Abstract
BackgroundSince 2011, the Global Influenza Hospital Surveillance Network (GIHSN) has used active surveillance to prospectively collect epidemiological and virological data on patients hospitalized with influenza virus infection. Here, we describe influenza virus strain circulation in the GIHSN participant countries during 2017–2018 season and examine factors associated with complicated hospitalization among patients admitted with laboratory-confirmed influenza illness.MethodsThe study enrolled patients who were hospitalized in a GIHSN hospital in the previous 48 h with acute respiratory symptoms and who had symptoms consistent with influenza within the 7 days before admission. Enrolled patients were tested by reverse transcription-polymerase chain reaction to confirm influenza virus infection. “Complicated hospitalization” was defined as a need for mechanical ventilation, admission to an intensive care unit, or in-hospital death. In each of four age strata (< 15, 15–< 50, 50–< 65, and ≥ 65 years), factors associated with complicated hospitalization in influenza-positive patients were identified by mixed effects logistic regression and those associated with length of hospital stay using a linear mixed-effects regression model.ResultsThe study included 12,803 hospitalized patients at 14 coordinating sites in 13 countries, of which 4306 (34%) tested positive for influenza. Influenza viruses B/Yamagata, A/H3N2, and A/H1N1pdm09 strains dominated and cocirculated, although the dominant strains varied between sites. Complicated hospitalization occurred in 10.6% of influenza-positive patients. Factors associated with complicated hospitalization in influenza-positive patients included chronic obstructive pulmonary disease (15–< 50 years and ≥ 65 years), diabetes (15–< 50 years), male sex (50–< 65 years), hospitalization during the last 12 months (50–< 65 years), and current smoking (≥65 years). Chronic obstructive pulmonary disease (50–< 65 years), other chronic conditions (15–< 50 years), influenza A (50–< 65 years), and hospitalization during the last 12 months (< 15 years) were associated with a longer hospital stay. The proportion of patients with complicated influenza did not differ between influenza A and B.ConclusionsComplicated hospitalizations occurred in over 10% of patients hospitalized with influenza virus infection. Factors commonly associated with complicated or longer hospitalization differed by age group but commonly included chronic obstructive pulmonary disease, diabetes, and hospitalization during the last 12 months.
Highlights
Since 2011, the Global Influenza Hospital Surveillance Network (GIHSN) has used active surveillance to prospectively collect epidemiological and virological data on patients hospitalized with influenza virus infection
Factors associated with complicated hospitalization in influenza-positive patients included chronic obstructive pulmonary disease (15–< 50 years and ≥ 65 years), diabetes (15–< 50 years), male sex (50–< 65 years), hospitalization during the last 12 months (50–< 65 years), and current smoking (≥65 years)
Factors commonly associated with complicated or longer hospitalization differed by age group but commonly included chronic obstructive pulmonary disease, diabetes, and hospitalization during the last 12 months
Summary
Since 2011, the Global Influenza Hospital Surveillance Network (GIHSN) has used active surveillance to prospectively collect epidemiological and virological data on patients hospitalized with influenza virus infection. In the United States, for example, the Centers for Disease Control and Prevention collect data on hospitalizations with laboratory-confirmed influenza illness through a network covering approximately 9% of the US population [6]. These data are used to make decisions about US prevention strategies, diagnosis, and treatment. More detailed data are needed from geographically diverse settings over several influenza seasons to assess how the different influenza viruses affect clinically meaningful outcomes Recognizing this need, the Global Influenza Hospital Surveillance Network (GIHSN) was established in 2011 [7]. In the 2017–2018 season, the GIHSN included 20 coordinating sites in 19 countries on five continents
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.