Повышенные трансаминазы у детей с гриппом предсказывают тяжелое течение и летальный исход

TOPLINE Hypertransaminasaemia, or elevated transaminase levels, appeared to serve as an early and reliable marker of systemic severity, identifying children at increased risk for complications, ICU admission, and mortality. METHODOLOGY - Researchers conducted a multicentre retrospective cohort study across 10 tertiary care centres in Italy from January 2023 to May 2025 to assess the role of elevated transaminase levels as a potential biomarker of disease severity and progression in children hospitalised for influenza infection. - A total of 543 children (mean age, 43 months; 57.6% boys) were included, of whom 23.4% had a laboratory-confirmed influenza infection comprising 102 cases of influenza A and 25 cases of influenza B, and the remaining 76.6% were diagnosed with non-influenza respiratory viral infections. - Children were stratified on the basis of the presence of hypertransaminasaemia, defined as aspartate aminotransferase and/or alanine aminotransferase levels greater than twice the upper normal value. - Clinical and laboratory parameters, including fever duration, inflammatory markers, length of hospitalisation, need for oxygen supplementation, and ICU admission, were compared between children with elevated and normal aminotransferase levels. TAKEAWAY - Hypertransaminasaemia was significantly more prevalent among patients with influenza B infection than among those with influenza A infection (40.0% vs 20.6%; P = .042). - Children with elevated transaminase levels showed a higher incidence of asthenia (54.8% vs 24.0%), myalgia (16.1% vs 4.2%), and hypovolaemic shock (9.7% vs 1.0%) than those with normal transaminase levels (P ≤ .05 for all). - The elevated transaminase group reported lower platelet counts (249 × 103 vs 328 × 103 cells/μL) and fibrinogen levels (255 vs 412 mg/dL) and higher ferritin levels (6581 vs 253 μg/L) than the normal transaminase group (P ≤ .05 for all), suggesting systemic inflammatory involvement. - Outcomes were significantly worse in the elevated transaminase group, with higher ICU admission rates (16.1% vs 4.2%; P = .024), longer hospital stays (mean, 10.2 vs 5.8 days; P = .002), and more deaths (two deaths in the elevated transaminase group). IN PRACTICE "Their integration into routine clinical assessment could support earlier and more tailored management decisions, including prolonged observation, timely start of antiviral therapies, or referral to higher level care facilities," the authors wrote. "For these reasons, the inclusion of AST [aspartate aminotransferase] and ALT [alanine aminotransferase] values into risk stratification tools or clinical severity scores may facilitate decision-making processes, particularly during seasonal influenza outbreaks," they added. SOURCE The study was led by Marco Poeta, University Hospital Federico II, Naples, Italy. It was published online on June 24, 2026, in Influenza and Other Respiratory Viruses. LIMITATIONS The study was limited by its retrospective design. Data on the dosing frequency and drug doses were unavailable. DISCLOSURES This study received funding from the European Union. The authors declared having no competing interests. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.