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

Zou, Qianda; Zheng, Shufa; Wang, Xiaochen; Liu, Sijia; Bao, Jiaqi; Yu, Fei; Wu, Wei; Wang, Xianjun; Shen, Bo; Zhou, Tong; Zhao, Zhiyuan; Wang, Yiping; Chen, Ruchang; Wang, Wei; Ma, Jianbo; Li, Yongcheng; Wu, Xiaoyan; Shen, Wei‐Feng; Xie, Fuyi; Vijaykrishna, Dhanasekaran; Chen, Yu

doi:10.1016/j.ijid.2020.01.017

Cited by 49 publications

(47 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, in clinical practice, COVID-19 and other viral infections like influenza need to be further differentiated. Influenza is also a contagious respiratory illness caused by influenza viruses that infect upper respiratory tract, and sometimes the lungs; the main symptoms of influenza are sudden high fever, headache, myalgia, general malaise; It can cause mild to severe illness, and at times can lead to death (MLO, 2015;Eccles, 2007;Zou et al, 2020). In this study, severe patients had abnormal hematological manifestations including significant lower lymphocytes and CD3 + T cells, increased fibribogen, D-dimer and fibrin/ fibrinogen degradation products (FDP) levels; a very high interleukin-6 level which demonstrated that cytokines storm might exsit.…”

Section: Discussionmentioning

confidence: 99%

“…These findings indicated that COVID-19 is a systemic disease, not just pneumonia. However, critical influenza may also cause complications with high morbidity and mortality, such as pneumonia, myocarditis, central nervous system disease and death (Zou et al, 2020). In this situation, we recommend to use a broad-spectrum molecular diagnostic panel for rapid detection of the most common respiratory pathogens to make a differential diagnosis (Bordi et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Risk-adapted Treatment Strategy For COVID-19 Patients

Zheng

Wang

Guo

et al. 2020

International Journal of Infectious Diseases

104

View full text Add to dashboard Cite

Background: There are no clear expert consensus or guidelines on how to treat 2019 coronavirus disease . The objective of this study is to investigate the short-term effect of risk-adapted treatment strategy on patients with COVID-19. Methods: We collected the medical records of 55 COVID-19 patients for analysis. We divided these patients into mild, moderate and severe groups, and risk-adapted treatment approaches were given according to the illness severity. Results: Twelve patients were in mild group and 22 were in moderate group (non-severe group, n = 34), and 21 patients were in severe group. At the end of the first two weeks after admission, clinical manifestations had completely despeared in 31(91.2%)patients in non-severe group, and 18(85.7%) patients in severe group (p = 0.85). Both groups had a satisfied chest CT imaging recovery, which includes 22(64.7%) patients in non-severe group and 12(57.1%) patients in severe group recovered at least 50% of the whole leisions in the first week, and 28(82.4%) and 16(76.2%) recovered at least 75% in the second week, respectively. There were no significant differences in SARS-CoV-2 nucleic acid negativity (p = 0.92). There were also no significant differences in the levels of SARS-CoV-2-IgM and IgG antibody production between the two groups (p = 0.13, 0.62). There were 45 cases were discharged from the hospital, and no patients died at the time of this clinical analysis. Conclusions: Risk-adapted treatment strategy was associated with significant clinical manifestations alleviation and clinical imaging recovery. In severe COVID-19 patients, early and short-term use of lowdose methylprednisolone was beneficial and did not delay SARS-CoV-2 nucleic acid clearance and influence IgG antibody production.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk-adapted Treatment Strategy For COVID-19 Patients

Zheng

Wang

Guo

et al. 2020

International Journal of Infectious Diseases

104

View full text Add to dashboard Cite

show abstract

“…3 Diabetes is a primary risk factor for the development of severe pneumonia and sepsis because of virus infections and occurs in 20% of patients with severe pneumonia. 4,5 Hyperglycaemia and a history of type 2 diabetes are independent predictors of mortality and morbidity in patients with SARS. 6 Diabetes is also identified as a major contributor to disease severity and mortality in Middle East respiratory syndrome (MERS-CoV).…”

Section: Introductionmentioning

confidence: 99%

Newly diagnosed diabetes is associated with a higher risk of mortality than known diabetes in hospitalized patients with COVID‐19

