Format

Send to

Choose Destination
Int J Infect Dis. 2019 Jan 11;81:6-9. doi: 10.1016/j.ijid.2019.01.005. [Epub ahead of print]

Predictors of fatality in influenza A virus subtype infections among inpatients in the 2015-2016 season.

Author information

1
Department of Infectious Diseases and Clinical Microbiology, Koç University Hospital, Istanbul, Turkey.
2
Department of Infectious Diseases and Clinical Microbiology, American Hospital, Istanbul, Turkey.
3
Department of Infectious Diseases and Clinical Microbiology, Memorial Hospital, Istanbul, Turkey.
4
Department of Infectious Diseases and Clinical Microbiology, Kartal Training and Research Hospital, Ministry of Health, Istanbul, Turkey.
5
Department of Infectious Diseases and Clinical Microbiology, Liv Hospital, Istanbul, Turkey.
6
Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Ministry of Health, Istanbul, Turkey.
7
Department of Infectious Diseases and Clinical Microbiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
8
Department of Infectious Diseases and Clinical Microbiology, Istanbul Training and Research Hospital, Ministry of Health, Istanbul, Turkey.
9
Department of Infectious Diseases and Clinical Microbiology, Istanbul Hospital, Baskent University, Istanbul, Turkey.
10
Department of Infectious Diseases and Clinical Microbiology, Safa Hospital, Istanbul, Turkey.
11
Department of Infectious Diseases and Clinical Microbiology, Goztepe Training and Research Hospital, Medeniyet University, Ministry of Health, Istanbul, Turkey.
12
Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Koç University, Istanbul, Turkey. Electronic address: oergonul@ku.edu.tr.

Abstract

BACKGROUND:

Infection with the influenza A virus can cause severe disease and mortality. The effect of the different subtypes of influenza on morbidity and mortality is not yet known in Turkey. The aim of this study was to describe the predictors of fatality related to influenza A infection among hospitalized patients in Istanbul during the 2015-2016 influenza season, and to detail the differences between infections caused by H3N2 and H1N1.

METHODS:

This was a multicenter study performed by the Istanbul Respiratory Infections Study Group of The Turkish Society of Clinical Microbiology and Infectious Diseases (KLİMİK), among patients hospitalized for influenza in Istanbul during the 2015-2016 influenza season.

RESULTS:

A total of 222 patients hospitalized with laboratory-confirmed influenza during the 2015-2016 season were included in the study, of whom 25 (11.2%) died. The fatality rate was significantly higher among patients older than 65 years of age and those with chronic heart and kidney diseases (p<0.001), chronic neurological diseases (p=0.009), and malignancies (p=0.021). Thrombocyte counts were lower in those who died than in those who survived (p<0.004). The median alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatinine phosphokinase, and C-reactive protein levels were higher among fatal cases. In the multivariate analysis for the prediction of fatality, being >65years old (odds ratio (OR) 6.9, 95% confidence interval (CI) 2.07-23.08, p=0.002), being infected with influenza A(H3N2) (OR 4.2, 95% CI 1.27-14.38, p=0.019), and a 1-day delay in antiviral use (OR 1.28, 95% CI 1.01-1.63, p=0.036) were found to be associated with an increased likelihood of fatality.

CONCLUSIONS:

The case fatality rate of influenza A(H3N2) was significantly higher than that of influenza A(H1N1). Detection of the infection, allowing the opportunity for the early use of antiviral agents, was found to be important for the prevention of fatality. The vaccination should be prioritized for at-risk groups.

KEYWORDS:

Fatality; H1N1; H3N2; Influenza A

PMID:
30641199
DOI:
10.1016/j.ijid.2019.01.005
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center