{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:04:28Z","timestamp":1787065468382,"version":"build-2736575974"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T00:00:00Z","timestamp":1704931200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>The highly infectious Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have caused large-scale transmission from Dec 2022 to Feb 2023 in China. After this event, a remarkable surge of influenza A (Flu A) occurred from March to May 2023, especially in pediatric patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to investigate the differences between pediatric patients infected with COVID-19 Omicron and Flu A virus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 1,063 hospitalized children who admitted into two tertiary general hospital of Guangdong province of China were included. Medical records were compared retrospectively in these patients during the pandemic periods of SARS-CoV-2 omicron and Flu A.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 592 Patients with Flu A were mostly preschool and school-aged (&amp;gt;3y, 76.0%), they showed higher ratio of high fever (\u226539\u00b0C), cough, rhinorrhea, and vomiting than patients with SARS-CoV-2 omicron. Most of the 471 Omicron patients were young children (0\u20133y, 74.5%) and had more poor appetite and dyspnea symptom. Benign acute children myositis (BACM) was only observed in patients with Flu A, and a significant male predominance. Multisystem inflammatory syndrome in children (MIS-C) was only found in patients with SARS-CoV-2 Omicron. Compared to the SARS-CoV-2 Omicron group, for both age groups (0\u20133 years and &amp;gt; 3 years), the Flu A group showed significantly reduced lymphocyte (Lym) counts (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), and elevated levels of aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and creatinine kinase-MB (CK-MB) in laboratory indexes (all\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). Additionally, it was found that more children hospitalized with COVID-19 had increased C-reactive protein (CRP) levels compared to those with Flu A.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Influenza A infections have notably surged in children, coinciding with the relaxation of COVID-19 related social restrictions. During the epidemic periods of Omicron and Flu A virus infection, different clinical and laboratory characteristics were observed in hospitalized children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2023.1289487","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T23:27:26Z","timestamp":1704929246000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Resurgence of influenza A after SARS-CoV-2 omicron wave and comparative analysis of hospitalized children with COVID-19 and influenza A virus infection"],"prefix":"10.3389","volume":"10","author":[{"given":"Fen","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Man-Tong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"He","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ze-Xiang","family":"Guan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhong-Xian","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Zhou","family":"Wen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Ye","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,1,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1001\/jamaoto.2020.0832","article-title":"Sudden and complete olfactory loss function as a possible symptom of COVID-19.","volume":"146","author":"Eliezer","year":"2020","journal-title":"JAMA Otolaryngol Head Neck Surg."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2512","DOI":"10.1001\/jama.2020.8391","article-title":"Olfactory dysfunction in COVID-19: diagnosis and management.","volume":"323","author":"Whitcroft","year":"2020","journal-title":"JAMA."},{"key":"B3","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1080\/07853890.2022.2031274","article-title":"Emerging COVID-19 variants and their impact on SARS-CoV-2 diagnosis, therapeutics and vaccines.","volume":"54","author":"Fernandes","year":"2022","journal-title":"Ann Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1016\/S0140-6736(22)00982-5","article-title":"Influenza.","volume":"400","author":"Uyeki","year":"2022","journal-title":"Lancet."},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1093\/jtm\/taaa087","article-title":"Positive impact of measures against COVID-19 on reducing influenza in the Northern Hemisphere.","volume":"27","author":"Chan","year":"2020","journal-title":"J Travel Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1305","DOI":"10.15585\/mmwr.mm6937a6","article-title":"Decreased influenza activity during the COVID-19 pandemic - United States, Australia, Chile, and South Africa, 2020.","volume":"69","author":"Olsen","year":"2020","journal-title":"Am J Transplant."},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1093\/jtm\/taac107","article-title":"Resurgence of influenza A infections in children after the relaxation of COVID-19-related social distancing measures and normalization of international travel in Qatar.","volume":"29","author":"P\u00e9rez-L\u00f3pez","year":"2022","journal-title":"J Travel Med."