{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T10:07:05Z","timestamp":1774951625552,"version":"3.50.1"},"reference-count":44,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The COVID-19 pandemic may have affected the care of patients with influenza. We investigated influenza antiviral use and associated factors in children hospitalized with influenza before and during the late COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We conducted active surveillance among US children with acute respiratory illness at 7 sites in the New Vaccine Surveillance Network before the COVID-19 pandemic (December 1, 2016 to March 31, 2020) and during the late pandemic period (July 1, 2021 to June 30, 2023). We included children hospitalized within 10 days of symptom onset who had positive test results for influenza by clinical or research testing. Research swabs were collected from all enrolled children; clinical testing was provider-directed. We used mixed-effects Poisson regression to compare incidence proportions of influenza antiviral use in the late pandemic with those of the prepandemic period. We determined factors associated with antiviral use during the late pandemic period using a mixed-effects logistic regression model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Among 1560 children hospitalized with influenza, antiviral use ranged between 48.3% and 56.8% prepandemic but declined to 38.1% in 2021 to 2022 and 46.1% in 2022 to 2023. The estimated antiviral use was 23% lower in the late pandemic (incidence proportion ratio,\u20090.77; 95% CI, 0.68\u20130.87) compared with the prepandemic period. During the late pandemic, factors associated with higher odds of antiviral use included an underlying medical condition presence, current season influenza vaccination, clinical influenza testing, intensive care unit admission, and site.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Influenza antiviral use in children hospitalized with influenza remained suboptimal following the COVID-19 pandemic. Our study highlights the need to improve antiviral use in children hospitalized with influenza.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2025-071898","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:02:52Z","timestamp":1768348972000},"source":"Crossref","is-referenced-by-count":0,"title":["Influenza Antiviral Use in Hospitalized Children Before and During the COVID-19 Pandemic"],"prefix":"10.1542","volume":"157","author":[{"given":"Olla","family":"Hamdan","sequence":"first","affiliation":[{"name":"1Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin Z.","family":"Amarin","sequence":"additional","affiliation":[{"name":"1Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James W.","family":"Antoon","sequence":"additional","affiliation":[{"name":"1Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tess","family":"Stopczynski","sequence":"additional","affiliation":[{"name":"1Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura S.","family":"Stewart","sequence":"additional","affiliation":[{"name":"1Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eileen J.","family":"Klein","sequence":"additional","affiliation":[{"name":"2Seattle Children\u2019s Research Institute and University of Washington School of Medicine, Seattle, Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet A.","family":"Englund","sequence":"additional","affiliation":[{"name":"2Seattle Children\u2019s Research Institute and University of Washington School of Medicine, Seattle, Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geoffrey A.","family":"Weinberg","sequence":"additional","affiliation":[{"name":"3University of Rochester School of Medicine and Dentistry and UR-Golisano Children\u2019s Hospital, Rochester, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter G.","family":"Szilagyi","sequence":"additional","affiliation":[{"name":"3University of Rochester School of Medicine and Dentistry and UR-Golisano Children\u2019s Hospital, Rochester, New York"},{"name":"4Department of Pediatrics, University of California at Los Angeles, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John V.","family":"Williams","sequence":"additional","affiliation":[{"name":"5UPMC Children\u2019s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"},{"name":"6Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marian G.","family":"Michaels","sequence":"additional","affiliation":[{"name":"5UPMC Children\u2019s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie A.","family":"Boom","sequence":"additional","affiliation":[{"name":"7Texas Children\u2019s Hospital and Baylor College of Medicine, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leila C.","family":"Sahni","sequence":"additional","affiliation":[{"name":"7Texas Children\u2019s Hospital and Baylor College of Medicine, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Allen","family":"Staat","sequence":"additional","affiliation":[{"name":"8Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth P.","family":"Schlaudecker","sequence":"additional","affiliation":[{"name":"8Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer