tetano
Editor, Senior Moderator
Eur J Clin Invest
. 2022 Aug 23;e13858.
doi: 10.1111/eci.13858. Online ahead of print.
In-hospital incidence of and risk factors for influenza associated respiratory failure
Blanca Ayuso García[SUP] 1 [/SUP], Álvaro Marchán-López[SUP] 1 [/SUP], Estíbaliz Arrieta Ortubay[SUP] 1 [/SUP], Cristina Castillo Maza[SUP] 1 [/SUP], Eva Romay Lema[SUP] 2 [/SUP], Antonio Lalueza[SUP] 1 3 4 [/SUP], Carlos Lumbreras[SUP] 1 3 4 5 [/SUP]
Affiliations
Abstract
Background: Respiratory failure (RF) is the most important complication of influenza virus infection. Its definition and incidence are heterogeneous in the literature.
Methods: This systematic review and meta-analysis aim to determine the incidence of and risk factors for RF in patients hospitalized with influenza. Electronic databases were searched for articles on RF in patients hospitalized for influenza infection up to December 2021 regardless of their geographical location. Observational and experimental studies were considered for inclusion, excluding case series. The Newcastle-Ottawa and Johanna Briggs scales were used for quality assessment. A random effects meta-analysis was performed, followed by subgroup analyses according to, among others, presence/absence of pneumonia, RF definition, serotype, and time period. PRISMA guidelines were followed for this review.
Results: Thirty-six studies were finally included into the meta-analysis. Overall RF incidence was 24% (range 5-85%, 95% confidence interval (95CI) 19-31%). Significantly higher incidences of RF were found in patients with pneumonia (42%, 95CI 28-57%, p=0.006), when RF was defined as hypoxemia (58%, 95CI 31-81%, p<0.001), and during the 2009 pandemic (25%, 95CI 16-36%) and post-pandemic period (23%, 95CI 15-34%, p=0.01). No differences were found between human influenza serotypes. Assessment of risk factors associated with the development of RF was not possible due to their inconsistent and heterogeneous reporting.
Conclusion: RF is frequent in hospitalized influenza patients, especially in patients with pneumonia and since the 2009 pandemic, although its definition and reporting widely vary in the literature. This complicates its characterization and comparison between cohorts and with other respiratory viruses.
Keywords: human Influenza; mechanical ventilation; respiratory failure; viral pneumonia.
. 2022 Aug 23;e13858.
doi: 10.1111/eci.13858. Online ahead of print.
In-hospital incidence of and risk factors for influenza associated respiratory failure
Blanca Ayuso García[SUP] 1 [/SUP], Álvaro Marchán-López[SUP] 1 [/SUP], Estíbaliz Arrieta Ortubay[SUP] 1 [/SUP], Cristina Castillo Maza[SUP] 1 [/SUP], Eva Romay Lema[SUP] 2 [/SUP], Antonio Lalueza[SUP] 1 3 4 [/SUP], Carlos Lumbreras[SUP] 1 3 4 5 [/SUP]
Affiliations
- PMID: 35997028
- DOI: 10.1111/eci.13858
Abstract
Background: Respiratory failure (RF) is the most important complication of influenza virus infection. Its definition and incidence are heterogeneous in the literature.
Methods: This systematic review and meta-analysis aim to determine the incidence of and risk factors for RF in patients hospitalized with influenza. Electronic databases were searched for articles on RF in patients hospitalized for influenza infection up to December 2021 regardless of their geographical location. Observational and experimental studies were considered for inclusion, excluding case series. The Newcastle-Ottawa and Johanna Briggs scales were used for quality assessment. A random effects meta-analysis was performed, followed by subgroup analyses according to, among others, presence/absence of pneumonia, RF definition, serotype, and time period. PRISMA guidelines were followed for this review.
Results: Thirty-six studies were finally included into the meta-analysis. Overall RF incidence was 24% (range 5-85%, 95% confidence interval (95CI) 19-31%). Significantly higher incidences of RF were found in patients with pneumonia (42%, 95CI 28-57%, p=0.006), when RF was defined as hypoxemia (58%, 95CI 31-81%, p<0.001), and during the 2009 pandemic (25%, 95CI 16-36%) and post-pandemic period (23%, 95CI 15-34%, p=0.01). No differences were found between human influenza serotypes. Assessment of risk factors associated with the development of RF was not possible due to their inconsistent and heterogeneous reporting.
Conclusion: RF is frequent in hospitalized influenza patients, especially in patients with pneumonia and since the 2009 pandemic, although its definition and reporting widely vary in the literature. This complicates its characterization and comparison between cohorts and with other respiratory viruses.
Keywords: human Influenza; mechanical ventilation; respiratory failure; viral pneumonia.