Epidemiology and characteristics of Varicella (chickenpox), in pediatric age groups

Abstract Introduction: Varicella (chickenpox) remains a widespread childhood disease that can lead to serious complications requiring hospitalization. Despite its generally benign nature in immunocompetent children, the lack of universal varicella vaccination in Albania sustains endemic transmission and recurrent outbreaks. Understanding the epidemiological and clinical patterns of hospitalized cases is essential for guiding prevention and treatment strategies. Aim: To evaluate the hospitalization burden, epidemiological characteristics, and clinical complications of varicella among pediatric patients hospitalized at the University Hospital Center “Mother Teresa” from 2022 to 2024. Methods: A retrospective observational study was conducted on 252 children admitted with varicella between 2022 and 2024. Data on demographic variables, clinical findings, laboratory results, complications, treatment, and outcomes were extracted from medical records. Complications were classified by system involvement. Descriptive statistics, cross tabulations, and multivariate logistic regression were used to identify predictors of complications and prolonged hospital stay. Results: Of the 252 hospitalized children, 65.5% developed at least one complication. Only 32.9% of children were discharged with a diagnosis of uncomplicated varicella, a significant drop compared to 82.2% on admission. The most common complications on discharge were: skin and soft tissue infections (18.7%), respiratory complications (30.9%), and neurological complications (4.4%) including cerebellar ataxia and encephalitis. Hospitalizations peaked during spring (32.1%) and winter (27%). The median hospital stay was 5 days and was significantly longer among patients with complications (p < 0.001). Early initiation of acyclovir treatment within 72 hours was associated with a shorter hospital stay (mean 5.3 vs. 6.5 days, p = 0.022). Multivariate logistic regression identified age under five years, presence of comorbidities, and admission during autumn or winter as independent predictors of complications. Children aged