https://doi.org/10.4081/monaldi.2021.1876
Predictors of severity and in-hospital mortality in patients with influenza
Submitted: April 3, 2021
Accepted: July 20, 2021
Published: August 10, 2021
Accepted: July 20, 2021
Abstract Views: 1329
PDF: 515
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Influenza virus is a common agent of acute respiratoty infections during epidemic periods. It is a major cause of morbidity and mortality and represent a significant burden on the healthcare system. We aimed to evaluate predictors of severity and of in-hospital mortality in patients hospitalized with influenza infection. We performed a retrospective cohort study of hospitalized, laboratory confirmed cases of influenza disease in Centro Hospitalar de São João between October 2016-May 2017 and October 2017-May 2018. The endpoints being analysed were severity and in-hospital mortality. A multivariate logistic regression analysis was used to determine independent predictors of severity and of in-hospital mortality. We studied 221 hospitalized influenza infection cases. Mean age 66±16 years, 57.9% were male, thirty-seven patients (16.7%) died in-hospital and 101 patients (45.7%) met severity criteria. C-reactive protein (CRP) was the only independent predictor of severity as well as the only independent predictor of higher in-hospital mortality in patients admitted due to influenza infection. Multivariate-adjusted CRP OR for severity was 1.10, 95% CI 1.06-1.15 per each 10 mg/L increase in CPR and for in-hospital mortality risk the OR was of 1.05, 95% CI 1.01-1.09, p=0.01, per each 10 mg/L increase. Concluding, in patients’ hospital-admitted due to influenza infection CRP was the only predictor of severity with a 10% increased risk of inotropic support/ventilatory support/prolonged hospitalization needs and a 5% increase risk of in-hospital death per each 10 mg/l increase.
Center for Disease Control and Prevention. Seasonal influenza (flu). Accessed: 01/06/2019. Available from: https://www.cdc.gov/flu/about/index.html
Uyeki TM. Influenza. Ann Intern Med 2017;167:ITC33-48.
Bresee J, Hayden FG. Epidemic influenza-responding to the expected but unpredictable. N Engl J Med 2013;368:589.
DOI: https://doi.org/10.1056/NEJMp1300375
European Centre for Disease Prevention and Control. Influenza virus characterisation, summary Europe, September 2018. Stockholm: ECDC; 2018.
Instituto Nacional de Saúde Doutor Ricardo Jorge I.P. [Boletim de Vigilância Epidemiológica da Gripe, Época 2016/2017 - Semana 20].[in Portuguese]. Instituto Nacional de Saúde Doutor Ricardo Jorge I.P., 2017.
Instituto Nacional de Saúde Doutor Ricardo Jorge I.P. [Boletim de Vigilância Epidemiológica da Gripe, Época 2017-2018 - Semana 20].[in Portuguese]. Instituto Nacional de Saúde Doutor Ricardo Jorge I.P., 2018.
Chaves SS, Aragon D, Bennett N, et al. Patients hospitalized with laboratory-confirmed influenza during the 2010-2011 influenza season: exploring disease severity by virus type and subtype. J Infect Dis 2013;208:1305-14.
DOI: https://doi.org/10.1093/infdis/jit316
Ribeiro AF, Pellini AC, Kitagawa BY, et al. Risk factors for death from Influenza A(H1N1)pdm09, State of Sao Paulo, Brazil, 2009. PLoS One 2015;10:e0118772.
Arriola C, Garg S, Anderson EJ, et al. Influenza vaccination modifies disease severity among community-dwelling adults hospitalized with influenza. Clin Infect Dis 2017;65:1289-97.
DOI: https://doi.org/10.1093/cid/cix468
Center for Disease Control and Prevention. Prevent flu. Accessed: 01/06/2019. Available from: https://www.cdc.gov/flu/prevent/vaccinations.htm
Ghebrehewet S, MacPherson P, Ho A. Influenza. BMJ 2016;355:i6258.
Moscona A. Neuraminidase inhibitors for influenza. N Engl J Med 2005;353:1363-73.
DOI: https://doi.org/10.1056/NEJMra050740
Cooper NJ, Sutton AJ, Abrams KR, et al. Effectiveness of neuraminidase inhibitors in treatment and prevention of influenza A and B: systematic review and meta-analyses of randomised controlled trials. BMJ 2003;326:1235.
DOI: https://doi.org/10.1136/bmj.326.7401.1235
Dobson J, Whitley RJ, Pocock S, Monto AS. Oseltamivir treatment for influenza in adults: a meta-analysis of randomised controlled trials. Lancet 2015;385:1729.
DOI: https://doi.org/10.1016/S0140-6736(14)62449-1
Jefferson T, Demicheli V, Rivetti D, et al. Antivirals for influenza in healthy adults: systematic review. Lancet 2006;367:303.
DOI: https://doi.org/10.1016/S0140-6736(06)67970-1
Hong KW, Cheong HJ, Choi WS, et al. Clinical courses and outcomes of hospitalized adult patients with seasonal influenza in Korea, 2011–2012: hospital-based influenza morbidity & mortality (HIMM) surveillance. J Infect Chemother 2014;29:9–14.
DOI: https://doi.org/10.1016/j.jiac.2013.07.001
Canak G, Kovacevic N, Turkulov V, et al. Clinical features, treatments and the outcomes of influenza A (H1N1) 2009 among the hospitalized patients in the clinic for infectious diseases in Novi Sad. Vojnosanit Pregl 2013;70:155–62.
