Effect of antiviral treatment in older patients hospitalized with confirmed influenza

Seasonal influenza causes significant morbidity and mortality in people aged ≥65 years. Antiviral treatment can reduce complications and disease severity. The objective of this study was to investigate the effect of antiviral treatment in patients aged ≥65 years hospitalized with confirmed influenza...

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Veröffentlicht in:Antiviral research 2020-06, Vol.178, p.104785-104785, Article 104785
Hauptverfasser: Soldevila, Núria, Toledo, Diana, Ortiz de Lejarazu, Raúl, Tamames, Sonia, Castilla, Jesús, Astray, Jenaro, Fernández, Maria Amelia, Martín, Vicente, Egurrola, Mikel, Morales Suárez-Varela, María, Domínguez, Àngela, Mayoral, J.M., Díaz-Borrego, J., Morillo, A., Pérez-Lozano, M.J., Gutiérrez, J., Pérez-Ruiz, M., Fernández-Sierra, M.A., Tamames, S., Rojo-Rello, S., Ortiz de Lejarazu, R., Fernández-Natal, M.I., Fernández-Villa, T., Pueyo, A., Martin, Vicente, Vilella, A., Campins, M., Antón, A., Navarro, G., Riera, M., Espejo, E., Mas, M.D., Pérez, R., Cayla, J.A., Rius, C., Godoy, P., Torner, N., Izquierdo, C., Torra, R., Force, L., Domínguez, A., Soldevila, N., Crespo, I., Toledo, D., Astray, J., Domínguez-Berjon, M.F., Gutiérrez, M.A., Jiménez, S., Gil, E., Martín, F., Génova-Maleras, R., Prados, M.C., Enzzine de Blas, F., Salvador, M.A., Galán, J.C., Navas, E., Rodríguez, L., Álvarez, C.J., Banderas, E., Fernandez, S., Chamorro, J., Casado, I., Díaz, J., Castilla, J., Egurrola, M., López de Goicoechea, M.J., Morales-Suárez-Varela, M., Sanz, F.
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Sprache:eng
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Zusammenfassung:Seasonal influenza causes significant morbidity and mortality in people aged ≥65 years. Antiviral treatment can reduce complications and disease severity. The objective of this study was to investigate the effect of antiviral treatment in patients aged ≥65 years hospitalized with confirmed influenza in preventing intensive care unit (ICU) admission or death. A retrospective cohort study was carried out in 20 hospitals from seven Spanish regions during 2013–2015 in patients aged ≥65 years. Hospitalized cases of laboratory-confirmed influenza were selected. To assess the association between antiviral treatment and ICU admission or death, the adjusted odds ratios (aOR) and their 95% confidence intervals (CI) were calculated using multivariate logistic regression. We included 715 hospitalized patients, of whom 640 (87.9%) received antiviral treatment, 77 (10.8%) required ICU admission and 66 (9.2%) died. In the 64–74 years age group, receipt of antiviral treatment ≤48 h (aOR 0.20; 95% CI 0.04–0.89), 3–4 days (aOR 0.23; 95% CI 0.05–0.92) and 5–7 days (aOR 0.24; 95% CI 0.03–0.91) after clinical symptom onset was associated with reduced mortality. Receipt of treatment >7 days after symptom onset was not associated with reduced mortality. No association of antiviral treatment with reduced mortality was observed in the >74 years age group or with the prevention of ICU admission in any age group. Antiviral treatment had a protective effect in avoiding death in patients aged 65–74 years hospitalized due to influenza when administered ≤48 h after symptom onset and when no more than 7 days had elapsed. •Antiviral treatment reduces deaths in hospitalized patients aged 65–74 years.•Antiviral treatment ≤48 hours after symptom onset and when no more than 6 days have elapsed is effective in avoiding deaths.•No association between antiviral treatment and the prevention of mortality was observed in patients aged >74 years.•No association between antiviral treatment and the prevention of ICU admission was observed.
ISSN:0166-3542
1872-9096
DOI:10.1016/j.antiviral.2020.104785