Abstract
Background By weekly monitoring of China's influenza situation, Chinese National Influenza Center observed that the 2017-18 season was predominated by influenza B virus (IBV)/Yamagata. No studies regarding hospitalizations in adults with IBV infections have been performed. We aimed to describe the clinical characteristics of hospitalized patients with IBV infection in northern China. Methods In this multicenter and retrospective study, we reviewed all consecutive adult patients with confirmed IBV infections at two level A tertiary teaching hospitals in northern China during the 2017-18 influenza season. Patients' clinical and diagnostic findings, as well as administered treatments and mortality data, were analyzed. Results A total of 573 patients with a confirmed diagnosis of IBV infection were identified, of whom 22 cases were analyzed because of IBV-related hospitalization. Most patients were admitted to the intensive care unit (ICU) and had at least one underlying disease. The total in-hospital mortality was 27.3%. An elevated initial pneumonia severity index score, elevated direct bilirubin values, and lower platelet levels were associated with mortality (p=0.020, 0.013, and 0.049, respectively). The quick development of bilateral diffuse alveolar infiltrates was the most common imaging characteristics, following consolidation and pleural effusion(s). Risk factors such as HIV infection, pregnancy, underlying medical conditions, coinfections, and treatment delays were not associated with mortality. Conclusions IBV should not be neglected because of its significant mortality. The elderly and patients with comorbidities, such as hypertension, diabetes, and connective tissue diseases, are more likely to have severe IBV-related pneumonia. Higher heart rates, direct bilirubin levels, initial PSI scores, and lower platelet levels are correlated with hospital mortality. Increased uptake in tetravalent influenza vaccine should be very helpful in preventing future cases of IBV hospitalizations.
Highlights
Influenza epidemics occur worldwide annually, but the 2017-18 season was one of the most severe influenza epidemics since the 2009 influenza A (H1N1) was pandemic in China [1]. ere have been three influenza strains described in humans: A, B, and C, with influenza A being very common, B less common, and C very uncommon [2, 3]. e threat that influenza B virus (IBV) poses to human patients has been somewhat controversial in the past decade
Severe community-acquired pneumonia (CAP) was defined by the modified American oracic Society criteria or by reaching a risk class V of the Pneumonia Severity Index (PSI) [14]. is study was approved by the Ethics Committee Board of Peking Union Medical College Hospital (PUMCH) and Second Hospital of Hebei Medical University (SHHMU) (S-K539 and 2018-P026). e informed consent forms by individuals were waived because of the retrospective feature of this study
Demographics and Clinical Characteristics. 22 patients with confirmed IBV-related hospitalizations were included during the study period. e patients’ median age was 57 years, and 40.9% were male (n 9)
Summary
Influenza epidemics occur worldwide annually, but the 2017-18 season was one of the most severe influenza epidemics since the 2009 influenza A (H1N1) was pandemic in China [1]. ere have been three influenza strains described in humans: A, B, and C, with influenza A being very common, B less common, and C very uncommon [2, 3]. e threat that influenza B virus (IBV) poses to human patients has been somewhat controversial in the past decade. As the Chinese National Influenza Center reported, the 2017-18 season was predominated by IBV (Yamagata lineage) and lower level circulation of IAV (H1N1 and H3N2) [12]. We aimed to BioMed Research International describe the clinical characteristics and outcomes in hospitalized adult patients attributable to IBV in northern China during the 2017-18 season. We aimed to describe the clinical characteristics of hospitalized patients with IBV infection in northern China. In this multicenter and retrospective study, we reviewed all consecutive adult patients with confirmed IBV infections at two level A tertiary teaching hospitals in northern China during the 2017-18 influenza season. E quick development of bilateral diffuse alveolar infiltrates was the most common imaging characteristics, following consolidation and pleural effusion(s) Risk factors such as HIV infection, pregnancy, underlying medical conditions, coinfections, and treatment delays were not associated with mortality. Increased uptake in tetravalent influenza vaccine should be very helpful in preventing future cases of IBV hospitalizations
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