Analysis of acute respiratory infections due to influenza virus A, B and RSV during an influenza epidemic 2018

Topoulos, Spiridon; Giesa, Christian; Gatermann, Sören; Fussen, René; Lemmen, Sebastian; Ewig, Santiago

doi:10.1007/s15010-018-1262-x

Cited by 32 publications

(24 citation statements)

References 22 publications

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“…Pneumonia on infection presentation was very frequent, in line with more recent reports [9][10][11][12][13][14][15][16][17], revealing how an important proportion of patients showed a direct viral injury in lung parenchyma and/or bacterial co-infection. However, despite being a life-threatening condition, it was neither predictive of NIV use nor of IHD.…”

Section: Discussionsupporting

confidence: 84%

“…Overall, the number of hospitalizations over the study period was remarkable comparing to recent reports [9], showing that over two years one out of five admissions with influenza and/or RSV infections involved oldest-old. Moreover, in our study, hospital-acquired influenza and/or RSV infections were not identified as predictors of pneumonia, use of NIV, and IHD for patients aged 65 years and older, moving away from evidence available so far [9,10].…”

Section: Discussionmentioning

confidence: 52%

“…The use of NIV was considerable when comparing with available evidence in a cohort of younger patients [9]. This finding might be related to both the type of respiratory failure on infection presentation and a remarkable rate of diagnosed or likely under-diagnosed chronic obstructive lung disease [18].…”

Section: Discussionmentioning

confidence: 99%

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Influenza and respiratory syncytial virus infections in the oldest-old continent

Boattini

Almeida

Christaki

et al. 2020

Eur J Clin Microbiol Infect Dis

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SARS-CoV-2 dramatically revealed the sudden impact of respiratory viruses in our lives. Influenza and respiratory syncytial virus (RSV) infections are associated with high rates of morbidity, mortality, and an important burden on healthcare systems worldwide, especially in elderly patients. The aim of this study was to identify severity predictors in the oldest-old admitted with influenza and/or RSV infections. This is a multicenter, retrospective study of all oldest-old patients (≥ 85 years old) admitted for laboratory-confirmed influenza and/or RSV infection in three tertiary hospitals in Portugal, Italy, and Cyprus over two consecutive winter seasons. The outcomes included the following: pneumonia on infection presentation, use of non-invasive ventilation (NIV), and in-hospital death (IHD). The association with possible predictors, including clinical features and type of virus infection, was assessed using uni-and multivariable analyses. A total of 251 oldest-old patients were included in the study. Pneumonia was evident in 32.3% (n = 81). NIV was implemented in 8.8% (n = 22), and IHD occurred in 13.9% (n = 35). Multivariable analyses revealed that chronic obstructive pulmonary disease (COPD) or asthma was associated with pneumonia (OR 1.86; 95% CI 1.02-3.43; p = 0.045). COPD or asthma (OR 4.4; 95% CI 1.67-11.6; p = 0.003), RSV (OR 3.12; 95% CI 1.09-8.92; p = 0.023), and influenza B infections (OR 3.77; 95% CI 1.06-13.5; p = 0.041) were associated with NIV use, respectively, while chronic kidney disease was associated with IHD (OR 2.50; 95% CI 1.14-5.51; p = 0.023). Among the oldest-old, chronic organ failure, such as COPD or asthma, and CKD predicted pneumonia and IHD, respectively, beyond the importance of viral virulence itself. These findings could impact on public health policies, such as fostering influenza immunization campaigns, home-based care programs, and end-of-life care. Filling knowledge gaps is crucial to set priorities and advise on transition model of care that best fits the oldest-old.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 52%

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Influenza and respiratory syncytial virus infections in the oldest-old continent

Boattini

Almeida

Christaki

et al. 2020

Eur J Clin Microbiol Infect Dis

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“…It is accessible, quickly available and has a short half‐life . The serum CRP concentration is commonly used as a surrogate marker for infection, and evidence suggests that it can be used to detect or to rule out colorectal anastomotic leak as a post‐operative complication . Multiple research articles focused on the determination of a cut‐off value for CRP .…”

