Effect of antiviral treatment in older patients hospitalized with confirmed influenza
Por:
Soldevila, N, Toledo, D, de Lejarazu, RO, Tamames, S, Castilla, J, Astray, J, Fernandez, MA, Martin, V, Egurrola, M, Suarez-Varela, MM, Dominguez, A, Mayoral, JM, Diaz-Borrego, J, Morillo, A, Perez-Lozano, MJ, Gutierrez, J, Perez-Ruiz, M, Fernandez-Sierra, MA, Tamames, S, Rojo-Rello, S, de Lejarazu, RO, Fernandez-Natal, MI, Fernandez-Villa, T, Pueyo, A, Vilella, A, Campins, M, Anton, A, Navarro, G, Riera, M, Espejo, E, Mas, MD, Perez, R, Cayla, JA, Rius, C, Godoy, P, Torner, N, Izquierdo, C, Torra, R, Force, L, Dominguez, A, Soldevila, N, Crespo, I, Toledo, D, Astray, J, Dominguez-Berjon, MF, Gutierrez, MA, Jimenez, S, Gil, E, Martin, F, Genova-Maleras, R, Prados, MC, de Blas, FE, Salvador, MA, Galan, JC, Navas, E, Rodriguez, L, Alvarez, CJ, Banderas, E, Fernandez, S, Chamorro, J, Casado, I, Diaz, J, Castilla, J, Egurrola, M, de Goicoechea, MJL, Morales-Suarez-Varela, M, Sanz, F
Publicada:
1 jun 2020
Resumen:
Seasonal influenza causes significant morbidity and mortality in people aged 65 years. Antiviral treatment can reduce complications and disease severity. The objective of this study was to investigate the effect of antiviral treatment in patients aged >= 65 years hospitalized with confirmed influenza in preventing intensive care unit (ICU) admission or death. A retrospective cohort study was carried out in 20 hospitals from seven Spanish regions during 2013-2015 in patients aged >= 65 years. Hospitalized cases of laboratory-confirmed influenza were selected. To assess the association between antiviral treatment and ICU admission or death, the adjusted odds ratios (aOR) and their 95% confidence intervals (CI) were calculated using multivariate logistic regression. We included 715 hospitalized patients, of whom 640 (87.9%) received antiviral treatment, 77 (10.8%) required ICU admission and 66 (9.2%) died. In the 64-74 years age group, receipt of antiviral treatment <= 48h (aOR 0.20; 95% CI 0.04-0.89), 3-4 days (aOR 0.23; 95% CI 0.05-0.92) and 5-7 days (aOR 0.24; 95% CI 0.03-0.91) after clinical symptom onset was associated with reduced mortality. Receipt of treatment > 7 days after symptom onset was not associated with reduced mortality. No association of antiviral treatment with reduced mortality was observed in the > 74 years age group or with the prevention of ICU admission in any age group. Antiviral treatment had a protective effect in avoiding death in patients aged 65-74 years hospitalized due to influenza when administered <= 48 h after symptom onset and when no more than 7 days had elapsed.
Filiaciones:
Soldevila, N:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Univ Barcelona, Dept Med, Barcelona, Spain
Univ Barcelona, CIBERESP, Catalonia, Spain
Toledo, D:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Univ Barcelona, Dept Med, Barcelona, Spain
Univ Barcelona, Catalonia, Spain
de Lejarazu, RO:
Hosp Clin Univ Valladolid, Valladolid, Spain
Tamames, S:
Junta Castilla & Leon, Direcc Gen Salud Publ Invest Desarrollo & Innovac, Leon, Spain
Junta Castilla & Leon, Dir Gen Salud Publ Invest Desarrollo & Innovac, Castile and Leon, Spain
Castilla, J:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Inst Salud Publ Navarra IdiSNA, Pamplona, Spain
Inst Salud Publ, Inst Invest Sanitaria Navarra, CIBERESP, Navarra, Spain
Astray, J:
Direcc Gen Salud Publ Comunidad Madrid, Madrid, Spain
Consejeria Sanidad, Madrid, Spain
Fernandez, MA:
Hosp Univ Virgen de las Nieves, Serv Med Prevent & Salud Publ, Granada, Spain
Martin, V:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Univ Leon, Inst Biomed BIOMED, Leon, Spain
Univ Leon, CIBERESP, Castile and Leon, Spain
Egurrola, M:
Hosp Galdakao, Serv Neumol, Usansolo, Spain
Hosp Galdakao, The Basque Country, Spain
Suarez-Varela, MM:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Univ Valencia, Dept Med Prevent, Valencia, Spain
Dominguez, A:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Univ Barcelona, Dept Med, Barcelona, Spain
Univ Barcelona, CIBERESP, Catalonia, Spain
Mayoral, JM:
Serv Vigilancia Andalucia, Andalucia, Spain
Serv Andaluz Salud, Andalucia, Spain
Diaz-Borrego, J:
Serv Andaluz Salud, Andalucia, Spain
Morillo, A:
Hosp Univ Virgen del Rocio, Andalucia, Spain
Perez-Lozano, MJ:
Hosp Univ Virgen de Valme, Andalucia, Spain
Gutierrez, J:
Hosp Univ Puerta del Mar, Andalucia, Spain
Perez-Ruiz, M:
Hosp Univ Virgen de la Nieves, Andalucia, Spain
Fernandez-Sierra, MA:
Hosp Univ Virgen de la Nieves, Andalucia, Spain
Tamames, S:
Junta Castilla & Leon, Direcc Gen Salud Publ Invest Desarrollo & Innovac, Leon, Spain
Junta Castilla & Leon, Dir Gen Salud Publ Invest Desarrollo & Innovac, Castile and Leon, Spain
Rojo-Rello, S:
Hosp Clin Univ Valladolid, Castile and Leon, Spain
de Lejarazu, RO:
Univ Valladolid, Castile and Leon, Spain
Fernandez-Natal, MI:
Complejo Asistencial Univ Leon, Castile and Leon, Spain
Fernandez-Villa, T:
Univ Leon, GIIGAS Grp Invest Interacc Gen Ambiente & Salud, Castile and Leon, Spain
Pueyo, A:
Hosp Univ Burgos, Castile and Leon, Spain
Vilella, A:
Hosp Clin, Catalonia, Spain
Campins, M:
Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Catalonia, Spain
Anton, A:
Univ Autonoma Barcelona, Hosp Univ Vall dHebron, Catalonia, Spain
Navarro, G:
Corp Sanitaria & Univ Parc Tauli, Catalonia, Spain
Riera, M:
Hosp Univ MutuaTerrassa, Catalonia, Spain
Espejo, E:
Hosp Terrassa, Catalonia, Spain
Mas, MD:
Xarxa Hospitalaria Manresa, ALTHAIA, Catalonia, Spain
Perez, R:
Xarxa Hospitalaria Manresa, ALTHAIA, Catalonia, Spain
Cayla, JA:
Agencia Salut Publ Barcelona, CIBERESP, Catalonia, Spain
Rius, C:
Agencia Salut Publ Barcelona, CIBERESP, Catalonia, Spain
Godoy, P:
Univ Lleida, Inst Recerca Biomed Lleida, Agencia Salut Publ Catalunya, CIBERESP, Catalonia, Spain
Torner, N:
Univ Barcelona, Agencia Salut Publ Catalunya, CIBERESP, Catalonia, Spain
Izquierdo, C:
Agencia Salut Publ Catalunya, Catalonia, Spain
Torra, R:
Agencia Salut Publ Catalunya, Catalonia, Spain
Force, L:
Hosp Mataro, Catalonia, Spain
Dominguez, A:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Univ Barcelona, Dept Med, Barcelona, Spain
Univ Barcelona, CIBERESP, Catalonia, Spain
Soldevila, N:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Univ Barcelona, Dept Med, Barcelona, Spain
Univ Barcelona, CIBERESP, Catalonia, Spain
Crespo, I:
Univ Barcelona, CIBERESP, Catalonia, Spain
Toledo, D:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Univ Barcelona, Dept Med, Barcelona, Spain
Univ Barcelona, Catalonia, Spain
Astray, J:
Direcc Gen Salud Publ Comunidad Madrid, Madrid, Spain
Consejeria Sanidad, Madrid, Spain
Dominguez-Berjon, MF:
Consejeria Sanidad, Madrid, Spain
Gutierrez, MA:
Consejeria Sanidad, Madrid, Spain
Jimenez, S:
Consejeria Sanidad, Madrid, Spain
Gil, E:
Consejeria Sanidad, Madrid, Spain
Martin, F:
Consejeria Sanidad, Madrid, Spain
Genova-Maleras, R:
Consejeria Sanidad, Madrid, Spain
Prados, MC:
Hosp Univ La Paz, Madrid, Spain
de Blas, FE:
Hosp Univ La Paz, Madrid, Spain
Salvador, MA:
Hosp Univ La Paz, Madrid, Spain
Galan, JC:
Hosp Ramon & Cajal, Madrid, Spain
Navas, E:
Hosp Ramon & Cajal, Madrid, Spain
Rodriguez, L:
Hosp Ramon & Cajal, Madrid, Spain
Alvarez, CJ:
Hosp Univ 12 Octubre, Madrid, Spain
Banderas, E:
Hosp Univ 12 Octubre, Madrid, Spain
Fernandez, S:
Hosp Univ 12 Octubre, Madrid, Spain
Chamorro, J:
Complejo Hosp Navarra, Navarra, Spain
Casado, I:
Inst Salud Publ Navarra, Navarra, Spain
Diaz, J:
Inst Salud Publ Navarra, Navarra, Spain
Castilla, J:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Inst Salud Publ Navarra IdiSNA, Pamplona, Spain
Inst Salud Publ, Inst Invest Sanitaria Navarra, CIBERESP, Navarra, Spain
Egurrola, M:
Hosp Galdakao, Serv Neumol, Usansolo, Spain
Hosp Galdakao, The Basque Country, Spain
de Goicoechea, MJL:
Hosp Galdakao, The Basque Country, Spain
Morales-Suarez-Varela, M:
Univ Valencia, CIBERESP, The Basque Country, Spain
Sanz, F:
Consorci Hosp Gen Univ Valencia, The Basque Country, Spain
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