DOI: https://doi.org/10.2298/VSP1302155C
Baden LR, Swaminathan S, Angarone M, et al. Prevention and treatment of cancer-related infections, version 2.2016, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 2016;14:882-913.
DOI: https://doi.org/10.6004/jnccn.2016.0093
Vasileva D, Badawi A. C-reactive protein as a biomarker of severe H1N1 influenza. Inflamm Res 2019;68:39–46.
DOI: https://doi.org/10.1007/s00011-018-1188-x
Zimmerman O, Rogowski O, Aviram G, et al. C-reactive protein serum levels as an early predictor of outcome in patients with pandemic H1N1 influenza A virus infection. BMC Infect Dis 2010;10:288.
DOI: https://doi.org/10.1186/1471-2334-10-288
Gao RB, Wang L, Bai T, et al. C-reactive mediating immunopathological lesions: a potential treatment option for severe influenza A diseases. EBioMedicine 2017;22:133–42.
DOI: https://doi.org/10.1016/j.ebiom.2017.07.010
Liu Q, Zhou YH, Yang ZQ. The cytokine storm of severe influenza and development of immunomodulatory therapy. Cell Mol Immunol 2016;13:3–10.
DOI: https://doi.org/10.1038/cmi.2015.74
Shah SH, Newby LK. C-reactive protein: a novel marker of cardiovascular risk. Cardiol Rev 2003;11:169-79.
DOI: https://doi.org/10.1097/01.CRD.0000077906.74217.6E
Supporting Agencies
not applicableHow to Cite
Serino, Mariana, Nuno Melo, João Paulo Caldas, Ana Ferreira, David Garcia, and Patrícia Lourenço. 2021. “Predictors of Severity and in-Hospital Mortality in Patients With Influenza”. Monaldi Archives for Chest Disease 92 (1). https://doi.org/10.4081/monaldi.2021.1876.
Copyright (c) 2021 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- C. Incorvaia, C. Pravettoni, M. Mauro, M.-R. Yacoub, F. Tarantini, G.G. Riario-Sforza, Effectiveness of omalizumab in a patient with severe asthma and atopic dermatitis , Monaldi Archives for Chest Disease: Vol. 69 No. 2 (2008): Pulmonary series
- G. Leoncini, L. Iurilli, L. Boni, G. Blanco, P. De Bellis, G. Catrambone, Treatment of iatrogenic and traumatic tracheal disruptions , Monaldi Archives for Chest Disease: Vol. 69 No. 3 (2008): Pulmonary series
- Stefania Angela Di Fusco, Furio Colivicchi, Nadia Aspromonte, Marco Tubaro, Alessandro Aiello, Massimo Santini, Direct oral anticoagulants in patients undergoing cardioversion: insight from randomized clinical trials , Monaldi Archives for Chest Disease: Vol. 87 No. 1 (2017)
- Rodolfo Citro, Antonello Panza, Paolo Masiello, Amelia Ravera, Lucia Tedesco, Rocco Leone, Marco Mirra, Roberta Giudice, Severino Iesu, Francesco Silvestri, Giuseppe Di Benedetto, Eduardo Bossone, Intramural aortic hematoma: no flap no warning? , Monaldi Archives for Chest Disease: Vol. 76 No. 1 (2011): Cardiac series
- Francesco Vetta, Gabriella Locorotondo, Giampaolo Vetta, Maria Mignano, Sonia Bracchitta, Prognostic impact of frailty in elderly cardiac surgery patients , Monaldi Archives for Chest Disease: Vol. 87 No. 2 (2017)
- Gennaro Ismeno, Antonio Falco, Francesco Paolo Tritto, Antonio d’Angelo, Francesco Longobardi, Girolamo Damiani, Joseph Marmo, Rosario Gregorio, Luigi Piazza, The use of “LAST†operation in high risk patient , Monaldi Archives for Chest Disease: Vol. 66 No. 1 (2006): Cardiac series
- Ravindra Nath, Neeraj Kumar Gupta, Amandeep Jaswal, Sparsh Gupta, Navjot Kaur, Santvana Kohli, Anirudh saxena, Pranav Ish, Rohit Kumar, Poornima Tiwari, Mukesh Kumar, Jugal Kishore, Geeta Yadav, Fellisha Marwein, Nitesh Gupta, Mortality among adult hospitalized patients during the first wave and second wave of COVID-19 pandemic at a tertiary care center in India , Monaldi Archives for Chest Disease: Vol. 92 No. 2 (2022)
- Kranti Garg, Karan Sharma, Aditi Gupta, Vishal Chopra, Association of cycle threshold values of CBNAAT with severity and outcome in COVID-19 , Monaldi Archives for Chest Disease: Vol. 91 No. 4 (2021)
- T. Kinnunen, O. Säynäjäkangas, T. Keistinen, Features of hospitalisations for acute exacerbation of COPD resulting in death , Monaldi Archives for Chest Disease: Vol. 67 No. 1 (2007): Pulmonary series
- Ivan Comelli, Alessandra Bologna, Andrea Ticinesi, Andrea Magnacavallo, Denis Comelli, Tiziana Meschi, Gianfranco Cervellin, Incidence of primary spontaneous pneumothorax is not associated with microclimatic variations. Results of a seven-year survey in a temperate climate area , Monaldi Archives for Chest Disease: Vol. 87 No. 1 (2017)
<< < 1 2 3 4 5 6 7 8 9 10 > >>
You may also start an advanced similarity search for this article.
