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Open Forum Infect Dis. 2017 Oct 7;4(4):ofx212. doi: 10.1093/ofid/ofx212. eCollection 2017 Fall.

Comparison of the Outcomes of Individuals With Medically Attended Influenza A and B Virus Infections Enrolled in 2 International Cohort Studies Over a 6-Year Period: 2009-2015.

Collaborators (339)

Aagaard B, Borges ÁHD, Cozzi-Lepri A, Eid M, Jansson PO, Jeppesen M, Joensen ZM, Pedersen RK, Lundgren J, Nielsen BR, Pearson M, Peters L, Qvist T, Angus B, Babiker A, Bennett R, Braimah N, Collaco-Moraes Y, Cursley A, Hudson F, Pett S, Russell C, Webb H, Carey D, Courtney-Rodgers D, Emery S, Shaw P, Gordin F, Sanchez A, Standridge B, Vjecha M, Brekke K, Campbell M, Denning E, DuChene A, Engen N, George M, Harrison M, Neaton JD, Nelson R, Quan SF, Schultz T, Wentworth D, Baxter J, Brown S, Hoover M, Beigel J, Davey RT Jr, Dewar R, Gover E, McConnell R, Metcalf J, Natarajan V, Rehman T, Voell J, Dwyer DE, Kok J, Uyeki TM, Munroe D, Aguila D, Alzogaray MF, Ballesteros MF, Barcan L, Barcelona L, Belloso W, Berdiñas V, Bonvehi P, Caeiro JP, Cisneros V, Crinejo A, David D, Doldan L, Ebenrstejin J, Lipari F, Lopardo A, Lopardo G, Losso M, Lucchetti P, Lupo S, Macias LM, de Tesco AM, Mykietiuk A, Nannini E, Nieto G, Nieto L, Peroni L, Retta I, Rodriguez P, Sanchez M, Sanchez P, de Paz Sierra M, Tavella S, Temporiti E, Trape L, Vieni I, Warley E, Yahni D, Zarate AH, Avihingsanon A, Charoentonpuban K, Chetchotisakd P, Kaewon P, Laopraynak N, Manosuthi W, Pussadee K, Putcharoen O, Ruxrungtham K, Suwanpimonkul G, Ubolyam S, Arduino R, Atkinson B, Aulicino TM, Baker JV, Bardascino C, Bass C, Baxter JD, Beilke M, Bentley BD, Lee Bertrand M, Brown AB, Carbonneau J, Cindrich R, Coburn P, Cohen CJ, Clark L, Cummins S, Dassow P, DeHovitz JA, Dharan NJ, Faber L, Farrough M, Freiberg M, Gardner E, Jo Garrett K, Geisler C, Glesby M, Green J, Grenade J, Gunderson E, Gunter J, Ham K, Holman S, Hughes V, Hurt C, Johnson M, Koerbel G, Koletar S, Lan A, MacArthur R, Marcus C, Markowitz N, Martinez ML, McLaughlin K, Nahra R, Nettles MJ, Nixon D, Novak R, Nuffer K, Olivet HB, Omotosho B, Paez AP, Paez-Quinde M, Parker S, Patil N, Polenakovik H, Powell S, Prosser RA, Reilly NA, Riska PF, Rizza S, Schooley R, Schwarber M, Scott J, Simon GL, Sivoravong J, Skiest DJ, Solorzano C, Sondengam R, Swanson N, Tedaldi E, Temesgen Z, Thomas D, Thron B, Traverse C, Uddin DE, Uslan DZ, Vasco M, Vaughan WM, Vecino I, Wade B, Walker C, Watson K, Watson V, Wohl D, Wolfe CR, Andry L, Bielen M, Clumeck N, Florence E, Kabeya K, Sagaer J, Weckx J, Anagnostou O, Antoniadou A, Daikos G, Gioukari V, Kalomenidis I, Kantzanou M, Koratzanis G, Koulouris N, Maltezos E, Metallidis S, Polixronopoulos V, Sambatakou H, Skoutelis A, Touloumi G, Vasilopoulos N, Bloch M, Cunningham N, Dwyer DE, Edwards S, Elliott J, Garlick J, Habel P, Kilkenny F, Lau H, MacRae K, McBride J, Moore R, Prone I, Ram R, Richmond S, Roth N, Meng Soo T, Jo-Anne T, Vincent T, Vlakahis E, Woolstencroft R, Chadwick D, Clarke T, Democratis J, Dockrell D, Heyderman R, Jeffs B, Kutter S, Llewelyn M, Minton J, Newport M, Price A, Benites C, Castillo R, Chinchay R, Cornelio E, Guevara M, Gutierrez L, Hidalgo J, La Rosa A, Pinedo Y, Saenz M, Vega J, Baadegaard B, Bach K, Collins P, Gerstoft J, Hergens L, Jensen LP, Joensen ZM, Kronborg G, Loftheim IR, Nielsen H, Oestergaard L, Pedersen C, Stauning Pedersen JA, Yehdego Y, Bergmann F, Boesecke C, Bogner JR, Brockmeyer N, Czaja-Harder C, Draenert R, Fätkenheuer G, Klinker H, Kümmerle T, Lehmann C, Müller V, Plettenberg A, Rockstroh J, Schlabe S, E Schmidt W, Schürmann D, Schüttfort G, Seybold U, Stephan C, Stoehr A, Tillmann K, Wiebecke S, Wolf T, Arribas J, Carbone J, Fernández Cruz E, Dalmau D, Estrada V, Herrero P, Knobel H, López P, Montejano R, Sans Moreno J, Ramón Paño J, Portas B, Rodrigo M, Romero P, Sánchez-Sendín D, Soriano V, Bakowska E, Horban AJ, Knysz B, Kowalska KP, Zubkiewicz-Zarebska A, Kase K, Mülle H, Zilmer K, Allendes G, Flores J, Northland R, Perez C, Velasco I, Wolff M, Chu MY, Wu TC, Burgmann H, Tobudic S, Imahashi M, Imamura J, Iwatani Y, Kogure A, Nakahata M, Sugiura W, Yokomaku Y, Maagaard A.

