tetano
Editor, Senior Moderator
Int J Infect Dis. 2020 Jan 21. pii: S1201-9712(20)30019-9. doi: 10.1016/j.ijid.2020.01.017. [Epub ahead of print] [h=1]Influenza A-associated severe pneumonia in hospitalized patients: Risk factors and NAI treatments.[/h]
Zou Q[SUP]1[/SUP], Zheng S[SUP]2[/SUP], Wang X[SUP]1[/SUP], Liu S[SUP]3[/SUP], Bao J[SUP]1[/SUP], Yu F[SUP]1[/SUP], Wu W[SUP]4[/SUP], Wang X[SUP]5[/SUP], Shen B[SUP]6[/SUP], Zhou T[SUP]7[/SUP], Zhao Z[SUP]8[/SUP], Wang Y[SUP]9[/SUP], Chen R[SUP]10[/SUP], Wang W[SUP]11[/SUP], Ma J[SUP]12[/SUP], Li Y[SUP]13[/SUP], Wu X[SUP]14[/SUP], Shen W[SUP]15[/SUP], Xie F[SUP]16[/SUP], Vijaykrishna D[SUP]17[/SUP], Chen Y[SUP]18[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]OBJECTIVE:[/h] The risk factors and the impact of NAI treatments in patients with severe influenza A-associated pneumonia remains unclear.
[h=4]METHODS:[/h] A multicenter, retrospective, observational study was conducted in Zhejiang, China during a severe influenza epidemic in August 2017-May 2018. Clinical records of patients (>14y) hospitalized with laboratory-confirmed influenza A virus infection and developed severe pneumonia were compared to those with mild-to-moderate pneumonia. Risk factors related to pneumonia severity and effects of NAI treatments (monotherapy and combination of peramivir and oseltamivir) were analyzed.
[h=4]RESULTS:[/h] 202 patients with influenza A-associated severe pneumonia were enrolled, of whom 84 (41.6%) had died. Male (OR = 1.782; 95% CI: 1.089-2.917; P = 0.022), chronic pulmonary disease (OR=2.581; 95% CI: 1.447-4.603; P = 0.001) and diabetes mellitus (OR = 2.042; 95% CI: 1.135-3.673; P = 0.017) were risk factors related to influenza A pneumonia severity. In cox proportional hazards model, severe pneumonia patients treated with double dose oseltamivir (300mg/d) had a better survival rate compared to those receiving single dose (150 mg/d) (HR=0.475; 95%CI: 0.254-0.887; P = 0.019). However, different doses of peramivir (300 mg/d vs. 600 mg/d) and combination therapy (oseltamivir-peramivir vs. monotherapy) showed no differences in 60-day mortality (P = 0.392 and P = 0.658, respectively).
[h=4]CONCLUSIONS:[/h] Male gender and patients with chronic pulmonary disease or diabetes mellitus were at high risk of developing severe pneumonia after influenza A infection. Double dose oseltamivir might be considered in treating influenza A-associated severe pneumonia.
Copyright ? 2020. Published by Elsevier Ltd.
[h=4]KEYWORDS:[/h] Double dose; Influenza; Oseltamivir; Severe pneumonia
PMID: 31978583 DOI: 10.1016/j.ijid.2020.01.017
Free full text
Zou Q[SUP]1[/SUP], Zheng S[SUP]2[/SUP], Wang X[SUP]1[/SUP], Liu S[SUP]3[/SUP], Bao J[SUP]1[/SUP], Yu F[SUP]1[/SUP], Wu W[SUP]4[/SUP], Wang X[SUP]5[/SUP], Shen B[SUP]6[/SUP], Zhou T[SUP]7[/SUP], Zhao Z[SUP]8[/SUP], Wang Y[SUP]9[/SUP], Chen R[SUP]10[/SUP], Wang W[SUP]11[/SUP], Ma J[SUP]12[/SUP], Li Y[SUP]13[/SUP], Wu X[SUP]14[/SUP], Shen W[SUP]15[/SUP], Xie F[SUP]16[/SUP], Vijaykrishna D[SUP]17[/SUP], Chen Y[SUP]18[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]OBJECTIVE:[/h] The risk factors and the impact of NAI treatments in patients with severe influenza A-associated pneumonia remains unclear.
[h=4]METHODS:[/h] A multicenter, retrospective, observational study was conducted in Zhejiang, China during a severe influenza epidemic in August 2017-May 2018. Clinical records of patients (>14y) hospitalized with laboratory-confirmed influenza A virus infection and developed severe pneumonia were compared to those with mild-to-moderate pneumonia. Risk factors related to pneumonia severity and effects of NAI treatments (monotherapy and combination of peramivir and oseltamivir) were analyzed.
[h=4]RESULTS:[/h] 202 patients with influenza A-associated severe pneumonia were enrolled, of whom 84 (41.6%) had died. Male (OR = 1.782; 95% CI: 1.089-2.917; P = 0.022), chronic pulmonary disease (OR=2.581; 95% CI: 1.447-4.603; P = 0.001) and diabetes mellitus (OR = 2.042; 95% CI: 1.135-3.673; P = 0.017) were risk factors related to influenza A pneumonia severity. In cox proportional hazards model, severe pneumonia patients treated with double dose oseltamivir (300mg/d) had a better survival rate compared to those receiving single dose (150 mg/d) (HR=0.475; 95%CI: 0.254-0.887; P = 0.019). However, different doses of peramivir (300 mg/d vs. 600 mg/d) and combination therapy (oseltamivir-peramivir vs. monotherapy) showed no differences in 60-day mortality (P = 0.392 and P = 0.658, respectively).
[h=4]CONCLUSIONS:[/h] Male gender and patients with chronic pulmonary disease or diabetes mellitus were at high risk of developing severe pneumonia after influenza A infection. Double dose oseltamivir might be considered in treating influenza A-associated severe pneumonia.
Copyright ? 2020. Published by Elsevier Ltd.
[h=4]KEYWORDS:[/h] Double dose; Influenza; Oseltamivir; Severe pneumonia
PMID: 31978583 DOI: 10.1016/j.ijid.2020.01.017
Free full text