Abstract
BackgroundInfluenza B is often perceived as a less severe strain of influenza. The epidemiology and clinical outcomes of influenza B have been less thoroughly investigated in hospitalised patients. The aims of this study were to describe clinical differences and outcomes between influenza A and B patients admitted over a period of 4 years.MethodsWe retrospectively collected data of all laboratory confirmed influenza patients ≥18 years at two tertiary hospitals in South Australia. Patients were confirmed as influenza positive if they had a positive polymerase-chain-reaction (PCR) test of a respiratory specimen. Complications during hospitalisation along with inpatient mortality were compared between influenza A and B. In addition, 30 day mortality and readmissions were compared. Logistic regression model compared outcomes after adjustment for age, Charlson index, sex and creatinine levels.ResultsBetween January 2016–March 2020, 1846 patients, mean age 66.5 years, were hospitalised for influenza. Of whom, 1630 (88.3%) had influenza A and 216 (11.7%) influenza B. Influenza B patients were significantly younger than influenza A. Influenza A patients were more likely be smokers with a history of chronic obstructive pulmonary disease (COPD) and ischaemic heart disease (IHD) than influenza B. Complications, including pneumonia and acute coronary syndrome (ACS) were similar between two groups, however, septic shock was more common in patients with influenza B. Adjusted analyses showed similar median length of hospital stay (LOS), in hospital mortality, 30-day mortality and readmissions between the two groups.ConclusionsInfluenza B is less prevalent and occurs mostly in younger hospitalised patients than influenza A. Both strains contribute equally to hospitalisation burden and complications.Trial registrationAustralia and New Zealand Clinical Trial Registry (ANZCR) no ACTRN12618000451202 date of registration 28/03/2018
Highlights
IntroductionThe epidemiology and clinical outcomes of influenza B have been less thoroughly investigated in hospitalised patients
Influenza B is often perceived as a less severe strain of influenza
Forty six (21.3%) influenza B patients were younger than 40 years, while 555 (34.1%) influenza A patients were older than 80 years of age (Table 1)
Summary
The epidemiology and clinical outcomes of influenza B have been less thoroughly investigated in hospitalised patients. The aims of this study were to describe clinical differences and outcomes between influenza A and B patients admitted over a period of 4 years. Its clinical importance is increasingly been recognised along with the need to characterise differences with the other influenza strains because influenza B shares significant influenza burden annually. Accurate identification of influenza types is gaining importance because antiviral resistance is increasingly becoming more prevalent among influenza subtypes [6]. This is especially important in settings with a complex pattern of antiviral resistance, where prompt identification of influenza types and subtypes will be especially useful to guide antiviral treatment
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