Clinical outcomes of influenza in individuals aged ≤20 years before and after COVID-19: a national analysis of mortality and complications

Influenza's clinical profile in children has changed post-COVID, with increased respiratory failure and a shift to older affected age groups, while mortality and severe cardiovascular complications remain stable. This study is the first to systematically compare pediatric influenza outcomes, including all major complications and mortality, pre- and post-COVID-19, revealing specific shifts in disease presentation and demographics. Informs clinical vigilance, diagnostic strategies, and public health planning for pediatric influenza by highlighting shifts in hospitalization patterns and complications observed during the post-mitigation period. Findings support preparedness efforts recognizing temporal disruptions surrounding the pandemic.