Journal Article

Influenza virus and factors that are associated with ICU admission, pulmonary co-infections and ICU mortality

Koch, R.M., Bergmans, D.C., Hoedemaekers, C.W.E., van Beuningen, D., van de Veerdonk, F.L., OudeLashof, A.M., van der Hoeven, J.G., Beumer, M.C., Kolwijck, E.

2019

Overview

While most influenza patients have a self-limited respiratory illness, 5–10% of hospitalized patients develop severe disease requiring ICU admission. The aim of this study was to identify influenza-specific factors associated with ICU admission and mortality. Furthermore, influenza-specific pulmonary bacterial, fungal and viral co-infections were investigated. 199 influenza patients, admitted to two academic hospitals in the Netherlands between 01-10-2015 and 01-04-2016 were investigated of which 45/199 were admitted to the ICU. A history of Obstructive/Central Sleep Apnea Syndrome, myocardial infarction, dyspnea, influenza type A, BMI > 30, the development of renal failure and bacterial and fungal co-infections, were observed more frequently in patients who were admitted to the ICU, compared with patients at the normal ward. Co-infections were evident in 55.6% of ICU-admitted patients, compared with 20.1% of patients at the normal ward, mainly caused by Staphylococcus aureus, Streptococcus pneumoniae, and Aspergillus fumigatus. Non-survivors suffered from diabetes mellitus and (pre-existent) renal failure more often. The current study indicates that a history of OSAS/CSAS, myocardial infarction and BMI > 30 might be related to ICU admission in influenza patients. Second, ICU patients develop more pulmonary co-infections. Last, (pre-existent) renal failure and diabetes mellitus are more often observed in non-survivors. •A history of OSAS/CSAS, myocardial infarction and BMI > 30 are risk factors for ICU admission.•Non-survivors suffer more often from diabetes mellitus and (pre-existent) renal failure.•ICU patients develop renal failure and bacterial/fungal co-infections more often.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Adult / Aged / Antibiotics / Bacterial / Bacterial infections / Body Mass Index / Chemotherapy / Chronic obstructive pulmonary disease / Co-infections / Coinfection - mortality / Comorbidity / Cytomegalovirus / Diabetes / Dyspnea / Female / Fungal / Heart attacks / Herpes viruses / Hospitalization / Humans / ICU admission / ICU mortality / Influenza / Influenza virus / Influenza, Human - mortality / Intensive care / Intensive Care Units / Male / Middle Aged / Mortality / Patients / Respiratory Tract Infections - complications / Respiratory Tract Infections - mortality / Retrospective Studies / Risk factors / Sepsis/Infection / Sleep apnea / Streptococcus infections / Viral / Viral infections