},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3390\/v15010116","article-title":"Flu and universal vaccine research in China.","volume":"15","author":"Li","year":"2023","journal-title":"Viruses."},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1111\/irv.13103","article-title":"Epidemiological and clinical characteristics of respiratory syncytial virus and influenza infections in hospitalized children before and during the COVID-19 pandemic in Central China.","volume":"17","author":"Ren","year":"2023","journal-title":"Influenza Other Respir Viruses."},{"key":"B10","doi-asserted-by":"publisher","first-page":"5683","DOI":"10.1016\/j.vaccine.2023.08.039","article-title":"Influenza vaccine effectiveness against influenza A during the delayed 2022\/23 epidemic in Shihezi, China.","volume":"41","author":"Su","year":"2023","journal-title":"Vaccine."},{"key":"B11","year":"2023","journal-title":"Novel coronavirus infection diagnosis and treatment protocol (Trail Version 10)."},{"key":"B12","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1503\/cmaj.090781","article-title":"A stiff-legged gait: benign acute childhood myositis.","volume":"181","author":"Jain","year":"2009","journal-title":"CMAJ."},{"key":"B13","doi-asserted-by":"publisher","first-page":"e276","DOI":"10.1016\/S1473-3099(20)30651-4","article-title":"COVID-19 and multisystem inflammatory syndrome in children and adolescents.","volume":"20","author":"Jiang","year":"2020","journal-title":"Lancet Infect Dis."},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2023.1167871","article-title":"Characteristics and outcomes of multisystem inflammatory syndrome in children: a multicenter, retrospective, observational cohort study in Mexico.","volume":"11","author":"Yamazaki-Nakashimada","year":"2023","journal-title":"Front Pediatr."},{"key":"B15","year":"2023","journal-title":"XBB strain hits the screen, these things you need to know."},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1186\/s12985-023-02040-z","article-title":"Comparison of 14 respiratory pathogens among hospitalized children during and after the COVID-19 outbreak in Chaoshan area.","volume":"20","author":"Lin","year":"2023","journal-title":"Virol J."},{"key":"B17","doi-asserted-by":"publisher","first-page":"3809","DOI":"10.1007\/s00284-020-02213-x","article-title":"Dynamic propagation and impact of pandemic FluA (2009 H1N1) in children: a detailed review.","volume":"77","author":"Ratre","year":"2020","journal-title":"Curr Microbiol."},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-3750-8","article-title":"A year of terror and a century of reflection: perspectives on the great Flu pandemic of 1918\u20131919.","volume":"19","author":"Nickol","year":"2019","journal-title":"BMC Infect Dis."},{"key":"B19","year":"","journal-title":"Guangdong Province Vaccine Circulation and Vaccination Management Information System (Virtual Private Network)"},{"key":"B20","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.","volume":"395","author":"Huang","year":"2020","journal-title":"Lancet."},{"key":"B21","first-page":"365","article-title":"Viral myositis in children.","volume":"63","author":"Magee","year":"2017","journal-title":"Can Fam Phys."},{"key":"B22","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1016\/j.arcped.2022.08.009","article-title":"Benign acute childhood myositis: a 5-year retrospective study.","volume":"29","author":"Costa Azevedo","year":"2022","journal-title":"Arch Pediatr."},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1111\/ped.15273","article-title":"Benign acute childhood myositis: factors associated with muscle symptoms and resolution.","volume":"64","author":"\u00d6zt\u00fcrk","year":"2022","journal-title":"Pediatr Int."},{"key":"B24","doi-asserted-by":"publisher","first-page":"4341","DOI":"10.1007\/s00431-023-05115-9","article-title":"Benign acute children myositis: 5 year experiences in a tertiary care pediatric hospital.","volume":"18","author":"Attaianese","year":"2023","journal-title":"Eur J Pediatr."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1607","DOI":"10.1016\/S0140-6736(20)31094-1","article-title":"Hyperinflammatory shock in children during COVID-19 pandemic.","volume":"395","author":"Riphagen","year":"2020","journal-title":"Lancet."},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.1021200","article-title":"Multisystem inflammatory syndrome (MIS-C) with SARS-CoV-2 SARS-CoV-2 Omicron variant BA.2.38 in a four-year-old Chinese girl: a case report.","volume":"10","author":"Wang","year":"2022","journal-title":"Front Public Health."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1111\/irv.13044","article-title":"Epidemiological and clinical features of SARS-CoV-2 infection in children during the outbreak of SARS-CoV-2 Omicron variant in Shanghai, March 7\u201331, 2022.","volume":"16","author":"Wang","year":"2022","journal-title":"Flu Other Respir Viruses."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1289487\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T23:27:30Z","timestamp":1704929250000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1289487\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,11]]},"references-count":27,"alternative-id":["10.3389\/fmed.2023.1289487"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.1289487","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,11]]},"article-number":"1289487"}}