tetano
Editor, Senior Moderator
Int J Infect Dis
. 2023 Sep 3;S1201-9712(23)00712-9.
doi: 10.1016/j.ijid.2023.08.027. Online ahead of print. Systematic influenza screening in cardiac intensive care units during the influenza season: a prospective study in Spain
Alicia Galar[SUP] 1 [/SUP], Miriam Juárez[SUP] 2 [/SUP], Iago Sousa-Casasnovas[SUP] 2 [/SUP], Pilar Catalán[SUP] 3 [/SUP], Maricela Valerio[SUP] 3 [/SUP], Pablo Antunez-Muiños[SUP] 4 [/SUP], Gema Barbeito[SUP] 5 [/SUP], Silvia Blanco-Alonso[SUP] 6 [/SUP], María Dolores Folgueira[SUP] 7 [/SUP], José María García-Acuña[SUP] 4 [/SUP], Antonio Lalueza[SUP] 8 [/SUP], Fernando Lázaro[SUP] 9 [/SUP], Esteban López De Sá[SUP] 10 [/SUP], Lorena Martín[SUP] 10 [/SUP], Elena Muñez[SUP] 6 [/SUP], Francisca Portero[SUP] 11 [/SUP], Antonio Ramos-Martínez[SUP] 6 [/SUP], María Pilar Romero Gómez[SUP] 9 [/SUP], Sandra Rosillo[SUP] 9 [/SUP], Francisco Fernández-Avilés[SUP] 12 [/SUP], Manuel Martínez-Sellés[SUP] 13 [/SUP], Emilio Bouza[SUP] 14 [/SUP], Patricia Muñoz[SUP] 15 [/SUP]
Affiliations
Background: Little is known about the incidence of influenza among admissions to the cardiac-intensive care unit (C-ICU), accuracy of clinical suspicion, and influenza vaccination uptake. We evaluated the incidence of influenza at C-ICU admission during the influenza season, potential underdiagnosis, and vaccination uptake.
Methods: Prospective study at five C-ICUs during the 2017-2020 influenza seasons. A nasopharyngeal swab was collected at admission from patients who consented (n=788). Testing was with Xpert®XpressFlu/RSV.
Results: Influenza was detected in 43 patients (5.5%) (40 FluA; 3 FluB) and clinically suspected in 27 (62.8%). Compared to non-influenza patients, influenza patients more frequently had heart failure (37.2% vs. 22.8%, p=0.031), previous contact with relatives with influenza-like illnesses (23.3% vs. 12.5%, p=0.042), antimicrobial use (67.4% vs. 23.2%, p<0.01), and need for mechanical ventilation (25.6% vs. 14.5%, p=0.048). Patients received oseltamivir promptly. We found no differences in mortality (11.6% vs. 5.2%, p=0.076). Influenza patients more frequently had myocarditis (9.3% vs. 0.9%, p<0.01) and pericarditis (7.0% vs. 0.8%, p=0.01). Overall, 43.0% of patients (339/788) were vaccinated (51.9% of those with a clear indication [303/584]).
Conclusions: Influenza seems to be a frequently underdiagnosed underlying condition in admissions to the C-ICU. Influenza should be screened for at C-ICU admission during influenza epidemics.
Keywords: Systematic screening; acute cardiac events; influenza.
. 2023 Sep 3;S1201-9712(23)00712-9.
doi: 10.1016/j.ijid.2023.08.027. Online ahead of print. Systematic influenza screening in cardiac intensive care units during the influenza season: a prospective study in Spain
Alicia Galar[SUP] 1 [/SUP], Miriam Juárez[SUP] 2 [/SUP], Iago Sousa-Casasnovas[SUP] 2 [/SUP], Pilar Catalán[SUP] 3 [/SUP], Maricela Valerio[SUP] 3 [/SUP], Pablo Antunez-Muiños[SUP] 4 [/SUP], Gema Barbeito[SUP] 5 [/SUP], Silvia Blanco-Alonso[SUP] 6 [/SUP], María Dolores Folgueira[SUP] 7 [/SUP], José María García-Acuña[SUP] 4 [/SUP], Antonio Lalueza[SUP] 8 [/SUP], Fernando Lázaro[SUP] 9 [/SUP], Esteban López De Sá[SUP] 10 [/SUP], Lorena Martín[SUP] 10 [/SUP], Elena Muñez[SUP] 6 [/SUP], Francisca Portero[SUP] 11 [/SUP], Antonio Ramos-Martínez[SUP] 6 [/SUP], María Pilar Romero Gómez[SUP] 9 [/SUP], Sandra Rosillo[SUP] 9 [/SUP], Francisco Fernández-Avilés[SUP] 12 [/SUP], Manuel Martínez-Sellés[SUP] 13 [/SUP], Emilio Bouza[SUP] 14 [/SUP], Patricia Muñoz[SUP] 15 [/SUP]
Affiliations
- PMID: 37669725
- DOI: 10.1016/j.ijid.2023.08.027
Background: Little is known about the incidence of influenza among admissions to the cardiac-intensive care unit (C-ICU), accuracy of clinical suspicion, and influenza vaccination uptake. We evaluated the incidence of influenza at C-ICU admission during the influenza season, potential underdiagnosis, and vaccination uptake.
Methods: Prospective study at five C-ICUs during the 2017-2020 influenza seasons. A nasopharyngeal swab was collected at admission from patients who consented (n=788). Testing was with Xpert®XpressFlu/RSV.
Results: Influenza was detected in 43 patients (5.5%) (40 FluA; 3 FluB) and clinically suspected in 27 (62.8%). Compared to non-influenza patients, influenza patients more frequently had heart failure (37.2% vs. 22.8%, p=0.031), previous contact with relatives with influenza-like illnesses (23.3% vs. 12.5%, p=0.042), antimicrobial use (67.4% vs. 23.2%, p<0.01), and need for mechanical ventilation (25.6% vs. 14.5%, p=0.048). Patients received oseltamivir promptly. We found no differences in mortality (11.6% vs. 5.2%, p=0.076). Influenza patients more frequently had myocarditis (9.3% vs. 0.9%, p<0.01) and pericarditis (7.0% vs. 0.8%, p=0.01). Overall, 43.0% of patients (339/788) were vaccinated (51.9% of those with a clear indication [303/584]).
Conclusions: Influenza seems to be a frequently underdiagnosed underlying condition in admissions to the C-ICU. Influenza should be screened for at C-ICU admission during influenza epidemics.
Keywords: Systematic screening; acute cardiac events; influenza.