Obesity and Respiratory Hospitalizations During Influenza Seasons in Ontario, Canada: A Cohort Study

Kwong, Jeffrey C.; Campitelli, Michael A.; Rosella, Laura

doi:10.1093/cid/cir442

Cited by 189 publications

(166 citation statements)

References 21 publications

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“…Based on multivariate regression analysis, obesity was independently associated with ICU admission and therefore the occurrence of severe disease. These findings were consistent with the results of previous studies (15,16).…”

Section: Discussionsupporting

confidence: 94%

Predictors of Hospitalization and Admission to Intensive Care Units of Influenza Patients in Serbia through Four Influenza Seasons from 2010/2011 to 2013/2014

et al. 2017

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Section: Discussionsupporting

confidence: 94%

Predictors of Hospitalization and Admission to Intensive Care Units of Influenza Patients in Serbia through Four Influenza Seasons from 2010/2011 to 2013/2014

et al. 2017

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“…One recent study of the NHANES cohort found a consistent association between obesity and pH1N1 hospitalisations/death, after stratifying by comorbidity, suggesting a true diathesis [34]. In the seasonal influenza literature, Kwong et al have demonstrated an association between obesity and increased respiratory hospitalisations, after adjusting for diabetes and cardiovascular disease [37]. Obesity may therefore account for the association between diabetes and influenzaattributable illness to an unknown extent [38].…”

Section: Discussionmentioning

confidence: 99%

Working-age adults with diabetes experience greater susceptibility to seasonal influenza: a population-based cohort study

et al. 2014

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Aims/hypothesis The aim of this work was to compare the incidence of illness attributable to influenza in working-age adults (age <65 years) with and without diabetes. Methods We performed a cohort study using administrative data from Manitoba, Canada, between 2000 and 2008. All working-age adults with diabetes were identified and matched with up to two non-diabetic controls. We analysed the rates of influenza-like illness physician visits and hospitalisations, pneumonia and influenza hospitalisations, and all-cause hospitalisations. Multivariable regressions were used to estimate the influenza-attributable rate of each outcome. Results We included 745,777 person-years of follow-up among 166,715 subjects. The median age was 50-51 years and 48-49% were women; adults with diabetes had more comorbidities and were more likely to be vaccinated for influenza than those without diabetes. Compared with similar adults without diabetes, those with diabetes had a 6% greater (RR 1.06, 95% CI 1.02, 1.10; absolute risk difference 6 per 1,000 adults per year) increase in all-cause hospitalisations associated with influenza, representing a total of 54 additional hospitalisations. There were no differences in the influenzaattributable rates of influenza-like illness (p = 0.06) or pneumonia and influenza (p = 0.11). Conclusions/interpretation Guidelines calling for influenza vaccinations in diabetic, in addition to elderly, adults implicitly single out working-age adults with diabetes. The evidence supporting such guidelines has hitherto been scant. We found that working-age adults with diabetes appear more susceptible to serious influenza-attributable illness. These findings represent the strongest available evidence for targeting diabetes as an indication for influenza vaccination, irrespective of age.

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“…Death was associated with both obesity, defined as BMI ≥30 (OR: 3.1; 95% CI = 1.5-6.6) and extreme obesity (OR: 7.6; 95% CI = 2.1-27.9). A Canadian cohort study covering 12 seasons (1996-97 through 2007-08) found that persons with a BMI of 30.0-34.9 and those with a BMI ≥35 were more likely than normal-weight persons to have a respiratory hospitalization during influenza seasons (OR: 1.45; 95% CI = 1.03-2.05 for BMI 30-34.9 and OR: 2.12; 95% CI = 1.45-3.10 for BMI ≥35) (85). Conversely, a two-season study in the United States found no association between obesity and medically attended LCI, including both seasonal and pandemic virus circulation (86).…”

Section: Persons With Increased Risk For Severe Influenza Illness Andmentioning

confidence: 99%

Prevention and Control of Seasonal Influenza with Vaccines

Grohskopf

Sokolow²,

Broder³

et al. 2016

MMWR Recomm. Rep.

383

279

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Obesity and Respiratory Hospitalizations During Influenza Seasons in Ontario, Canada: A Cohort Study

Abstract: Evidence from the 2009 H1N1 pandemic suggests that severe obesity was a risk factor for serious complications from influenza infection. Our study identifies severe obesity as a risk factor for respiratory hospitalizations during seasonal influenza epidemics.

Cited by 189 publications

References 21 publications

Predictors of Hospitalization and Admission to Intensive Care Units of Influenza Patients in Serbia through Four Influenza Seasons from 2010/2011 to 2013/2014

Predictors of Hospitalization and Admission to Intensive Care Units of Influenza Patients in Serbia through Four Influenza Seasons from 2010/2011 to 2013/2014

Working-age adults with diabetes experience greater susceptibility to seasonal influenza: a population-based cohort study

Prevention and Control of Seasonal Influenza with Vaccines

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