Tian

Chen

et al. 2020

Diabetes Obesity Metabolism

244

266

View full text Add to dashboard Cite

Aim To evaluate the association between different degrees of hyperglycaemia and the risk of all‐cause mortality among hospitalized patients with COVID‐19. Materials and Methods In a retrospective study conducted from 22 January to 17 March 2020, 453 patients were admitted to Union Hospital in Wuhan, China, with laboratory‐confirmed severe acute respiratory syndrome coronavirus 2 infection. Patients were classified into four categories: normal glucose, hyperglycaemia (fasting glucose 5.6‐6.9 mmol/L and/or HbA1c 5.7%‐6.4%), newly diagnosed diabetes (fasting glucose ≥7 mmol/L and/or HbA1c ≥6.5%) and known diabetes. The major outcomes included in‐hospital mortality, intensive care unit (ICU) admission and invasive mechanical ventilation (IMV). Results Patients with newly diagnosed diabetes constituted the highest percentage to be admitted to the ICU (11.7%) and require IMV (11.7%), followed by patients with known diabetes (4.1%; 9.2%) and patients with hyperglycaemia (6.2%; 4.7%), compared with patients with normal glucose (1.5%; 2.3%), respectively. The multivariable‐adjusted hazard ratios of mortality among COVID‐19 patients with normal glucose, hyperglycaemia, newly diagnosed diabetes and known diabetes were 1.00, 3.29 (95% confidence interval [CI] 0.65‐16.6), 9.42 (95% CI 2.18‐40.7) and 4.63 (95% CI 1.02‐21.0), respectively. Conclusion We showed that COVID‐19 patients with newly diagnosed diabetes had the highest risk of all‐cause mortality compared with COVID‐19 patients with known diabetes, hyperglycaemia and normal glucose. Patients with COVID‐19 need to be kept under surveillance for blood glucose screening.

show abstract

“…Diabetes is associated with an increased risk of developing pneumonia, 1,2 including its viral forms. 3,4 Patients with diabetes experience higher mortality after pneumonia compared with patients without diabetes. 5 In addition, diabetes has been recognized as a risk factor for the development of severe pneumonia and death because of 2019 coronavirus disease (COVID-19).…”

Section: Introductionmentioning

confidence: 99%

Exposure to dipeptidyl‐peptidase 4 inhibitors and the risk of pneumonia among people with type 2 diabetes: Retrospective cohort study and meta‐analysis

Morieri

Bonora

Longato

et al. 2020

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

Aim Concerns have been raised that dipeptidyl‐peptidase 4 inhibitors (DPP‐4i) may increase the risk of pneumonia. We analysed observational data and clinical trials to explore whether use of DPP‐4i modifies the risk of pneumonia. Methods We identified patients with diabetes in the Veneto region administrative database and performed propensity score matching between new users of DPP‐4 inhibitors and new users of other oral glucose‐lowering medications (OGLMs). We compared the rate of hospitalization for pneumonia between matched cohorts using the Cox proportional hazard model. The same analysis was repeated using the database of a local diabetes outpatient clinic. We retrieved similar observational studies from the literature to perform a meta‐analysis. Results from trials reporting pneumonia rates among patients randomized to DPP‐4 inhibitors versus placebo/active comparators were also meta‐analysed. Results In the regional database, after matching 6495 patients/group, new users of DPP‐4 inhibitors had a lower rate of hospitalization for pneumonia than new users of other OGLMs (HR 0.76; 95% CI 0.61‐0.95). In the outpatient database, after matching 867 patients/group, new users of DPP‐4 inhibitors showed a non‐significantly lower rate of hospitalization for pneumonia (HR 0.65; 95% CI 0.41‐1.04). The meta‐analysis of observational studies yielded an overall non‐significant lower risk of hospitalization for pneumonia among DPP‐4 inhibitor users (RR 0.81; 95% CI 0.65‐1.01). The meta‐analysis of randomized controlled trials showed no overall effect of DPP‐4 inhibitors on pneumonia risk (RR 1.06; 95% CI 0.93‐1.20). Conclusion The use of DPP‐4 inhibitors can be considered as safe with regard to the risk of pneumonia.

show abstract

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

Cited by 49 publications

References 31 publications

Risk-adapted Treatment Strategy For COVID-19 Patients

Risk-adapted Treatment Strategy For COVID-19 Patients

Newly diagnosed diabetes is associated with a higher risk of mortality than known diabetes in hospitalized patients with COVID‐19

Exposure to dipeptidyl‐peptidase 4 inhibitors and the risk of pneumonia among people with type 2 diabetes: Retrospective cohort study and meta‐analysis

Contact Info

Product

Resources

About