E.","family":"Schuster","sequence":"additional","affiliation":[{"name":"9Children\u2019s Mercy Hospital, Kansas City, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rangaraj","family":"Selvarangan","sequence":"additional","affiliation":[{"name":"9Children\u2019s Mercy Hospital, Kansas City, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariana P.","family":"Toepfer","sequence":"additional","affiliation":[{"name":"10National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidi L.","family":"Moline","sequence":"additional","affiliation":[{"name":"10National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James D.","family":"Chappell","sequence":"additional","affiliation":[{"name":"1Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew J.","family":"Spieker","sequence":"additional","affiliation":[{"name":"1Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha M.","family":"Olson","sequence":"additional","affiliation":[{"name":"10National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha B.","family":"Halasa","sequence":"additional","affiliation":[{"name":"1Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"issue":"4","key":"2026033105172587900_r1","doi-asserted-by":"crossref","first-page":"e497","DOI":"10.1016\/S2214-109X(19)30545-5","article-title":"Global burden of respiratory infections associated with seasonal influenza in children under 5\u00a0years in 2018: a systematic review and modelling study","volume":"8","author":"Wang","year":"2020","journal-title":"Lancet Glob Health."},{"key":"2026033105172587900_r2","article-title":"Preliminary estimated flu disease burden 2023\u20132024 flu season","author":"Centers for Disease Control and Prevention","year":"2024"},{"key":"2026033105172587900_r3","article-title":"Influenza antiviral medications: 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and meta-analysis","volume":"3","author":"Gill","year":"2015","journal-title":"Lancet Respir Med."},{"issue":"1","key":"2026033105172587900_r36","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1097\/MOP.0000000000000721","article-title":"Pediatric influenza and illness severity: what is known and what questions remain?","volume":"31","author":"Doyle","year":"2019","journal-title":"Curr Opin Pediatr."},{"issue":"2","key":"2026033105172587900_r37","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1093\/jac\/dky445","article-title":"Risk of neuropsychiatric adverse events associated with the use of oseltamivir: a nationwide population-based case-crossover study","volume":"74","author":"Kang","year":"2019","journal-title":"J Antimicrob Chemother."},{"issue":"5","key":"2026033105172587900_r38","doi-asserted-by":"crossref","first-page":"e2024069111","DOI":"10.1542\/peds.2024-069111","article-title":"Variability of clinician recommendations for oseltamivir in children 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Predictors of antiviral receipt for influenza in hospitalized U.S. children, New Vaccine Surveillance Network (NVSN), 2016\u20132020","volume":"10","author":"Amarin","year":"2023","journal-title":"Open For Infect Dis."},{"issue":"9","key":"2026033105172587900_r41","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1093\/jpids\/piae075","article-title":"Factors associated with nonprescription of oseltamivir for infant influenza over 9 seasons","volume":"13","author":"Zaheer","year":"2024","journal-title":"J Pediatric Infect Dis Soc."},{"issue":"9","key":"2026033105172587900_r42","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1093\/cid\/cis636","article-title":"Treatment with neuraminidase inhibitors for critically ill patients with influenza A (H1N1)pdm09","volume":"55","author":"Louie","year":"2012","journal-title":"Clin Infect Dis."},{"issue":"4","key":"2026033105172587900_r43","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1093\/cid\/ciq144","article-title":"Risk factors for severe illness with 2009 pandemic influenza A (H1N1) virus infection in China","volume":"52","author":"Yu","year":"2011","journal-title":"Clin Infect Dis."},{"issue":"5","key":"2026033105172587900_r44","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1164\/rccm.200802-282OC","article-title":"Mortality reduction with influenza vaccine in patients with pneumonia outside \u201cflu\u201d season: pleiotropic benefits or residual confounding?","volume":"178","author":"Eurich","year":"2008","journal-title":"Am J Respir Crit Care Med."}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2025-071898\/1906250\/pediatrics.2025071898.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2025-071898\/1906250\/pediatrics.2025071898.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T09:17:39Z","timestamp":1774948659000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/157\/2\/e2025071898\/206090\/Influenza-Antiviral-Use-in-Hospitalized-Children"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,14]]},"references-count":44,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1,14]]},"published-print":{"date-parts":[[2026,2,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2025-071898","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,14]]},"article-number":"e2025071898"}}