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Title: Risk factors associated with severe outcomes in adult hospitalized patients according to influenza type and subtype
Author: Martínez, Ana
Soldevila, Núria
Romero Tamarit, Arancha
Torner Gràcia, Núria
Godoy i García, Pere
Rius, Cristina
Jané, Mireia
Domínguez García, Àngela
Surveillance of Hospitalized Cases of Severe Influenza in Catalonia Working Group
Keywords: Influenzavirus
Malalties pulmonars obstructives cròniques
Influenza viruses
Chronic obstructive pulmonary diseases
Issue Date: 11-Jan-2019
Publisher: Public Library of Science (PLoS)
Abstract: Seasonal influenza is a cause of hospitalization, especially in people with underlying disease or extreme age, and its severity may differ depending on the types and subtypes of circulating viruses. We investigated the factors associated with ICU admission or death in hospitalized patients with severe laboratory-confirmed influenza according to the viral type and subtype. An observational epidemiological study was carried out in patients aged ≥18 years from 12 Catalan hospitals between 2010 and 2016. For each reported case we collected demographic, virological and clinical characteristics. A mixed-effects logistic regression model was used to estimate crude and adjusted ORs. 1726 hospitalized patients were included: 595 (34.5%) were admitted to the ICU and 224 (13.0%) died. Lower ICU admission was associated with age ≥75 years in all influenza types and subtypes and with age 65-74 years for type A. In contrast, the 65-74 and ≥75 years age groups were associated with an increased risk of death in all types and subtypes, especially for type B (aOR 27.42, 95% CI: 4.95-151.93 and 15.96; 95% CI: 3.01-84.68). The comorbidity most closely associated with severe outcomes was immune deficiency, which was associated with death for type B (aOR 9.02, 95% CI: 3.05-26.69) and subtype A(H1N1)pdm09 (aOR 3.16, 95% CI: 1.77-5.66). Older age was a differential factor for ICU admission and death: it was associated with lower ICU admission but a risk factor for death. The comorbidity with the closest association with death was immune deficiency, mainly in influenza type B patients.
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It is part of: PLoS One, 2019, vol. 14, num. 1, p. e0210353
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ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (Medicina)

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