{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T13:29:31Z","timestamp":1759411771861,"version":"3.40.5"},"reference-count":42,"publisher":"American Academy of Pediatrics (AAP)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,1]]},"abstract":"<jats:sec><jats:title>OBJECTIVES<\/jats:title><jats:p>Varicella is a common, usually benign, and autolimited disease in children but can lead to severe complications and hospitalization. With this study, we aim to analyze all varicella hospitalizations to provide epidemiological information to help outline preventive policies.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>We assessed all varicella hospitalizations in children aged 0 to 17 years, from 2000 to 2015, in mainland, public Portuguese hospitals using a Portuguese administrative database. Seasonality, geographic distribution, severity, complications, risk factors, use of diagnostic and treatment procedures and hospitalization costs were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 5120 hospitalizations were registered, with an annual rate of 17.3 hospitalizations per 100\u2009000 inhabitants. A higher number of hospitalizations occurred during the summer period and in Southern regions. The median length of stay was of 4 days (interquartile range: 3.0\u20137.0). We found a high rate of severe complications, mostly dermatologic (19.6%), neurologic (6.0%), and respiratory (5.1%). Of the total number of patients, 0.8% were immunocompromised and 0.1% were pregnant. Total direct hospitalization costs during the 16-year period were estimated to be 7\u2009110\u2009719\u20ac (8\u2009603\u2009970 USD), with a mean annual cost of 444\u2009419.92\u20ac (537\u2009748.10 USD).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCULSIONS<\/jats:title><jats:p>This is the first national study in which useful epidemiological data to evaluate the burden and impact of varicella in Portugal is provided.<\/jats:p><\/jats:sec>","DOI":"10.1542\/hpeds.2020-004275","type":"journal-article","created":{"date-parts":[[2021,8,2]],"date-time":"2021-08-02T09:28:34Z","timestamp":1627896514000},"page":"856-864","source":"Crossref","is-referenced-by-count":3,"title":["Varicella Admissions in Children and Adolescents in Portugal: 2000\u20132015"],"prefix":"10.1542","volume":"11","author":[{"given":"Jos\u00e9","family":"Fontoura-Matias","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Centro Hospitalar S\u00e3o Jo\u00e3o, Porto, Portugal"}]},{"given":"Raquel Sofia","family":"Moreira","sequence":"additional","affiliation":[{"name":"Faculty of Medicine"}]},{"given":"Ana","family":"Reis-Melo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Centro Hospitalar S\u00e3o Jo\u00e3o, Porto, Portugal"},{"name":"Department of Biomedicine, Faculty of Medicine"}]},{"given":"Alberto","family":"Freitas","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Information and Health Decision Sciences- MEDCIDS, Faculty of Medicine"},{"name":"Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine"}]},{"given":"In\u00eas","family":"Azevedo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Centro Hospitalar S\u00e3o Jo\u00e3o, Porto, Portugal"},{"name":"EpiUnit, Institute of Public Health"},{"name":"Department of Obstetrics, Gynecology and Pediatrics, Faculty of Medicine, Universidade do Porto, Porto, Portugal"}]}],"member":"417","published-online":{"date-parts":[[2021,8,1]]},"reference":[{"key":"2021121007505546200_b1","doi-asserted-by":"crossref","first-page":"15016","DOI":"10.1038\/nrdp.2015.16","article-title":"Varicella zoster virus infection","volume":"1","author":"Gershon","year":"2015","journal-title":"Nat Rev Dis Primers"},{"key":"2021121007505546200_b2","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1016\/S0163-4453(17)30188-3","article-title":"Is chickenpox so bad, what do we know about immunity to varicella zoster virus, and what does it tell us about the future?","volume":"74","author":"Gershon","year":"2017","journal-title":"J Infect"},{"issue":"5","key":"2021121007505546200_b3","doi-asserted-by":"crossref","DOI":"10.1542\/peds.105.5.e60","article-title":"Invasive group A streptococcal disease in children and association with varicella-zoster virus infection","volume":"105","author":"Laupland","year":"2000","journal-title":"Pediatrics"},{"issue":"7","key":"2021121007505546200_b4","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1136\/adc.2008.141994","article-title":"Necrotising fasciitis complicating varicella","volume":"93","author":"de Benedictis","year":"2008","journal-title":"Arch Dis Child"},{"issue":"21","key":"2021121007505546200_b5","first-page":"2486","article-title":"[Varicella zoster complications]","volume":"114","author":"Chelsom","year":"1994","journal-title":"Tidsskr Nor Laegeforen"},{"issue":"1","key":"2021121007505546200_b6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.medmal.2018.04.395","article-title":"Chickenpox: an update","volume":"49","author":"Lo Presti","year":"2019","journal-title":"Med Mal Infect"},{"issue":"25","key":"2021121007505546200_b7","first-page":"265","article-title":"Varicella and herpes zoster vaccines: WHO position paper, June 2014","volume":"89","year":"2014","journal-title":"Wkly Epidemiol Rec"},{"issue":"6","key":"2021121007505546200_b8","doi-asserted-by":"crossref","first-page":"741","DOI":"10.20344\/amp.6264","article-title":"Clinical and epidemiological study of complicated infection by varicella-zoster virus in the pediatric age [in Portuguese]","volume":"28","author":"Maia","year":"2015","journal-title":"Acta Med Port"},{"volume-title":"Estatisticas da Sa\u00fade","year":"2015","author":"Instituto Nacional Estatistica","key":"2021121007505546200_b9"},{"key":"2021121007505546200_b10","unstructured":"Instituto Nacional de Estatistica. 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