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Intern Med . Clinical Characteristics Associated with Mortality between Surviving and Non-surviving Adult Patients with Severe Influenza Requiring Hos

tetano

Editor, Senior Moderator
Intern Med

. 2026 Oct 15.
doi: 10.2169/internalmedicine.8035-26. Online ahead of print.

Clinical Characteristics Associated with Mortality between Surviving and Non-surviving Adult Patients with Severe Influenza Requiring Hospitalization: An Internet-based, Prospective, Multicenter, Cohort Study in Japan​


Masafumi Seki 1 , Akihiro Ito 2 , Yuki Shiko 3 , Maiko Osawa 3 , Yukiko Oya 3 4 , Kazuhiro Tateda 5 , Jiro Fujita 6 , Kosaku Komiya 7 , Akihiko Kawana 8 , Koichi Izumikawa 9 , Toshiaki Kikuchi 10 , Norio Ohmagari 11 , Mitsuhiro Yamada 12 , Takaya Maruyama 13 , Takahiro Takazono 9 , Makoto Miki 14 , Yoshitsugu Miyazaki 15 , Yoshitaka Yamazaki 16 , Hiroshi Kakeya 17 , Yuta Hayashi 18 , Hideaki Nagai 19 , Tadashi Ishida 2

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Free article

Abstract​


Introduction Influenza remains a huge issue, but its prognosis and clinical characteristics are still unclear. This study aimed to clarify the clinical differences between adults hospitalized with influenza between survivors and nonsurvivors.Methods Clinical data of patients who were severely ill with influenza and required hospitalization were gathered and analyzed between September 2019 and August 2025 (six influenza seasons) using an internet surveillance system; patients who did not survive were excluded.Results Of the 490 patients with severe influenza, 32 (6.53%) did not survive and were older than the surviving patients. In the non-surviving patients, very few or none had been vaccinated against influenza or pneumococcal infections. The non-surviving patients had more pure viral pneumonia and more received mechanical ventilation. The male-to-female ratio, underlying diseases, virus type, and use of antibiotics were similar between survivors and non-survivors.Conclusions Non-surviving patients were older and developed more severe respiratory failure due to pure viral pneumonia than surviving patients. Very low vaccination rates for influenza and pneumococcus might be suggested in hospitalized adults with severe influenza.

Keywords: Influenza; MRSA; Mechanical ventilation; Pseudomonas aeruginosa; Pure viral pneumonia; Vaccine.
 
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