Section: Introductionmentioning

confidence: 99%

Systematic use of the serum C‐reactive protein concentration and computed tomography for the detection of intestinal anastomotic leaks

Laycock

Kirubakaran

et al. 2019

ANZ Journal of Surgery

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Background This study aimed to characterize the time‐dependent relationship between serum C‐reactive protein (CRP) and anastomotic integrity in the early post‐operative period and to develop a systematic use of CRP and computed tomography. Methods Patients aged 18 years or over who had the formation of a left‐sided colonic or a colorectal anastomosis, in Royal Sussex County Hospital, were included. The post‐operative day (POD) CRP cut‐off values were calculated according to receiver operating characteristic analysis to evaluate the sensitivities and specificities of the proposed cut‐off parameters. Results A total of 125 left‐sided colonic and colorectal anastomoses were recruited and analysed. When comparing to POD1 CRP cut‐off, the calculated CRP ratio cut‐off values of all the rest of PODs (2–5) were highly significant in the laparoscopic group and the overall group (P < 0.001). This statistically significant ratio was also demonstrated in the open group at POD2 (P < 0.0001). Conclusion CRP and CRP ratios cut‐off values were sensitive to detect an anastomotic leak in the early post‐operative period. The cut‐off values could facilitate the development of systematic use of CRP and computed tomography.

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“…The overall in-hospital mortality rate for both groups was 5.6% with a numerically but not statistically significantly higher mortality rate in the influenza A group (8.3% for influenza A vs. 4.7% for influenza B, p = 0.172). Other studies of hospitalized patients described a similar mortality rate (3.7-5.2%) without differences between influenza A and B virus infections [27,28,32]. Of the studies one analyzed community and healthcare-acquired influenza infections and described an in-hospital mortality rate of 366 Is there a clinical difference between influenza A and B virus infections in hospitalized patients?…”

Section: Discussionmentioning

confidence: 95%

Is there a clinical difference between influenza A and B virus infections in hospitalized patients?

Karolyi

Pawelka

Daller

et al. 2019

Wien Klin Wochenschr

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Purpose The clinical presentation, complications and mortality in molecularly confirmed influenza A and B infections were analyzed. Methods This retrospective observational single-centre study included all influenza positive patients older than 18 years who were hospitalized and treated at the flu isolation ward during 2017/2018. The diagnosis was based on point-of-care tests with the Alere TM .Results Of the 396 patients tested positive for influenza, 24.2% had influenza A and 75.8% influenza B. Influenza A patients were younger (median age 67.5 years vs. 77 years, p < 0.001), were more often smokers (27.7% vs. 16.8%, p = 0.021), had chronic pulmonary diseases more frequently (39.6% vs. 26.3%, p = 0.013), presented with a higher body temperature (38.6°C vs. 38.3°C, p = 0.004), leucocyte count (8 G/L vs. 6.8 G/L, p = 0.002), C-reactive protein (CRP) level (41 mg/l vs. 23 mg/l, p < 0.001) and had dyspnea more often (41.7% vs. 28%, p = 0.012). Influenza B patients had an underlying chronic kidney disease in 37% vs. 18.8% (p < 0.001) and presented with vomiting on admission more frequently (21.7% vs. 11.5%, p = 0.027). Influenza A patients were admitted for 8 days vs. 7 days (p = 0.023). There were no differences in the rate of complications; however, 22 (5.6%) patients died during the hospital stay. The in-hospital mortality was higher in influenza A patients (8.3% vs 4.7%, p = 0.172). Conclusion Some differences were found between influenza A and B virus infections but symptoms were overlapping, which necessitates polymerase chain reaction point-of-care testing for accurate diagnosis. Influenza A was a more severe disease than influenza B during the period 2017/2018.

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Analysis of acute respiratory infections due to influenza virus A, B and RSV during an influenza epidemic 2018

Cited by 32 publications

References 22 publications

Influenza and respiratory syncytial virus infections in the oldest-old continent

Influenza and respiratory syncytial virus infections in the oldest-old continent

Systematic use of the serum C‐reactive protein concentration and computed tomography for the detection of intestinal anastomotic leaks

Is there a clinical difference between influenza A and B virus infections in hospitalized patients?

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