Influenza, influenza-like symptoms and their association with cardiovascular risks: a systematic review and meta-analysis of observational studies

Kwok, Chun Shing; Aslam, Saadia; Kontopantelis, Evangelos; Myint, Phyo Kyaw; Zaman, M Justin S; Buchan, Iain; Loke, Yoon K.; Mamas, Mamas A.

doi:10.1111/ijcp.12646

Cited by 50 publications

(35 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, influenza vaccination was negatively associated with AMI (pooled OR: 0.71; 95% CI: 0.56-0.91). 49 These findings are in keeping with other studies on the association between influenza and AMI, 62,63 and influenza vaccination and AMI. 64,65 The pathogenesis may be due to several mechanisms, including increased coronary and systemic inflammatory activity that drives procoagulant processes, dominant prothrombotic conditions, increased biomechanical stress on coronary arteries, variations in the coronary arterial tone, disturbed hemodynamic hemostasis, and altered metabolic balance.…”

Section: Cardiovascular Complicationssupporting

confidence: 89%

Influenza Infections and Emergent Viral Infections in Intensive Care Unit

Cantan

Luyt

Martín‐Loeches

2019

Semin Respir Crit Care Med

View full text Add to dashboard Cite

Critically ill patients are admitted to an intensive care unit (ICU) for multiple reasons. In this study, we aim to analyze the current evidence and findings associated with influenza and other emergent viral infections, namely, herpes simplex virus type 1 (HSV-1), Epstein-Barr virus (EBV), and cytomegalovirus (CMV).Among medical conditions, community-acquired respiratory infections are the most frequent reason for ventilatory support in ICUs. Community-acquired pneumonia in a severe form including the need of invasive mechanical ventilation and/or vasopressors is associated with high mortality rates. However, after the pandemic that occurred in 2009 by H1N1 influenza, the number of cases being admitted to ICUs with viral infections is on the rise. Patients in whom an etiology would not have been identified in the past are currently being tested with more sensitive viral molecular diagnostic tools, and patients being admitted to ICUs have more preexisting medical conditions that can predispose to viral infections. Viral infections can trigger the dysregulation of the immune system by inducing a massive cytokine response. This cytokine storm can cause endothelial damage and dysfunction, deregulation of coagulation, and, consequently, alteration of microvascular permeability, tissue edema, and shock. In severe influenza, this vascular hyperpermeability can lead to acute lung injury, multiorgan failure, and encephalopathy. In immunocompetent patients, the most common viral infections are respiratory, and influenza should be considered in patients with severe respiratory failure being admitted to ICU. Seasonality and coinfection are two important features when considering influenza as a pathogen in critically ill patients.Herpesviridae (HSV, CMV, and EBV) may reactivate in ICU patients, and their reactivation is associated with morbidity/mortality. However, whether a specific treatment may impact on outcome remains to be determined.

show abstract

Section: Cardiovascular Complicationssupporting

confidence: 89%

Influenza Infections and Emergent Viral Infections in Intensive Care Unit

Cantan

Luyt

Martín‐Loeches

2019

Semin Respir Crit Care Med

View full text Add to dashboard Cite

show abstract

“…Indeed, TMPRSS2 has an important role in influenza virus and other viral respiratory infections whereas MX1 participates in the cellular antiviral response. CVDs can be associated with influenza-like illness (Kwok et al, 2015 ) probably through immune mechanisms of atherosclerosis (Frostegård, 2013 ).…”

Section: Discussionmentioning

confidence: 99%

Pleiotropic Meta-Analyses of Longitudinal Studies Discover Novel Genetic Variants Associated with Age-Related Diseases

Kernogitski

Kulminskaya

et al. 2016

Front. Genet.