Author information

1
Institute of Clinical Pathology and Medical Research, NSW Health Pathology, Westmead Hospital, Westmead, Sydney, Australia.
2
Minnesota Department of Health, St. Paul, Minnesota.
3
Hospital J.M. Ramos Mejía, Buenos Aires, Argentina.
4
National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Washington, DC.
5
University College London, London, UK.
6
Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
7
Influenza Division, US Centers for Disease Control and Prevention, Atlanta, Georgia.
8
Veterans Affairs Medical Center, Washington, DC.
9
Nuffield Department of Medicine, University of Oxford, Oxford, UK.
10
Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.
11
Kirby Institute, University of New South Wales, Sydney, Australia.

Abstract

Background:

Outcome data from prospective follow-up studies comparing infections with different influenza virus types/subtypes are limited.

Methods:

Demographic, clinical characteristics and follow-up outcomes for adults with laboratory-confirmed influenza A(H1N1)pdm09, A(H3N2), or B virus infections were compared in 2 prospective cohorts enrolled globally from 2009 through 2015. Logistic regression was used to compare outcomes among influenza virus type/subtypes.

Results:

Of 3952 outpatients, 1290 (32.6%) had A(H1N1)pdm09 virus infection, 1857 (47.0%) had A(H3N2), and 805 (20.4%) had influenza B. Of 1398 inpatients, 641 (45.8%) had A(H1N1)pdm09, 532 (38.1%) had A(H3N2), and 225 (16.1%) had influenza B. Outpatients with A(H1N1)pdm09 were younger with fewer comorbidities and were more likely to be hospitalized during the 14-day follow-up (3.3%) than influenza B (2.2%) or A(H3N2) (0.7%; P < .0001). Hospitalized patients with A(H1N1)pdm09 (20.3%) were more likely to be enrolled from intensive care units (ICUs) than those with A(H3N2) (11.3%) or B (9.8%; P < .0001). However, 60-day follow-up of discharged inpatients showed no difference in disease progression (P = .32) or all-cause mortality (P = .30) among influenza types/subtypes. These findings were consistent after covariate adjustment, in sensitivity analyses, and for subgroups defined by age, enrollment location, and comorbidities.

Conclusions:

Outpatients infected with influenza A(H1N1)pdm09 or influenza B were more likely to be hospitalized than those with A(H3N2). Hospitalized patients infected with A(H1N1)pdm09 were younger and more likely to have severe disease at study entry (measured by ICU enrollment), but did not have worse 60-day outcomes.

KEYWORDS:

follow-up; influenza A(H1N1)pdm09; influenza A(H3N2); influenza B; outcomes

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