Gerontology . Influenza A-Associated In-Hospital Mortality in Very Older People: Does Inflammation Also Play a Role?

[tetano]

Gerontology


. 2021 Sep 30;1-9.
doi: 10.1159/000519157. Online ahead of print.
Influenza A-Associated In-Hospital Mortality in Very Older People: Does Inflammation Also Play a Role?


Estibaliz Arrieta ¹ , Antonio Lalueza ^{1 2 3} , Blanca Ayuso-García ¹ , Hernando Trujillo ¹ , Dolores Folgueira ^{2 3 4} , Diana Paredes ¹ , Miguel Ángel Verdejo ¹ , Javier Camacho ¹ , José María Caso ¹ , Carlos Heredia ¹ , Cecilia Cueto-Felgueroso ⁵ , Daniel Pleguezuelo ⁶ , Antonio Serrano ^{3 6} , Carlos Lumbreras ^{1 2 3 7}



Affiliations

• PMID: 34592742
• DOI: 10.1159/000519157

Abstract

Background: The aim of the study was to analyze the clinical manifestations and outcome of the oldest old (people aged ≥85 years) who were admitted to the hospital with a confirmed influenza A virus infection in comparison with younger patients and to assess the role of inflammation in the outcome of influenza infection in this population.
Methods: This is an observational prospective study including all adult patients with influenza A virus infection hospitalized in a tertiary teaching hospital in Madrid, in 2 consecutive influenza seasons (2016-17 and 2017-18).
Results: Five hundred nine hospitalized patients with influenza A infection were included, of whom 117 (23%) were older than 85 years (median age: 89.3 ± 3.2). We compared the clinical characteristics and outcome with those of the rest of the population (median age: 72.8 ± 15.7). Overall, mortality was higher in older patients (10% vs. 4%; p = 0.03) with no differences in clinical presentation. Patients older than 85 years who ultimately died (12 out of 117) showed increased systemic inflammation expressed by higher levels of C-reactive protein (CRP) and ferritin compared to survivors who were discharged (odds ratio [OR] of CRP >20 mg/dL: 5.16, 95% confidence interval [CI]: 1.29-20.57, and OR of ferritin >500 mg: 4.3, 95% CI: 1.04-17.35).
Conclusions: Patients aged 85 and older with influenza A virus infection presented a higher in-hospital mortality than younger subjects. CRP and ferritin levels were higher in the oldest old who died, suggesting that inflammation could play a key role in the outcome of this subset of patients.

Keywords: Inflammation; Influenza; Older people; Oldest old; Outcome.