tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2023 Nov 29;10(12)
fad599.
doi: 10.1093/ofid/ofad599. eCollection 2023 Dec. Association of Chronic Medical Conditions With Severe Outcomes Among Nonpregnant Adults 18-49 Years Old Hospitalized With Influenza, FluSurv-NET, 2011-2019
Efemona A Famati[SUP] 1 2 [/SUP], Dawud Ujamaa[SUP] 1 3 [/SUP], Alissa O'Halloran[SUP] 1 [/SUP], Pam Daily Kirley[SUP] 4 [/SUP], Shua J Chai[SUP] 4 5 [/SUP], Isaac Armistead[SUP] 6 [/SUP], Nisha B Alden[SUP] 6 [/SUP], Kimberly Yousey-Hindes[SUP] 7 [/SUP], Kyle P Openo[SUP] 8 9 10 [/SUP], Patricia A Ryan[SUP] 11 [/SUP], Maya L Monroe[SUP] 11 [/SUP], Anna Falkowski[SUP] 12 [/SUP], Sue Kim[SUP] 12 [/SUP], Ruth Lynfield[SUP] 13 [/SUP], Melissa McMahon[SUP] 13 [/SUP], Kathy M Angeles[SUP] 14 [/SUP], Sarah A Khanlian[SUP] 14 [/SUP], Nancy L Spina[SUP] 15 [/SUP], Nancy M Bennett[SUP] 16 [/SUP], Maria A Gaitán[SUP] 16 [/SUP], Eli Shiltz[SUP] 17 [/SUP], Krista Lung[SUP] 17 [/SUP], Ann Thomas[SUP] 18 [/SUP], H Keipp Talbot[SUP] 19 [/SUP], William Schaffner[SUP] 19 [/SUP], Andrea George[SUP] 20 [/SUP], Holly Staten[SUP] 20 [/SUP], Catherine H Bozio[SUP] 1 [/SUP], Shikha Garg[SUP] 1 [/SUP]
Affiliations
Background: Older age and chronic conditions are associated with severe influenza outcomes; however, data are only comprehensively available for adults ≥65 years old. Using data from the Influenza Hospitalization Surveillance Network (FluSurv-NET), we identified characteristics associated with severe outcomes in adults 18-49 years old hospitalized with influenza.
Methods: We included FluSurv-NET data from nonpregnant adults 18-49 years old hospitalized with laboratory-confirmed influenza during the 2011-2012 through 2018-2019 seasons. We used bivariate and multivariable logistic regression to determine associations between select characteristics and severe outcomes including intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), and in-hospital death.
Results: A total of 16 140 patients aged 18-49 years and hospitalized with influenza were included in the analysis; the median age was 39 years, and 26% received current-season influenza vaccine before hospitalization. Obesity, asthma, and diabetes mellitus were the most common chronic conditions. Conditions associated with a significantly increased risk of severe outcomes included age group 30-39 or 40-49 years (IMV, age group 30-39 years: adjusted odds ratio [aOR], 1.25; IMV, age group 40-49 years: aOR, 1.36; death, age group 30-39 years: aOR, 1.28; death, age group 40-49 years: aOR, 1.69), being unvaccinated (ICU: aOR, 1.18; IMV: aOR, 1.25; death: aOR, 1.48), and having chronic conditions including extreme obesity and chronic lung, cardiovascular, metabolic, neurologic, or liver diseases (ICU: range aOR, 1.22-1.56; IMV: range aOR, 1.17-1.54; death: range aOR, 1.43-2.36).
Conclusions: To reduce the morbidity and mortality associated with influenza among adults aged 18-49 years, health care providers should strongly encourage receipt of annual influenza vaccine and lifestyle/behavioral modifications, particularly among those with chronic medical conditions.
Keywords: adults; chronic conditions; hospitalizations; influenza; severe.
