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J Crit Care. 2019 Apr;50:59-65. doi: 10.1016/j.jcrc.2018.11.013. Epub 2018 Nov 15.

Influenza virus and factors that are associated with ICU admission, pulmonary co-infections and ICU mortality.

Author information

1
Radboud University Medical Center, Department of Intensive Care Medicine, PO Box 9101, 6500 HB Nijmegen, the Netherlands.
2
Radboud University Medical Center, Department of Intensive Care Medicine, PO Box 9101, 6500 HB Nijmegen, the Netherlands. Electronic address: rebecca.koch@radboudumc.nl.
3
Maastricht University Medical Center, Department of Internal Medicine, PO Box 5800, 6202AZ Maastricht, the Netherlands.
4
Radboud University Medical Center, Department of Internal Medicine, PO Box 9101, 6500 HB Nijmegen, the Netherlands.
5
Radboud University Medical Center, Department of Medical Microbiology, PO Box 9101, 6500 HB Nijmegen, the Netherlands.
6
Maastricht university medical center, Department of Intensive Care Medicine, PO Box 5800, 6202AZ Maastricht, the Netherlands.

Abstract

PURPOSE:

While most influenza patients have a self-limited respiratory illness, 5-10% of hospitalized patients develop severe disease requiring ICU admission. The aim of this study was to identify influenza-specific factors associated with ICU admission and mortality. Furthermore, influenza-specific pulmonary bacterial, fungal and viral co-infections were investigated.

METHODS:

199 influenza patients, admitted to two academic hospitals in the Netherlands between 01-10-2015 and 01-04-2016 were investigated of which 45/199 were admitted to the ICU.

RESULTS:

A history of Obstructive/Central Sleep Apnea Syndrome, myocardial infarction, dyspnea, influenza type A, BMI > 30, the development of renal failure and bacterial and fungal co-infections, were observed more frequently in patients who were admitted to the ICU, compared with patients at the normal ward. Co-infections were evident in 55.6% of ICU-admitted patients, compared with 20.1% of patients at the normal ward, mainly caused by Staphylococcus aureus, Streptococcus pneumoniae, and Aspergillus fumigatus. Non-survivors suffered from diabetes mellitus and (pre-existent) renal failure more often.

CONCLUSIONS:

The current study indicates that a history of OSAS/CSAS, myocardial infarction and BMI > 30 might be related to ICU admission in influenza patients. Second, ICU patients develop more pulmonary co-infections. Last, (pre-existent) renal failure and diabetes mellitus are more often observed in non-survivors.

KEYWORDS:

Bacterial; Co-infections; Fungal; ICU admission; ICU mortality; Influenza virus; Risk factors; Viral

PMID:
30481669
DOI:
10.1016/j.jcrc.2018.11.013

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