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Article: Influenza A-associated severe pneumonia in hospitalized patients: Risk factors and NAI treatments

TitleInfluenza A-associated severe pneumonia in hospitalized patients: Risk factors and NAI treatments
Authors
KeywordsDouble dose
Severe pneumonia
Influenza
Oseltamivir
Issue Date2020
Citation
International Journal of Infectious Diseases, 2020, v. 92, p. 208-213 How to Cite?
Abstract© 2020 The Authors Objective: The risk factors and the impact of NAI treatments in patients with severe influenza A-associated pneumonia remain unclear. Methods: A multicenter, retrospective, observational study was conducted in Zhejiang, China during a severe influenza epidemic in August 2017–May 2018. Clinical records of patients (>14 y) hospitalized with laboratory-confirmed influenza A virus infection and who developed severe pneumonia were compared to those with mild-to-moderate pneumonia. Risk factors related to pneumonia severity and effects of NAI treatments (monotherapy and combination of peramivir and oseltamivir) were analyzed. Results: 202 patients with influenza A-associated severe pneumonia were enrolled, of whom 84 (41.6%) had died. Male gender (OR = 1.782; 95% CI: 1.089–2.917; P = 0.022), chronic pulmonary disease (OR = 2.581; 95% CI: 1.447–4.603; P = 0.001) and diabetes mellitus (OR = 2.042; 95% CI: 1.135–3.673; P = 0.017) were risk factors related to influenza A pneumonia severity. In cox proportional hazards model, severe pneumonia patients treated with double dose oseltamivir (300mg/d) had a better survival rate compared to those receiving a single dose (150 mg/d) (HR = 0.475; 95%CI: 0.254–0.887; P = 0.019). However, different doses of peramivir (300 mg/d vs. 600 mg/d) and combination therapy (oseltamivir-peramivir vs. monotherapy) showed no differences in 60-day mortality (P = 0.392 and P = 0.658, respectively). Conclusions: Patients with male gender, chronic pulmonary disease, or diabetes mellitus were at high risk of developing severe pneumonia after influenza A infection. Double dose oseltamivir might be considered in treating influenza A-associated severe pneumonia.
Persistent Identifierhttp://hdl.handle.net/10722/288790
ISSN
2023 Impact Factor: 4.8
2023 SCImago Journal Rankings: 1.435
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorZou, Qianda-
dc.contributor.authorZheng, Shufa-
dc.contributor.authorWang, Xiaochen-
dc.contributor.authorLiu, Sijia-
dc.contributor.authorBao, Jiaqi-
dc.contributor.authorYu, Fei-
dc.contributor.authorWu, Wei-
dc.contributor.authorWang, Xianjun-
dc.contributor.authorShen, Bo-
dc.contributor.authorZhou, Tieli-
dc.contributor.authorZhao, Zhigang-
dc.contributor.authorWang, Yiping-
dc.contributor.authorChen, Ruchang-
dc.contributor.authorWang, Wei-
dc.contributor.authorMa, Jianbo-
dc.contributor.authorLi, Yongcheng-
dc.contributor.authorWu, Xiaoyan-
dc.contributor.authorShen, Weifeng-
dc.contributor.authorXie, Fuyi-
dc.contributor.authorVijaykrishna, Dhanasekaran-
dc.contributor.authorChen, Yu-
dc.date.accessioned2020-10-12T08:05:52Z-
dc.date.available2020-10-12T08:05:52Z-
dc.date.issued2020-
dc.identifier.citationInternational Journal of Infectious Diseases, 2020, v. 92, p. 208-213-
dc.identifier.issn1201-9712-
dc.identifier.urihttp://hdl.handle.net/10722/288790-
dc.description.abstract© 2020 The Authors Objective: The risk factors and the impact of NAI treatments in patients with severe influenza A-associated pneumonia remain unclear. Methods: A multicenter, retrospective, observational study was conducted in Zhejiang, China during a severe influenza epidemic in August 2017–May 2018. Clinical records of patients (>14 y) hospitalized with laboratory-confirmed influenza A virus infection and who developed severe pneumonia were compared to those with mild-to-moderate pneumonia. Risk factors related to pneumonia severity and effects of NAI treatments (monotherapy and combination of peramivir and oseltamivir) were analyzed. Results: 202 patients with influenza A-associated severe pneumonia were enrolled, of whom 84 (41.6%) had died. Male gender (OR = 1.782; 95% CI: 1.089–2.917; P = 0.022), chronic pulmonary disease (OR = 2.581; 95% CI: 1.447–4.603; P = 0.001) and diabetes mellitus (OR = 2.042; 95% CI: 1.135–3.673; P = 0.017) were risk factors related to influenza A pneumonia severity. In cox proportional hazards model, severe pneumonia patients treated with double dose oseltamivir (300mg/d) had a better survival rate compared to those receiving a single dose (150 mg/d) (HR = 0.475; 95%CI: 0.254–0.887; P = 0.019). However, different doses of peramivir (300 mg/d vs. 600 mg/d) and combination therapy (oseltamivir-peramivir vs. monotherapy) showed no differences in 60-day mortality (P = 0.392 and P = 0.658, respectively). Conclusions: Patients with male gender, chronic pulmonary disease, or diabetes mellitus were at high risk of developing severe pneumonia after influenza A infection. Double dose oseltamivir might be considered in treating influenza A-associated severe pneumonia.-
dc.languageeng-
dc.relation.ispartofInternational Journal of Infectious Diseases-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectDouble dose-
dc.subjectSevere pneumonia-
dc.subjectInfluenza-
dc.subjectOseltamivir-
dc.titleInfluenza A-associated severe pneumonia in hospitalized patients: Risk factors and NAI treatments-
dc.typeArticle-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1016/j.ijid.2020.01.017-
dc.identifier.pmid31978583-
dc.identifier.scopuseid_2-s2.0-85079281122-
dc.identifier.hkuros317459-
dc.identifier.volume92-
dc.identifier.spage208-
dc.identifier.epage213-
dc.identifier.eissn1878-3511-
dc.identifier.isiWOS:000519191900033-
dc.identifier.issnl1201-9712-

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