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Int J Infect Dis. 2019 Jan 11. pii: S1201-9712(19)30016-5. doi: 10.1016/j.ijid.2019.01.005. [Epub ahead of print]
Predictors of Fatality in Influenza A Virus Subtypes Infection among inpatients in 2015-2016 season.
Tekin S1, Keske S2, Alan S3, Batirel A4, Karakoc C5, Tasdelen-Fisgin N6, Simsek-Yavuz S7, Işler B8, Aydin M9, Kapmaz M10, Yilmaz-Karadag F11, Ergonul O12.
Author information
Abstract
BACKGROUND:
Influenza A infection could cause to severe disease and mortality. The effect of different subtypes of Influenza on morbidity and mortality is not known yet in Turkey OBJECTIVES: We aimed to describe the predictors for fatality related to influenza A infection among hospitalized patients in İstanbul in 2015-2016 influenza season, and to detail the differences between H3N2 and H1N1.
STUDY DESIGN:
This is a multicenter study performed by Istanbul respiratory infections study group of The Turkish Society of Clinical Microbiology and Infectious Diseases (KLIMIK), among the patients, who were hospitalized for influenza in 2015-2016 influenza season in Istanbul.
RESULTS:
In 2015-2016 season, 222 hospitalized, laboratory-confirmed influenza cases were included, 25 (11.2%) died. The fatality rate was significantly higher among the patients older than 65 years, and the patients with chronic heart and kidney diseases (p <0.001), chronic neurological diseases (p=0.009), and malignancies (p=0.021). Thrombocyte counts were lower in the fatal group compared to the surviving patients (p <0.004). The median alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatinine phosphokinase, and C-reactive protein (CRP) levels were higher among fatal cases. In multivariate analysis for the prediction of fatality, being >65years old, (OR: 6.9, CI: 2.07-23.08, p=0.002), being infected with influenza A(H3N2) (OR: 4.2, CI: 1.27-14.38, p=0.019), and one-day delay in antiviral use (OR:1.28, CI:1.01-1.63, p=0.036) were found to be increased the likelihood of fatality.
CONCLUSIONS:
The case fatality rate of Influenza A(H3N2) was significantly higher than influenza A(H1N1). Detection of the infection, allowing opportunity for the early use of antiviral agents, was found to be important for prevention of fatality. The vaccination should be prioritized for at-risk groups.
Copyright ? 2019. Published by Elsevier Ltd.
KEYWORDS:
H1N1; H3N2; Influenza A; fatality
PMID: 30641199 DOI: 10.1016/j.ijid.2019.01.005
Predictors of Fatality in Influenza A Virus Subtypes Infection among inpatients in 2015-2016 season.
Tekin S1, Keske S2, Alan S3, Batirel A4, Karakoc C5, Tasdelen-Fisgin N6, Simsek-Yavuz S7, Işler B8, Aydin M9, Kapmaz M10, Yilmaz-Karadag F11, Ergonul O12.
Author information
Abstract
BACKGROUND:
Influenza A infection could cause to severe disease and mortality. The effect of different subtypes of Influenza on morbidity and mortality is not known yet in Turkey OBJECTIVES: We aimed to describe the predictors for fatality related to influenza A infection among hospitalized patients in İstanbul in 2015-2016 influenza season, and to detail the differences between H3N2 and H1N1.
STUDY DESIGN:
This is a multicenter study performed by Istanbul respiratory infections study group of The Turkish Society of Clinical Microbiology and Infectious Diseases (KLIMIK), among the patients, who were hospitalized for influenza in 2015-2016 influenza season in Istanbul.
RESULTS:
In 2015-2016 season, 222 hospitalized, laboratory-confirmed influenza cases were included, 25 (11.2%) died. The fatality rate was significantly higher among the patients older than 65 years, and the patients with chronic heart and kidney diseases (p <0.001), chronic neurological diseases (p=0.009), and malignancies (p=0.021). Thrombocyte counts were lower in the fatal group compared to the surviving patients (p <0.004). The median alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatinine phosphokinase, and C-reactive protein (CRP) levels were higher among fatal cases. In multivariate analysis for the prediction of fatality, being >65years old, (OR: 6.9, CI: 2.07-23.08, p=0.002), being infected with influenza A(H3N2) (OR: 4.2, CI: 1.27-14.38, p=0.019), and one-day delay in antiviral use (OR:1.28, CI:1.01-1.63, p=0.036) were found to be increased the likelihood of fatality.
CONCLUSIONS:
The case fatality rate of Influenza A(H3N2) was significantly higher than influenza A(H1N1). Detection of the infection, allowing opportunity for the early use of antiviral agents, was found to be important for prevention of fatality. The vaccination should be prioritized for at-risk groups.
Copyright ? 2019. Published by Elsevier Ltd.
KEYWORDS:
H1N1; H3N2; Influenza A; fatality
PMID: 30641199 DOI: 10.1016/j.ijid.2019.01.005