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Antiviral Res. 2020 Mar 29:104785. doi: 10.1016/j.antiviral.2020.104785. [Epub ahead of print]
Effect of antiviral treatment in older patients hospitalized with confirmed influenza.
Soldevila N1, Toledo D2, Ortiz de Lejarazu R3, Tamames S4, Castilla J5, Astray J6, Fern?ndez MA7, Mart?n V8, Egurrola M9, Morales Su?rez-Varela M10, Dom?nguez ?11; Working Group of Project PI12/02079.
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Abstract
Seasonal influenza causes significant morbidity and mortality in people aged ≥65 years. Antiviral treatment can reduce complications and disease severity. The objective of this study was to investigate the effect of antiviral treatment in patients aged ≥65 years hospitalized with confirmed influenza in preventing intensive care unit (ICU) admission or death. A cross-sectional study was carried out in 20 hospitals from seven Spanish regions during 2013-2015 in patients aged ≥65 years. Hospitalized cases of laboratory-confirmed influenza were selected. To assess the association between antiviral treatment and ICU admission or death, the adjusted odds ratios (aOR) and their 95% confidence intervals (CI) were calculated using multivariate logistic regression. We included 715 hospitalized patients, of whom 640 (87.9%) received antiviral treatment, 77 (10.8%) required ICU admission and 66 (9.2%) died. In the 64-74 years age group, receipt of antiviral treatment ≤48 h (aOR 0.20; 95% CI 0.04-0.89), 3-4 days (aOR 0.23; 95% CI 0.05-0.92) and 5-7 days (aOR 0.24; 95% CI 0.03-0.91) after clinical symptom onset was associated with reduced mortality. Receipt of treatment >7 days after symptom onset was not associated with reduced mortality. No association of antiviral treatment with reduced mortality was observed in the >74 years age group or with the prevention of ICU admission in any age group. Antiviral treatment had a protective effect in avoiding death in patients aged 65-74 years hospitalized due to influenza when administered ≤48 h after symptom onset and when no more than 7 days had elapsed.
Copyright ? 2020. Published by Elsevier B.V.
KEYWORDS:
Adherence; Antiviral treatment; Hospitalized patients; Influenza; Older people
PMID:32234540DOI:10.1016/j.antiviral.2020.104785