. 2023 Nov 29;10(12)
fad599.doi: 10.1093/ofid/ofad599. eCollection 2023 Dec. Association of Chronic Medical Conditions With Severe Outcomes Among Nonpregnant Adults 18-49 Years Old Hospitalized With Influenza, FluSurv-NET, 2011-2019
Efemona A Famati[SUP] 1 2 [/SUP], Dawud Ujamaa[SUP] 1 3 [/SUP], Alissa O'Halloran[SUP] 1 [/SUP], Pam Daily Kirley[SUP] 4 [/SUP], Shua J Chai[SUP] 4 5 [/SUP], Isaac Armistead[SUP] 6 [/SUP], Nisha B Alden[SUP] 6 [/SUP], Kimberly Yousey-Hindes[SUP] 7 [/SUP], Kyle P Openo[SUP] 8 9 10 [/SUP], Patricia A Ryan[SUP] 11 [/SUP], Maya L Monroe[SUP] 11 [/SUP], Anna Falkowski[SUP] 12 [/SUP], Sue Kim[SUP] 12 [/SUP], Ruth Lynfield[SUP] 13 [/SUP], Melissa McMahon[SUP] 13 [/SUP], Kathy M Angeles[SUP] 14 [/SUP], Sarah A Khanlian[SUP] 14 [/SUP], Nancy L Spina[SUP] 15 [/SUP], Nancy M Bennett[SUP] 16 [/SUP], Maria A Gaitán[SUP] 16 [/SUP], Eli Shiltz[SUP] 17 [/SUP], Krista Lung[SUP] 17 [/SUP], Ann Thomas[SUP] 18 [/SUP], H Keipp Talbot[SUP] 19 [/SUP], William Schaffner[SUP] 19 [/SUP], Andrea George[SUP] 20 [/SUP], Holly Staten[SUP] 20 [/SUP], Catherine H Bozio[SUP] 1 [/SUP], Shikha Garg[SUP] 1 [/SUP]
Affiliations
- PMID: 38130595
- PMCID: PMC10733180
- DOI: 10.1093/ofid/ofad599
Background: Older age and chronic conditions are associated with severe influenza outcomes; however, data are only comprehensively available for adults ≥65 years old. Using data from the Influenza Hospitalization Surveillance Network (FluSurv-NET), we identified characteristics associated with severe outcomes in adults 18-49 years old hospitalized with influenza.
Methods: We included FluSurv-NET data from nonpregnant adults 18-49 years old hospitalized with laboratory-confirmed influenza during the 2011-2012 through 2018-2019 seasons. We used bivariate and multivariable logistic regression to determine associations between select characteristics and severe outcomes including intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), and in-hospital death.
Results: A total of 16 140 patients aged 18-49 years and hospitalized with influenza were included in the analysis; the median age was 39 years, and 26% received current-season influenza vaccine before hospitalization. Obesity, asthma, and diabetes mellitus were the most common chronic conditions. Conditions associated with a significantly increased risk of severe outcomes included age group 30-39 or 40-49 years (IMV, age group 30-39 years: adjusted odds ratio [aOR], 1.25; IMV, age group 40-49 years: aOR, 1.36; death, age group 30-39 years: aOR, 1.28; death, age group 40-49 years: aOR, 1.69), being unvaccinated (ICU: aOR, 1.18; IMV: aOR, 1.25; death: aOR, 1.48), and having chronic conditions including extreme obesity and chronic lung, cardiovascular, metabolic, neurologic, or liver diseases (ICU: range aOR, 1.22-1.56; IMV: range aOR, 1.17-1.54; death: range aOR, 1.43-2.36).
Conclusions: To reduce the morbidity and mortality associated with influenza among adults aged 18-49 years, health care providers should strongly encourage receipt of annual influenza vaccine and lifestyle/behavioral modifications, particularly among those with chronic medical conditions.
Keywords: adults; chronic conditions; hospitalizations; influenza; severe.