Clinical characteristics and outcomes in adult patients hospitalized with influenza, respiratory syncytial virus and human metapneumovirus infections

Chen, Liang; Han, Xiudi; Bai, Lu; Zhang, Jian

doi:10.1080/14787210.2021.1846520

Cited by 15 publications

(34 citation statements)

References 48 publications

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“…Relative to patients without CVEs, those with CVEs were more likely to suffer from hypertention (31.1% vs 24.3%, p = 0.021), coronary artery disease (42.3% vs 18.8%, p < 0.001), preexisting heart failure (7.8% vs 1.8%, p < 0.001), cerebrovascular disease (13.7% vs 8.2%, p = 0.006), and chronic kidney disease (7.2% vs 1.6%, p < 0.001). Mental confusion (35.2% vs 7.1%, p < 0.001), respiratory rates ≥ 30 breaths/min (25.6% vs 9.4%, p < 0.001), leukocyte counts > 10×10 9 /L (30.4% vs 24.5, p = 0.046), lymphocytes < 0.8×10 9 /L (83.3% vs 33.3%, p < 0.001), hemoglobin (HB) levels < 100 g/L (39.9% vs 17.5%, p < 0.001), blood urea nitrogen (BUN) > 7 mmol/L (65.9% vs 33.3%, p < 0.001), and PaO 2 /FiO 2 < 300 mmHg (54.9% vs 45.4, p = 0.005) at time of admission were more frequently observed in patients with CVEs than in patients without CVEs. Patients with CVEs were more likely to be treated with systemic corticosteroids (50.9% vs 15.8%, p < 0.001), ACEIs/ARBs (54.6% vs 35.4%, p < 0.001), statins (54.9% vs 37.0%, bp < 0.001), anticoagulants (19.1% vs 7.1%, p < 0.001), and β-receptor blockers (27.6% vs 16.5%, p < 0.001), and were less likely to have undergone early NAI therapy (15.4% vs 43.7%, p < 0.001) (Table 1 2).…”

Section: Risk Factors Associated With Cve Incidence In Flu-p Patientsmentioning

confidence: 99%

“…Influenza virus causes an estimated 15-20% of CAP cases, with over 3-5 million cases and 290,000-650,000 deaths globally each year. 8 Severe influenza infections result in pneumonia in over half of affected patients, 9 and such influenza-associated pneumonia (Flu-p) can additionally cause multiple organ dysfunction. Time-series analyses have shown that CVE rates are elevated during and immediately following influenza epidemics.…”

Section: Introductionmentioning

confidence: 99%

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Complications of Cardiovascular Events in Patients Hospitalized with Influenza-Related Pneumonia

Chen¹,

Han²,

Li³

et al. 2021

IDR

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Purpose: Influenza virus infections are a key cause of community-acquired pneumonia (CAP). Cardiovascular events (CVEs) are common among CAP and influenza patients, but there have been few population-based studies of influenza-related pneumonia (Flu-p) patients published to date. Methods: A retrospective analysis of 1191 immunocompetent hospitalized adult Flu-p patients from January 2012 to December 2018 in five teaching hospitals in China was conducted. Results: A total of 24.6% (293/1191) of patients developed at least one form of CVE-related complication while hospitalized. In a multivariate logistic regression analysis, hypertension, cerebrovascular disease, coronary artery disease, preexisting heart failure, systolic blood pressure <90 mmHg, respiratory rates ≥30 breaths/min, a lymphocyte count <0.8×10 9 /L, PaO 2 /FiO 2 <300 mmHg, and systemic corticosteroid administration were independently associated with the incidence of CVEs; while early neuraminidase inhibitor treatment and angiotensin converting enzyme inhibitors/angiotensin II receptor blocker treatment were associated with a lower risk of CVEs. After controlling for potential confounding variables, we determined that CVEs were linked to a higher risk of 30-day mortality (OR 3.307,, p < 0.001) in Flu-p patients. Conclusion: CVE-related complications are common among hospitalized Flu-p patients and are associated with negative patient outcomes. Clarifying these CVE-related risk factors can aid in their clinical prevention and management.

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Section: Risk Factors Associated With Cve Incidence In Flu-p Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Complications of Cardiovascular Events in Patients Hospitalized with Influenza-Related Pneumonia

Chen¹,

Han²,

Li³

et al. 2021

IDR

Self Cite

View full text Add to dashboard Cite

show abstract

“…Relative to patients without CVEs, those with CVEs were more likely to suffer from hypertention (31.1% vs 24.3%, p = 0.021), coronary artery disease (42.3% vs 18.8%, p < 0.001), preexistingheart failure (7.8% vs 1.8%, p < 0.001), cerebrovascular disease (13.7% vs 8.2%, p = 0.006), and chronic kidney disease (7.2% vs 1.6%, p < 0.001). Mental confusion (35.2% vs 7.1%, p < 0.001), respiratory rates ≥ 30 breaths/min (25.6% vs 9.4%, p < 0.001), leukocyte counts > 10×10 9 /L (30.4% vs 24.5, p = 0.046), lymphocytes < 0.8×10 9 /L (83.3% vs 33.3%, p < 0.001), hemoglobin (HB) levels < 100 g/L (39.9% vs 17.5%, p < 0.001), blood urea nitrogen (BUN) > 7 mmol/L (65.9% vs 33.3%, p < 0.001), and PaO 2 /FiO 2 < 300 mmHg (54.9% vs 45.4, p = 0.005) at time of admission were more frequently observed in patients with CVEs than in patients without CVEs. Patients with CVEs were more likely to be treated with systemic corticosteroids (50.9% vs 15.8%, p < 0.001), ACEIs/ARBs (54.6% vs 35.4%, p < 0.001), statins (54.9% vs 37.0%,bp < 0.001), anticoagulants (19.1% vs 7.1%, p < 0.001), and β-receptor blockers (27.6% vs 16.5%, p < 0.001), and were less likely to have undergone early NAI therapy (15.4% vs 43.7%, p < 0.001) (Table 1).…”

