Int J Infect Dis . Superinfection is associated with short-term outcome and mortality in viral respiratory tract infections during the fall-winter seasons 2016-2018 in the Greater Paris area: the SUPERFLUOUS study

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Int J Infect Dis


. 2022 Apr 8;S1201-9712(22)00207-7.
doi: 10.1016/j.ijid.2022.04.008. Online ahead of print.
Superinfection is associated with short-term outcome and mortality in viral respiratory tract infections during the fall-winter seasons 2016-2018 in the Greater Paris area: the SUPERFLUOUS study


Benjamin Davido ¹ , Benoit Lemarie ² , Elyanne Gault ³ , Marion Pepin ⁴ , Karim Jaffal ² , Sebastien Beaune ⁵ , Lotfi Dahmane ⁶ , Jennifer Dumoulin ⁷ , Segolene Greffe ⁸ , Djillali Annane ⁹ , Pierre De Truchis ²



Affiliations

• PMID: 35405349
• DOI: 10.1016/j.ijid.2022.04.008

Abstract

Background: Following the study of the predictors of superinfection in viral respiratory tract infections (VRTIs), this study analyses the predictors of the outcome.
Methods: Multicenter retrospective study conducted among adults who tested positive for VRTIs with RT-PCR. We compared characteristics between Influenzavirus, Paramyxoviridae and Pneumoviridae and identified predictors of favourable short-term outcome, admission to intensive care unit (ICU) and mortality.
Results: 590 patients had VRTI, including 347 (59%) influenza infections. Mean (SD) patient age was 71.0 (18.3) years, with a sex-ratio of 0.91. In multivariate analyses, predictors of short-term favourable outcome were age≤75 years-old (aOR,5.38 [95% CI,1.59-18.2]), absence of respiratory disease (4.94,[1.01-24.37]) and absence of superinfection (3.91,[1.37-11.13]). The predictors of ICU admission were age≤75 years-old (3.28,[1.71-6.25]), chronic respiratory disease (2.49,[1.20-5.19]) and procalcitonin level >0.25ng/mL (4.25,[1.55-11.67]). Predictors of mortality were use of inhaled corticosteroids (2.49,[1.10-5.63]), influenza infection (2.73,[1.27-5.85]), Charlson score ≥5 (5.35,[1.90-15.05]), superinfection (2.54,[1.05-6.18]) and eosinophil count <50/µL (4.39,[1.19-16.2]). Certainty of superinfection was significantly associated with mortality (2.23,[1.15-4.3]).
Conclusion: Our study revealed that superinfection was significantly related to the outcome, and that virus species impacts mortality. These findings plead for improving the tools used in daily practice to confirm certainty of superinfection and for a broader vaccination of individuals at risk of VRTIs.

Keywords: Paramyxoviridae, Pneumoviridae; influenza; mortality; outcome; respiratory tract infections; respiratory viruses.