View full text Add to dashboard Cite

Age-related diseases may result from shared biological mechanisms in intrinsic processes of aging. Genetic effects on age-related diseases are often modulated by environmental factors due to their little contribution to fitness or are mediated through certain endophenotypes. Identification of genetic variants with pleiotropic effects on both common complex diseases and endophenotypes may reveal potential conflicting evolutionary pressures and deliver new insights into shared genetic contribution to healthspan and lifespan. Here, we performed pleiotropic meta-analyses of genetic variants using five NIH-funded datasets by integrating univariate summary statistics for age-related diseases and endophenotypes. We investigated three groups of traits: (1) endophenotypes such as blood glucose, blood pressure, lipids, hematocrit, and body mass index, (2) time-to-event outcomes such as the age-at-onset of diabetes mellitus (DM), cancer, cardiovascular diseases (CVDs) and neurodegenerative diseases (NDs), and (3) both combined. In addition to replicating previous findings, we identify seven novel genome-wide significant loci (< 5e-08), out of which five are low-frequency variants. Specifically, from Group 2, we find rs7632505 on 3q21.1 in SEMA5B, rs460976 on 21q22.3 (1 kb from TMPRSS2) and rs12420422 on 11q24.1 predominantly associated with a variety of CVDs, rs4905014 in ITPK1 associated with stroke and heart failure, rs7081476 on 10p12.1 in ANKRD26 associated with multiple diseases including DM, CVDs, and NDs. From Group 3, we find rs8082812 on 18p11.22 and rs1869717 on 4q31.3 associated with both endophenotypes and CVDs. Our follow-up analyses show that rs7632505, rs4905014, and rs8082812 have age-dependent effects on coronary heart disease or stroke. Functional annotation suggests that most of these SNPs are within regulatory regions or DNase clusters and in linkage disequilibrium with expression quantitative trait loci, implying their potential regulatory influence on the expression of nearby genes. Our mediation analyses suggest that the effects of some SNPs are mediated by specific endophenotypes. In conclusion, these findings indicate that loci with pleiotropic effects on age-related disorders tend to be enriched in genes involved in underlying mechanisms potentially related to nervous, cardiovascular and immune system functions, stress resistance, inflammation, ion channels and hematopoiesis, supporting the hypothesis of shared pathological role of infection, and inflammation in chronic age-related diseases.

show abstract

“…Reduction in community-wide ILI burden might reduce morbid events and hospitalizations, especially for patients at risk for cardiopulmonary events such as acute myocardial infarction or exacerbations of chronic obstructive pulmonary disease or asthma. 7,[46][47][48] These findings have potential implications for epidemiologic and health services studies designed to evaluate clinical outcomes over time. The variability in timing and severity of each influenza season (and resulting ILI incidence) can affect morbidity and mortality events, and investigators should consider accounting for ILI in their analyses.…”

Section: Discussionmentioning

confidence: 93%

Excess Deaths Attributable to Influenza-Like Illness in the ESRD Population

Gilbertson

Rothman

Chertow

et al. 2019

JASN

View full text Add to dashboard Cite

Background Morbidity and mortality vary seasonally. Timing and severity of influenza seasons contribute to those patterns, especially among vulnerable populations such as patients with ESRD. However, the extent to which influenza-like illness (ILI), a syndrome comprising a range of potentially serious respiratory tract infections, contributes to mortality in patients with ESRD has not been quantified.Methods We used data from the Centers for Disease Control and Prevention (CDC) Outpatient Influenzalike Illness Surveillance Network and Centers for Medicare and Medicaid Services ESRD death data from 2000 to 2013. After addressing the increasing trend in deaths due to the growing prevalent ESRD population, we calculated quarterly relative mortality compared with average third-quarter (summer) death counts. We used linear regression models to assess the relationship between ILI data and mortality, separately for quarters 4 and 1 for each influenza season, and model parameter estimates to predict seasonal mortality counts and calculate excess ILI-associated deaths.Results An estimated 1% absolute increase in quarterly ILI was associated with a 1.5% increase in relative mortality for quarter 4 and a 2.0% increase for quarter 1. The average number of annual deaths potentially attributable to ILI was substantial, about 1100 deaths per year.Conclusions We found an association between community ILI activity and seasonal variation in all-cause mortality in patients with ESRD, with ILI likely contributing to .1000 deaths annually. Surveillance efforts, such as timely reporting to the CDC of ILI activity within dialysis units during influenza season, may help focus attention on high-risk periods for this vulnerable population.

show abstract

Influenza, influenza-like symptoms and their association with cardiovascular risks: a systematic review and meta-analysis of observational studies

Cited by 50 publications

References 38 publications

Influenza Infections and Emergent Viral Infections in Intensive Care Unit

Influenza Infections and Emergent Viral Infections in Intensive Care Unit

Pleiotropic Meta-Analyses of Longitudinal Studies Discover Novel Genetic Variants Associated with Age-Related Diseases

Excess Deaths Attributable to Influenza-Like Illness in the ESRD Population

Contact Info

Product

Resources

About