Author:
Soldevila Núria,Acosta Lesly,Martínez Ana,Godoy Pere,Torner Núria,Rius Cristina,Jané Mireia,Domínguez Angela,Alsedà M.,Álvarez J.,Arias C.,Balañà P. J.,Barrabeig I.,Camps N.,Carol M.,Ferràs J.,Ferrús G.,Follia N.,Bach P.,Minguell S.,Parrón I.,Plasència E.,Sala-Farré M. R.,Torra R.,Torres J.,Marcos M. A.,Mosquera M. M.,Vilella A.,Antón A.,Pumarola T.,Campins M.,García D.,Oller Perez-Hita A.,Espejo E.,Freixas N.,Riera Garcia M.,Maraver E.,Mas D.,Pérez R.,Rebull J.,Pou J.,García-Pardo G.,Olona M.,Barcenilla F.,Castellana D.,Navarro-Rubio G.,Force L.,Mòdol-Deltell J. M.,Mena G.,Matas L.,Alvarez A.,Torrel J. M.,
Abstract
AbstractInfluenza is an important cause of severe illness and death among patients with underlying medical conditions and in the elderly. The aim of this study was to investigate factors associated with ICU admission and death in patients hospitalized with severe laboratory-confirmed influenza during the 2017–2018 season in Catalonia. An observational epidemiological case-to-case study was carried out. Reported cases of severe laboratory-confirmed influenza requiring hospitalization in 2017–2018 influenza season were included. Mixed-effects regression analysis was used to estimate the factors associated with ICU admission and death. A total of 1306 cases of hospitalized severe influenza cases were included, of whom 175 (13.4%) died and 217 (16.6%) were ICU admitted. Age 65–74 years and ≥ 75 years and having ≥ 2 comorbidities were positively associated with death (aOR 3.19; 95%CI 1.19–8.50, aOR 6.95, 95%CI 2.76–1.80 and aOR 1.99; 95%CI 1.12–3.52, respectively). Neuraminidase inhibitor treatment and pneumonia were negatively associated with death. The 65–74 years and ≥ 75 years age groups were negatively associated with ICU admission (aOR 0.41; 95%CI 0.23–0.74 and aOR 0.30; 95%CI 0.17–0.53, respectively). A factor positively associated with ICU admission was neuraminidase inhibitor treatment. Our results support the need to investigate the worst outcomes of hospitalized severe cases, distinguishing between death and ICU admission.
Funder
Programme of Prevention, Surveillance and Control of Transmissible Diseases (PREVICET), CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III
Catalan Agency for the Management of Grants for University Research
Publisher
Springer Science and Business Media LLC
Reference49 articles.
1. Treanor, J. J. Influenza viruses, including avian influenza and swine influenza. In Principles and Practice of Infectious Diseases 9th edn (eds Bennett, J. E. et al.) 2143–2176 (Elsevier, 2020).
2. World Health Organization. Influenza (Seasonal). (Accessed 15 Oct 2020) https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal) (2018).
3. Chaudhari, P. P., Monuteaux, M. C., Pannaraj, P. S., Khemani, R. G. & Bachur, R. G. Age-stratified risk of critical illness in young children presenting to the emergency department with suspected influenza. J. Pediatr. 215, 132–138 (2019).
4. Wong, P. L. et al. The effect of age on clinical characteristics, hospitalization and mortality of patients with influenza-related illness at a tertiary care centre in Malaysia. Influenza. Other. Respir. Viruses. 14, 286–293 (2020).
5. Martínez, A. et al. Risk factors associated with severe outcomes in adult hospitalized patients according to influenza type and subtype. PLoS ONE 14, e0210353 (2019).