Effect of neuraminidase inhibitor (oseltamivir) treatment on outcome of hospitalised influenza patients, surveillance data from 11 EU countries, 2010 to 2020

Background: Timely treatment with neuraminidase inhibitors (NAI) can reduce severe outcomes in influenza patients. Aim: We assessed the impact of antiviral treatment on in-hospital deaths of laboratory-confirmed influenza patients in 11 European Union countries from 2010/11 to 2019/20. Methods: Case...

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Detalhes bibliográficos
Autores: Adlhoch, Cornelia, Delgado-Sanz, Concepcion, Carnahan, AnnaSara, Larrauri, Amparo, Popovici, Odette, Bossuyt, Nathalie, Thomas, Isabelle, Kynčl, Jan, Slezák, Pavel, Brytting, Mia, Guiomar, Raquel, Redlberger-Fritz, Monika, Maistre Melillo, Jackie, Melillo, Tanya, van Gageldonk-Lafeber, Arianne B, Marbus, Sierk D, O'Donnell, Joan, Domegan, Lisa, Gomes Dias, Joana, Olsen, Sonja J
Tipo de documento: artigo
Data de publicação:2023
País:España
Recursos:Instituto de Salud Carlos III (ISCIII)
Repositório:Repisalud
Idioma:inglês
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/16485
Acesso em linha:http://hdl.handle.net/20.500.12105/16485
Access Level:Acceso aberto
Palavra-chave:Oseltamivir
Influenza, Human
Humans
Aged
Neuraminidase
Hospital Mortality
Antiviral Agents
Enzyme Inhibitors
Guanidines
Zanamivir
Treatment Outcome
Descrição
Resumo:Background: Timely treatment with neuraminidase inhibitors (NAI) can reduce severe outcomes in influenza patients. Aim: We assessed the impact of antiviral treatment on in-hospital deaths of laboratory-confirmed influenza patients in 11 European Union countries from 2010/11 to 2019/20. Methods: Case-based surveillance data from hospitalised patients with known age, sex, outcome, ward, vaccination status, timing of antiviral treatment, and hospitalisation were obtained. A mixed effect logistic regression model using country as random intercept was applied to estimate the adjusted odds ratio (aOR) for in-hospital death in patients treated with NAIs vs not treated. Results: Of 19,937 patients, 31% received NAIs within 48 hours of hospital admission. Older age (60-79 years aOR 3.0, 95% CI: 2.4-3.8; 80 years 8.3 (6.6-10.5)) and intensive care unit admission (3.8, 95% CI: 3.4-4.2) increased risk of dying, while early hospital admission after symptom onset decreased risk (aOR 0.91, 95% CI: 0.90-0.93). NAI treatment initiation within 48 hours and up to 7 days reduced risk of dying (0-48 hours aOR 0.51, 95% CI: 0.45-0.59; 3-4 days 0.59 (0.51-0.67); 5-7 days 0.64 (0.56-0.74)), in particular in patients 40 years and older (e.g. treatment within 48 hours: 40-59 years aOR 0.43, 95% CI: 0.28-0.66; 60-79 years 0.50 (0.39-0.63); ≥80 years 0.51 (0.42-0.63)). Conclusion: NAI treatment given within 48 hours and possibly up to 7 days after symptom onset reduced risk of in-hospital death. NAI treatment should be considered in older patients to prevent severe outcomes.

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