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: 1330
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
- B. Chakrabarti, P.D.O. Davies, Pleural tuberculosis , Monaldi Archives for Chest Disease: Vol. 65 No. 1 (2006): Pulmonary series
- E. Grossi, E. Crisanti, G. Poletti, V. Poletti, Fire-eater’s pneumonitis , Monaldi Archives for Chest Disease: Vol. 65 No. 1 (2006): Pulmonary series
- Francesco Giallauria, Teresa Paragliola, Francesco Pilerci, Domenico Del Forno, Anna De Lorenzo, Athanasio Manakos, Rosa Lucci, Marianna Psaroudaki, Mariantonietta D’Agostino, Carlo Vigorito, Role of smokers in the household and of cardiac rehabilitation in smoking behaviour after acute myocardial infarction , Monaldi Archives for Chest Disease: Vol. 64 No. 2 (2005): Cardiac series
- E. Garattini, D. Bilton, G. Cremona, M. Hodson, Adult cystic fibrosis care in the 21st century , Monaldi Archives for Chest Disease: Vol. 75 No. 3 (2011): Pulmonary series
- Gabriella Malfatto, Paola Cuoccio, Caterina Bizzi, Giovanna Branzi, Alessandra Villani, Francesco Della Rosa, Gianfranco Parati, Mario Facchini, What underlies NYHA class in elderly patients with heart failure? role of diastolic dysfunction, functional mitral regurgitation and abnormal ventilation during exercise , Monaldi Archives for Chest Disease: Vol. 72 No. 2 (2009): Cardiac series
- L. Montella, M. Caraglia, A. Abbruzzese, A. Soricelli, M. Caputi, G. Squame, M. Salvatore, S. Del Prete, G. Palmieri, Mediastinal Images Resembling Thymus Following 131-I Treatment for Thyroid Cancer , Monaldi Archives for Chest Disease: Vol. 63 No. 2 (2005): Pulmonary series
- Roberto Tramarin, Stefania De Feo, Marco Ambrosetti, Raffaele Griffo, Franco Maslowsky, Paola Vaghi, ISYDE-2008 Study presentation The Italian Survey on cardiac rehabilitation: a snapshot of current cardiac rehabilitation programmes and provides in Italy , Monaldi Archives for Chest Disease: Vol. 68 No. 4 (2007): Cardiac series
- F. Ravenna, S. Saturni, A. Casalini, F.P. Pilato, C. Pasquini, G. Caramori, A. Papi, Bronchial glomus tumor mimicking a COPD exacerbation , Monaldi Archives for Chest Disease: Vol. 75 No. 3 (2011): Pulmonary series
- Monica Ceresa, Soccorso Capomolla, GianDomenico Pinna, Eleonora Aiolfi, Maria Teresa La Rovere, Oreste Febo, Vincenzo Paganini, Angelo Rossi, Giampaolo Guazzotti, Angelo Caporotondi, Roberto Maestri, Franco Cobelli, Anemia in chronic heart failure patients: comparison between invasive and non-invasive prognostic markers , Monaldi Archives for Chest Disease: Vol. 64 No. 2 (2005): Cardiac series
- F.J. de Serres, M. Luisetti, I. Ferrarotti, I. Blanco, E. Fernández-Bustillo, Alpha-1 antitrypsin deficiency in Italy: regional differences of the PIS and PIZ deficiency alleles , Monaldi Archives for Chest Disease: Vol. 63 No. 3 (2005): Pulmonary series
<< < 46 47 48 49 50 51 52 53 54 55 > >>
You may also start an advanced similarity search for this article.
