trombetta, L.; De Peppo Cocco, M.; Piccirilli, G.; Andreozzi, L.; Battelli, E.; Castaldo, P.; Corsini, I.; Pierantoni, L.; et al. Burden and Clinical Characteristics of Influenza and Its Complications in Children Across Multiple Epidemic Seasons. Viruses 2025, 17, 1574. https://doi.org/10.3390/v17121574

AMA Style

Dondi A, Guida F, Trombetta L, De Peppo Cocco M, Piccirilli G, Andreozzi L, Battelli E, Castaldo P, Corsini I, Pierantoni L, et al. Burden and Clinical Characteristics of Influenza and Its Complications in Children Across Multiple Epidemic Seasons. Viruses. 2025; 17(12):1574. https://doi.org/10.3390/v17121574

Chicago/Turabian Style

Dondi, Arianna, Fiorentina Guida, Ludovica Trombetta, Maddalena De Peppo Cocco, Giulia Piccirilli, Laura Andreozzi, Eleonora Battelli, Pasquale Castaldo, Ilaria Corsini, Luca Pierantoni, and et al. 2025. "Burden and Clinical Characteristics of Influenza and Its Complications in Children Across Multiple Epidemic Seasons" Viruses 17, no. 12: 1574. https://doi.org/10.3390/v17121574

APA Style

Dondi, A., Guida, F., Trombetta, L., De Peppo Cocco, M., Piccirilli, G., Andreozzi, L., Battelli, E., Castaldo, P., Corsini, I., Pierantoni, L., Franceschiello, M., Gabrielli, L., Gennari, M., Periccioli, D., Lazzarotto, T., Zama, D., & Lanari, M. (2025). Burden and Clinical Characteristics of Influenza and Its Complications in Children Across Multiple Epidemic Seasons. Viruses, 17(12), 1574. https://doi.org/10.3390/v17121574

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