Currently, real-world studies on children with influenza in China are mainly based on retrospective clinical data analysis, and lack prospective designs from the patient's perspective to evaluate the self-reported outcomes and real-world experiences. In this real-world prospective cohort study, we enrolled 5-14 years old of influenza pediatric outpatients with administration of antivirals by physicians during the influenza season from December 2024 to March 2025, in the Children’s Hospital of Henan Province. Follow-ups was conducted using telephone visit and Influenza Patient-reported Outcome (FLU-PRO) diary for patients. The primary clinical outcomes were the FLU-PRO scores to assess influenza symptoms duration and severity. Secondary clinical outcomes included health-related quality of life (HRQoL) by EQ-5D-Y-3L, patients and their family’s satisfaction and preference. Among 208 pediatric influenza patients (120 oseltamivir (OST); 88 baloxavir marboxil (BXM)), BXM demonstrated better taste acceptability (26.14% highest satisfaction vs. oseltamivir’s 17.5% slightly/5.83% strongly dislike; p=0.0019) and superior preference (unwilling to reuse for children: 3.41% vs. 16.67%, p=0.0238; for parents: 2.27% vs. 10.83%, p=0.0116). OST granule had lower adherence (12.5% discontinuation, 27.5% due to poor palatability or digestive discomfort). The baseline Flu-PRO score was higher in the BXM group than in the OST group, but the changes in follow-up scores were similar between groups, showing a declining trend with no statistically significant differences, so as the EQ-5D-Y-3L score. Patient-reported outcomes (PROs) were comparable between the two groups, and patients’ overall satisfaction and preference significantly favored BXM, indicating BXM as a favorable antiviral option based on real-world patient experience

Chengyu Li is pursuing her Master's in Epidemiology at Fudan University School of Public Health, specializing in major infectious diseases and biosecurity. Her current research focuses on the real-world effectiveness of baloxavir marboxil in pediatric outpatients and patient-reported outcome tools for influenza.