Section: Risk Factors Associated With Cve Incidence In Flu-p Patientsmentioning

confidence: 99%

“…In uenza virus causes an estimated 15-20% of CAP cases, with over 3-5 million cases and 290,000-650,000 deaths globally each year [8]. Severe in uenza infections result in pneumonia in over half of affected patients [9], and such in uenza-associated pneumonia (Flu-p) can additionally cause multiple organ dysfunction. Time-series analyses have shown that CVE rates are elevated during and immediately following in uenza epidemics [10].…”

Section: Introductionmentioning

confidence: 99%

Complications of Cardiovascular Events in Patients Hospitalized with Influenza-Related Pneumonia

Chen

Han

et al. 2021

Preprint

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Background: Influenza virus infections are a key cause of community-acquired pneumonia (CAP). Cardiovascular events (CVEs) are common among CAP and influenza patients, but there have been few population-based studies of influenza-related pneumonia (Flu-p) patients published to date. Methods: A retrospective analysis of 1191 immunocompetent hospitalized adult Flu-p patients from January 2012 - December 2018 in five teaching hospitals in China was conducted.Results: A total of 24.6% (293/1191) of patients developed at least one form of CVE-related complication while hospitalization. In a multivariate logistic regression analysis, hypertension, cerebrovascular disease, coronary artery disease, preexisting heart failure, systolic blood pressure < 90 mmHg, respiratory rates ≥ 30 breaths/min, a lymphocyte count < 0.8×109/L, PaO2/FiO2 < 300 mmHg, systemic corticosteroid administration, early neuraminidase inhibitor treatment, and angiotensin converting enzyme inhibitors/angiotensin II receptor blocker treatment were independently associated with the risk of CVEs. After controlling for potential confounding variables, we determined that CVEs were linked to a higher risk of 30-day mortality (OR 3.307, 95% CI 2.198-4.975, p < 0.001) in Flu-p patients. Conclusions: CVE-related complications are common among hospitalized Flu-p patients, and are associated with negative patient outcomes. Clarifying these CVE-related risk factors can aid in their clinical prevention and care.

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“…In uenza is a common viral respiratory disease that affects between 5% and 10% of the world's population each year, resulting in roughly 3-5 million severe infections and 290,000 -650,000 annual deaths [1][2]. In uenza-related pneumonia (Flu-p) is a severe form of in uenza infection associated with over 50% of in uenza-related hospitalizations [3][4].…”

Section: Introductionmentioning

confidence: 99%

The severity and risk factors for mortality in immunocompromised adult patients hospitalized with influenza-related pneumonia

Chen

Han

et al. 2021

Preprint

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Objective To explore disease severity and risk factors for 30-day mortality of adult immunocompromised (IC) patients hospitalized with influenza-related pneumonia (Flu-p).Method A total of 122 IC and 1,191 immunocompetent patients hospitalized with Flu-p from January 2012 to December 2018 were recruited retrospectively from five teaching hospitals in China. Results After controlling for confounders, multivariate logistic regression analysis showed that immunosuppression was associated with increased risks for invasive ventilation [odds ratio: (OR) 2.475, 95% confidence interval (CI): 1.511-4.053, p < 0.001], admittance to the intensive care unit (OR: 3.247, 95% CI: 2.064-5.106, p < 0.001), and 30-day mortality (OR: 3.206, 95% CI: 1.926-5.335, p < 0.001) in patients with Flu-p. Another multivariate logistic regression model revealed that baseline lymphocyte counts (OR: 0.993, 95% CI: 0.990-0.996, p < 0.001), coinfection (OR: 5.450, 95% C:I 1.638-18.167, p = 0.006), early neuraminidase inhibitor therapy (OR 0.401, 95% CI 0.127-0.878, p = 0.001), and systemic corticosteroid use at admission (OR: 6.414, 95% C:I 1.348-30.512, p = 0.020) were independently related to 30-day mortality in IC patients with Flu-p. Based on receiver operating characteristic curve (ROC) analysis, the optimal cutoff for lymphocyte counts was 0.6×109/L [area under the ROC (AUROC) = 0.824, 95% CI: 0.744 - 0.887], sensitivity: 97.8%, specificity: 73.7%].Conclusions IC conditions are associated with more severe outcomes in patients with Flu-p. The predictors for mortality that we identified may be valuable for the management of Flu-p among IC patients.

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Clinical characteristics and outcomes in adult patients hospitalized with influenza, respiratory syncytial virus and human metapneumovirus infections

Abstract: Zhang (2020): Clinical characteristics and outcomes in adult patients hospitalized with influenza, respiratory syncytial virus and human metapneumovirus infections, Expert Review of Anti-infective Therapy,

Cited by 15 publications

References 48 publications

Complications of Cardiovascular Events in Patients Hospitalized with Influenza-Related Pneumonia

Complications of Cardiovascular Events in Patients Hospitalized with Influenza-Related Pneumonia

Complications of Cardiovascular Events in Patients Hospitalized with Influenza-Related Pneumonia

The severity and risk factors for mortality in immunocompromised adult patients hospitalized with influenza-related pneumonia

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