We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Outcomes of Immunocompromised Adults Hospitalized With Laboratory-confirmed Influenza in the United States, 2011–2015.
- Authors
Collins, Jennifer P; Campbell, Angela P; Openo, Kyle; Farley, Monica M; Cummings, Charisse Nitura; Hill, Mary; Schaffner, William; Lindegren, Mary Lou; Thomas, Ann; Billing, Laurie; Bennett, Nancy; Spina, Nancy; Bargsten, Marisa; Lynfield, Ruth; Eckel, Seth; Ryan, Patricia; Yousey-Hindes, Kimberly; Herlihy, Rachel; Kirley, Pam Daily; Garg, Shikha
- Abstract
Background Hospitalized immunocompromised (IC) adults with influenza may have worse outcomes than hospitalized non-IC adults. Methods We identified adults hospitalized with laboratory-confirmed influenza during 2011–2015 seasons through CDC's Influenza Hospitalization Surveillance Network. IC patients had human immunodefiency virus (HIV)/AIDS, cancer, stem cell or organ transplantation, nonsteroid immunosuppressive therapy, immunoglobulin deficiency, asplenia, and/or other rare conditions. We compared demographic and clinical characteristics of IC and non-IC adults using descriptive statistics. Multivariable logistic regression and Cox proportional hazards models controlled for confounding by patient demographic characteristics, pre-existing medical conditions, influenza vaccination, and other factors. Results Among 35 348 adults, 3633 (10%) were IC; cancer (44%), nonsteroid immunosuppressive therapy (44%), and HIV (18%) were most common. IC patients were more likely than non-IC patients to have received influenza vaccination (53% vs 46%; P <.001), and ~85% of both groups received antivirals. In multivariable analysis, IC adults had higher mortality (adjusted odds ratio [aOR], 1.46; 95% confidence interval [CI], 1.20–1.76). Intensive care was more likely among IC patients 65–79 years (aOR, 1.25; 95% CI, 1.06–1.48) and those >80 years (aOR, 1.35; 95% CI, 1.06–1.73) compared with non-IC patients in those age groups. IC patients were hospitalized longer (adjusted hazard ratio of discharge, 0.86; 95% CI,.83–.88) and more likely to require mechanical ventilation (aOR, 1.19; 95% CI, 1.05–1.36). Conclusions Substantial morbidity and mortality occurred among IC adults hospitalized with influenza. Influenza vaccination and antiviral administration could be increased in both IC and non-IC adults.
- Subjects
UNITED States; INFLUENZA diagnosis; INFLUENZA treatment; AGE distribution; ANTIVIRAL agents; ARTIFICIAL respiration; CANCER patients; CENTERS for Disease Control &; Prevention (U.S.); COMPARATIVE studies; CONFIDENCE intervals; CRITICAL care medicine; CLINICAL pathology; DISEASES; HIV-positive persons; HOSPITAL care; LENGTH of stay in hospitals; IMMUNIZATION; IMMUNOTHERAPY; INFLUENZA; INFLUENZA vaccines; EVALUATION of medical care; MORTALITY; MULTIVARIATE analysis; NONSTEROIDAL anti-inflammatory agents; PUBLIC health surveillance; RARE diseases; TIME; MULTIPLE regression analysis; PROPORTIONAL hazards models; DESCRIPTIVE statistics; IMMUNOCOMPROMISED patients; ODDS ratio; EVALUATION; SYMPTOMS
- Publication
Clinical Infectious Diseases, 2020, Vol 79, Issue 10, p2121
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciz638