tetano
Editor, Senior Moderator
Clin Infect Dis
. 2024 Nov 28:ciae584.
doi: 10.1093/cid/ciae584. Online ahead of print. Benefit of early oseltamivir therapy for adults hospitalized with influenza A: an observational study
Nathaniel M Lewis[SUP] 1 [/SUP], Elizabeth J Harker[SUP] 1 [/SUP], Lauren B Grant[SUP] 1 [/SUP], Yuwei Zhu[SUP] 2 [/SUP], Carlos G Grijalva[SUP] 2 [/SUP], James D Chappell[SUP] 2 [/SUP], Jillian P Rhoads[SUP] 2 [/SUP], Adrienne Baughman[SUP] 2 [/SUP], Jonathan D Casey[SUP] 2 [/SUP], Paul W Blair[SUP] 2 [/SUP], Ian D Jones[SUP] 2 [/SUP], Cassandra A Johnson[SUP] 2 [/SUP], Adam S Lauring[SUP] 3 [/SUP], Manju Gaglani[SUP] 4 5 [/SUP], Shekhar Ghamande[SUP] 5 [/SUP], Cristie Columbus[SUP] 5 6 [/SUP], Jay S Steingrub[SUP] 7 [/SUP], Nathan I Shapiro[SUP] 8 [/SUP], Abhijit Duggal[SUP] 9 [/SUP], Laurence W Busse[SUP] 10 [/SUP], Jamie Felzer[SUP] 10 [/SUP], Matthew E Prekker[SUP] 11 [/SUP], Ithan D Peltan[SUP] 12 13 [/SUP], Samuel M Brown[SUP] 12 13 [/SUP], David N Hager[SUP] 14 [/SUP], Michelle N Gong[SUP] 15 [/SUP], Amira Mohamed[SUP] 15 [/SUP], Matthew C Exline[SUP] 16 [/SUP], Akram Khan[SUP] 17 [/SUP], Catherine L Hough[SUP] 17 [/SUP], Jennifer G Wilson[SUP] 18 [/SUP], Jarrod Mosier[SUP] 19 [/SUP], Nida Qadir[SUP] 20 [/SUP], Steven Y Chang[SUP] 20 [/SUP], Adit A Ginde[SUP] 21 [/SUP], Amanda Martinez[SUP] 21 [/SUP], Nicholas M Mohr[SUP] 22 [/SUP], Christopher Mallow[SUP] 23 [/SUP], Estelle S Harris[SUP] 12 [/SUP], Nicholas J Johnson[SUP] 24 [/SUP], Vasisht Srinivasan[SUP] 24 [/SUP], Kevin W Gibbs[SUP] 25 [/SUP], Jennie H Kwon[SUP] 26 [/SUP], Ivana A Vaughn[SUP] 27 [/SUP], Mayur Ramesh[SUP] 27 [/SUP], Basmah Safdar[SUP] 28 [/SUP], Anirudh Goyal[SUP] 28 [/SUP], Lauren E DeLamielleure[SUP] 28 [/SUP], Jennifer DeCuir[SUP] 29 [/SUP], Diya Surie[SUP] 29 [/SUP], Fatimah S Dawood[SUP] 29 [/SUP], Mark W Tenforde[SUP] 1 [/SUP], Timothy M Uyeki[SUP] 1 [/SUP], Shikha Garg[SUP] 1 [/SUP], Sascha Ellington[SUP] 1 [/SUP], Wesley H Self[SUP] 2 [/SUP]; Investigating Respiratory Viruses in the Acutely Ill (IVY) Network
Collaborators, Affiliations
Background: clinical guidelines recommend initiation of antiviral therapy as soon as possible for patients hospitalized with confirmed or suspected influenza.
Methods: A multicenter US observational sentinel surveillance network prospectively enrolled adults (aged ≥18 years) hospitalized with laboratory-confirmed influenza at 24 hospitals during October 1, 2022-July 21, 2023. A multivariable proportional odds model was used to compare peak pulmonary disease severity (no oxygen support, standard supplemental oxygen, high-flow oxygen/non-invasive ventilation, invasive mechanical ventilation, or death) after the day of hospital admission among patients starting oseltamivir treatment on the day of admission (early) versus those who did not (late or not treated), adjusting for baseline (admission day) severity, age, sex, site, and vaccination status. Multivariable logistic regression models were used to evaluate the odds of intensive care unit (ICU) admission, acute kidney replacement therapy or vasopressor use, and in-hospital death.
Results: A total of 840 influenza-positive patients were analyzed, including 415 (49%) who started oseltamivir treatment on the day of admission, and 425 (51%) who did not. Compared with late or not treated patients, those treated early had lower peak pulmonary disease severity (proportional aOR: 0.60, 95% CI: 0.49-0.72), and lower odds of intensive care unit admission (aOR: 0.24, 95% CI: 0.13-0.47), acute kidney replacement therapy or vasopressor use (aOR: 0.40, 95% CI: 0.22-0.67), and in-hospital death (aOR: 0.36, 95% CI: 0.18-0.72).
Conclusion: Among adults hospitalized with influenza, treatment with oseltamivir on day of hospital admission was associated reduced risk of disease progression, including pulmonary and extrapulmonary organ failure and death.
Keywords: antiviral therapy; influenza; oseltamivir; severity.
