Risk factors associated with severe outcomes in adult hospitalized patients according to influenza type and subtype
Martínez, Ana (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Soldevila, Núria (Universitat de Barcelona)
Romero-Tamarit, Arantxa (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Torner, Núria (Universitat de Barcelona)
Godoy, Pere (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Rius i Gibert, Maria Cristina (Agència de Salut Pública de Barcelona)
Jané i Checa, Mireia (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Domínguez, Ángela (Universitat de Barcelona)
Marcos, M.A. (Hospital Clínic i Provincial de Barcelona)
Mosquera, Maria del Mar (Hospital Clínic i Provincial de Barcelona)
Vilella, A. (Hospital Clínic i Provincial de Barcelona)
Antón, A. (Hospital Universitari Vall d'Hebron)
Pumarola Suñé, Tomàs (Hospital Universitari Vall d'Hebron)
Campins Martí, Magda (Hospital Universitari Vall d'Hebron)
Navarro Rubio, Gemma (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Universitat Autònoma de Barcelona

Date:	2019
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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Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	PloS one, Vol. 14 Núm. 1 (january 2019) , p. e0210353, ISSN 1932-6203

DOI: 10.1371/journal.pone.0210353
PMID: 30633778

15 p, 897.4 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Parc Taulí Research and Innovation Institute (I3PT
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles