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Outcomes of Immunocompromised Adults Hospitalized With Laboratory-confirmed Influenza in the United States, 2011-2015.


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.

SUBMITTER: Collins JP 

PROVIDER: S-EPMC7201407 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Outcomes of Immunocompromised Adults Hospitalized With Laboratory-confirmed Influenza in the United States, 2011-2015.

Collins Jennifer P JP   Campbell Angela P AP   Openo Kyle K   Farley Monica M MM   Cummings Charisse Nitura CN   Hill Mary M   Schaffner William W   Lindegren Mary Lou ML   Thomas Ann A   Billing Laurie L   Bennett Nancy N   Spina Nancy N   Bargsten Marisa M   Lynfield Ruth R   Eckel Seth S   Ryan Patricia P   Yousey-Hindes Kimberly K   Herlihy Rachel R   Kirley Pam Daily PD   Garg Shikha S   Anderson Evan J EJ  

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20200501 10


<h4>Background</h4>Hospitalized immunocompromised (IC) adults with influenza may have worse outcomes than hospitalized non-IC adults.<h4>Methods</h4>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 co  ...[more]

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