Seasonal influenza-associated intensive care unit admission and death in tropical Singapore, 2011-2015

Zhang, Xiaozhu; Kyaw, Win Mar; Ho, Hanley J.; Tay, Min Zhi; Huang, Hongjie; Hein, Aung Aung; Chow, Angela

doi:10.1016/j.jcv.2019.06.005

Cited by 9 publications

(7 citation statements)

References 42 publications

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“…Previous studies reported underlying chronic medical conditions of the host, such as cardiac disease, chronic pulmonary disease, immunosuppression, diabetes mellitus, obesity and pregnancy, were major factors associated with influenza severity (Chow et al, 2019). Similarly, our study found patients with comorbidities including chronic pulmonary disease and diabetes mellitus had a higher predisposition to critical influenza (Mertz et al, 2013;Zhang et al, 2019). Decreased lung compliance is related to persistent viral RNA detection, which contribute to the higher risk of progression to severe disease in these patients (Chow et al, 2019).…”

Section: Discussionsupporting

confidence: 74%

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

Zou

Zheng

Wang

et al. 2020

International Journal of Infectious Diseases

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Section: Discussionsupporting

confidence: 74%

“…Pandemic and seasonal influenza infections can progress to severe pneumonia and cause substantial mortality (Paules and Subbarao, 2017). Patients who are elderly, obese, pregnant or with comorbidity are at high risks of hospitalization, ICU admission and mortality (Mertz et al, 2013;Zhang et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

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

Zou

Zheng

Wang

et al. 2020

International Journal of Infectious Diseases

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“…The CCI is a validated clinical score that has demonstrated its usefulness both in a chronic and acute setting. It is related to the mortality of sepsis, pneumonia and seasonal influenza [13,[24][25][26][27]. In the cardiovascular acute setting, it has also been used as a reliable prognostic tool in situations such as acute myocardial infarction [28].…”

Section: Discussionmentioning

confidence: 99%

“…Cardiovascular morbidity has also been associated with both worse outcomes in COVID-19. Whether the excess of mortality in patients with myocardial injury can be explained by the higher prevalence of comorbidities in this population is still a subject of discussion [4,[9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Myocardial injury determination improves risk stratification and predicts mortality in COVID-19 patients

et al. 2020

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Background: Despite being associated with worse prognosis in patients with COVID-19, systematic determination of myocardial injury is not recommended. The aim of the study was to study the effect of myocardial injury assessment on risk stratification of COVID-19 patients. Methods: Seven hundred seven consecutive adult patients admitted to a large tertiary hospital with confirmed COVID-19 were included. Demographic data, comorbidities, laboratory results and clinical outcomes were recorded. Charlson comorbidity index (CCI) was calculated in order to quantify the degree of comorbidities. Independent association of cardiac troponin I (cTnI) increase with outcomes was evaluated by multivariate regression analyses and area under curve. In addition, propensity-score matching was performed to assemble a cohort of patients with similar baseline characteristics.Results: In the matched cohort (mean age 66.76 ± 15.7 years, 37.3% females), cTnI increase above the upper limit was present in 20.9% of the population and was associated with worse clinical outcomes, including all-cause mortality within 30 days (45.1% vs. 23.2%; p = 0.005). The addition of cTnI to a multivariate prediction model showed a significant improvement in the area under the time-dependent receiver operating characteristic curve (0.775 vs. 0.756, DC-statistic = 0.019; 95% confidence interval 0.001-0.037). Use of renin-angiotensin-aldosterone system inhibitors was not associated with mortality after adjusting by baseline risk factors. Conclusions: Myocardial injury is independently associated with adverse outcomes irrespective of baseline comorbidities and its addition to multivariate regression models significantly improves their performance in predicting mortality. The determination of myocardial injury biomarkers on hospital admission and its combination with CCI can classify patients in three risk groups (high, intermediate and low) with a clearly distinct 30-day mortality.

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“…These findings are consistent with the findings of other studies. Studies have found that hypoalbuminemia [ 27 , 28 ] and chronic kidney diseases [ 29 ] are associated with increased morbidity and mortality in patients with influenza.…”

Section: Discussionmentioning

confidence: 99%

The impact of obesity on seasonal influenza: a single-center, retrospective study conducted in Israel

Atamna

Daskal

Babich

et al. 2021

Eur J Clin Microbiol Infect Dis

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Obesity is associated with an increased susceptibility to infections. Several studies have reported adverse clinical outcomes of influenza among obese individuals. Our aim was to examine the association between obesity and the clinical outcomes of hospitalized adult patients ill with seasonal influenza. Consecutive hospitalized adult patients between 10/2017 and 4/2018 with laboratory confirmed influenza A and B were divided into an obese group (body mass index (BMI) ≥ 30 kg/m 2) and controls. The primary outcome was a composite endpoint of 30-day all-cause mortality, vasopressor use, mechanical ventilation, ICU admission, and severe influenza complication (myocarditis and encephalitis). Secondary outcomes encompassed all the components of the primary outcome, 90-day all-cause mortality, occurrence of pneumonia, length of hospital stay, and 90-day readmission rates. The study comprised 512 hospitalized adults diagnosed with laboratory-confirmed influenza A (195/512) and B (317/512). Within this group, 17% (86/512) were classified obese; the remaining 83% (426/512) were controls. Results of the composite outcome (7/85, 8% vs. 45/422, 11%; p=0.5) and the crude 30-day all-cause mortality rate (5/86, 6% vs. 34/426, 8%, p=0.5) were similar between the two groups. The multivariate analysis demonstrated that obesity was not a significant risk factor for influenza adverse events (OR=1.3, CI 95% 0.3-3.3; p=0.5), whereas advanced age, chronic kidney disease, and hypoalbuminemia were significant risk factors (OR=1.03, OR=2.7, and OR=5.4, respectively). Obesity was not associated with influenza-related morbidity and mortality among the hospitalized adults during the 2017-2018 influenza season. Further studies researching different influenza seasons are essential.

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Seasonal influenza-associated intensive care unit admission and death in tropical Singapore, 2011-2015

Cited by 9 publications

References 42 publications

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

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

Myocardial injury determination improves risk stratification and predicts mortality in COVID-19 patients

The impact of obesity on seasonal influenza: a single-center, retrospective study conducted in Israel

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