{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T14:35:53Z","timestamp":1786545353275,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Influenza Resp Viruses"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Elevated transaminases have been associated with increased severity in adult influenza cases, but data in the pediatric population are limited. This study aims to evaluate the prevalence, clinical characteristics and prognostic value of elevated transaminases in children hospitalized for influenza.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicentre retrospective cohort study was conducted on 543 children hospitalized for acute viral respiratory infections. Demographic, clinical, biochemical, radiological features, and outcome were collected and analyzed, comparing children with influenza to those with other respiratory viruses. The association between elevated transaminases and clinical severity, complications, and intensive care unit (ICU) admission was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 543 children, 127 (23.4%) had laboratory\u2010confirmed influenza, with 24.4% showing elevated transaminases versus 7.2% in noninfluenza infections (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Influenza B was associated with a higher prevalence of hypertransaminasemia (40%) than influenza A (20.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.042). Asthenia, myalgia, and hypovolemic shock were more common in the elevated transaminase group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Biochemical markers indicated muscular rather than hepatic origin of hypertransaminasemia. Elevated transaminases correlated with length of hospital stay (10.2 vs. 5.8\u2009days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), ICU admission (OR 4.4,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035), high\u2010flow oxygen need (OR 4.6,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), and intravenous fluids (OR 6.2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Two deaths occurred, both in the elevated transaminase group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Elevated transaminases occur in one fourth of children hospitalized for influenza and are associated with more severe disease, systemic complications, and worse outcomes. The findings suggest that transaminase elevation reflects systemic and muscular involvement rather than primary liver injury. Monitoring transaminases provides an early, easy marker to identify children at risk of severe influenza.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/irv.70283","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T10:33:57Z","timestamp":1782297237000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hypertransaminasemia Is a Marker of Severity in Children Hospitalized for Influenza"],"prefix":"10.1111","volume":"20","author":[{"given":"Marco","family":"Poeta","sequence":"first","affiliation":[{"name":"Pediatric Infectious Disease Unit, Department of Maternal and Child Health University Hospital \u201cFederico II\u201d  Naples Italy"},{"name":"Department of Translational Medical Science University of Naples \u201cFederico II\u201d  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4986-1425","authenticated-orcid":false,"given":"Cristina","family":"Moracas","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Science University of Naples \u201cFederico II\u201d  Naples Italy"},{"name":"PhD National Programme in One Health Approaches to Infectious Diseases and Life Science Research, Department of Public Health, Experimental and Forensic Medicine University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Venturini","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Meyer Children's Hospital Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Sgubbi","sequence":"additional","affiliation":[{"name":"Department of Clinical, Surgical, Diagnostic and Pediatric Sciences Fondazione IRCCS Policlinico San Matteo  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8445-1236","authenticated-orcid":false,"given":"Maria Sole","family":"Valentino","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease Unit, Luigi Sacco Hospital University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Folgori","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Vittore Buzzi Children's Hospital  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2430-2981","authenticated-orcid":false,"given":"Laura","family":"Petrarca","sequence":"additional","affiliation":[{"name":"Department of Maternal, Infantile and Urological Sciences Sapienza University of Rome  Rome 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