. 2024 Nov 28:ciae584.
doi: 10.1093/cid/ciae584. Online ahead of print. Benefit of early oseltamivir therapy for adults hospitalized with influenza A: an observational study
Nathaniel M Lewis[SUP] 1 [/SUP], Elizabeth J Harker[SUP] 1 [/SUP], Lauren B Grant[SUP] 1 [/SUP], Yuwei Zhu[SUP] 2 [/SUP], Carlos G Grijalva[SUP] 2 [/SUP], James D Chappell[SUP] 2 [/SUP], Jillian P Rhoads[SUP] 2 [/SUP], Adrienne Baughman[SUP] 2 [/SUP], Jonathan D Casey[SUP] 2 [/SUP], Paul W Blair[SUP] 2 [/SUP], Ian D Jones[SUP] 2 [/SUP], Cassandra A Johnson[SUP] 2 [/SUP], Adam S Lauring[SUP] 3 [/SUP], Manju Gaglani[SUP] 4 5 [/SUP], Shekhar Ghamande[SUP] 5 [/SUP], Cristie Columbus[SUP] 5 6 [/SUP], Jay S Steingrub[SUP] 7 [/SUP], Nathan I Shapiro[SUP] 8 [/SUP], Abhijit Duggal[SUP] 9 [/SUP], Laurence W Busse[SUP] 10 [/SUP], Jamie Felzer[SUP] 10 [/SUP], Matthew E Prekker[SUP] 11 [/SUP], Ithan D Peltan[SUP] 12 13 [/SUP], Samuel M Brown[SUP] 12 13 [/SUP], David N Hager[SUP] 14 [/SUP], Michelle N Gong[SUP] 15 [/SUP], Amira Mohamed[SUP] 15 [/SUP], Matthew C Exline[SUP] 16 [/SUP], Akram Khan[SUP] 17 [/SUP], Catherine L Hough[SUP] 17 [/SUP], Jennifer G Wilson[SUP] 18 [/SUP], Jarrod Mosier[SUP] 19 [/SUP], Nida Qadir[SUP] 20 [/SUP], Steven Y Chang[SUP] 20 [/SUP], Adit A Ginde[SUP] 21 [/SUP], Amanda Martinez[SUP] 21 [/SUP], Nicholas M Mohr[SUP] 22 [/SUP], Christopher Mallow[SUP] 23 [/SUP], Estelle S Harris[SUP] 12 [/SUP], Nicholas J Johnson[SUP] 24 [/SUP], Vasisht Srinivasan[SUP] 24 [/SUP], Kevin W Gibbs[SUP] 25 [/SUP], Jennie H Kwon[SUP] 26 [/SUP], Ivana A Vaughn[SUP] 27 [/SUP], Mayur Ramesh[SUP] 27 [/SUP], Basmah Safdar[SUP] 28 [/SUP], Anirudh Goyal[SUP] 28 [/SUP], Lauren E DeLamielleure[SUP] 28 [/SUP], Jennifer DeCuir[SUP] 29 [/SUP], Diya Surie[SUP] 29 [/SUP], Fatimah S Dawood[SUP] 29 [/SUP], Mark W Tenforde[SUP] 1 [/SUP], Timothy M Uyeki[SUP] 1 [/SUP], Shikha Garg[SUP] 1 [/SUP], Sascha Ellington[SUP] 1 [/SUP], Wesley H Self[SUP] 2 [/SUP]; Investigating Respiratory Viruses in the Acutely Ill (IVY) Network
Collaborators, Affiliations
- PMID: 39607747
- DOI: 10.1093/cid/ciae584
Background: clinical guidelines recommend initiation of antiviral therapy as soon as possible for patients hospitalized with confirmed or suspected influenza.
Methods: A multicenter US observational sentinel surveillance network prospectively enrolled adults (aged ≥18 years) hospitalized with laboratory-confirmed influenza at 24 hospitals during October 1, 2022-July 21, 2023. A multivariable proportional odds model was used to compare peak pulmonary disease severity (no oxygen support, standard supplemental oxygen, high-flow oxygen/non-invasive ventilation, invasive mechanical ventilation, or death) after the day of hospital admission among patients starting oseltamivir treatment on the day of admission (early) versus those who did not (late or not treated), adjusting for baseline (admission day) severity, age, sex, site, and vaccination status. Multivariable logistic regression models were used to evaluate the odds of intensive care unit (ICU) admission, acute kidney replacement therapy or vasopressor use, and in-hospital death.
Results: A total of 840 influenza-positive patients were analyzed, including 415 (49%) who started oseltamivir treatment on the day of admission, and 425 (51%) who did not. Compared with late or not treated patients, those treated early had lower peak pulmonary disease severity (proportional aOR: 0.60, 95% CI: 0.49-0.72), and lower odds of intensive care unit admission (aOR: 0.24, 95% CI: 0.13-0.47), acute kidney replacement therapy or vasopressor use (aOR: 0.40, 95% CI: 0.22-0.67), and in-hospital death (aOR: 0.36, 95% CI: 0.18-0.72).
Conclusion: Among adults hospitalized with influenza, treatment with oseltamivir on day of hospital admission was associated reduced risk of disease progression, including pulmonary and extrapulmonary organ failure and death.
Keywords: antiviral therapy; influenza; oseltamivir; severity.