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Risk of Severe Influenza Among Adults With Chronic Medical Conditions.
Walker, Tiffany A; Waite, Ben; Thompson, Mark G; McArthur, Colin; Wong, Conroy; Baker, Michael G; Wood, Tim; Haubrock, Jennifer; Roberts, Sally; Gross, Diane K; Huang, Q Sue; Newbern, E Claire.
  • Walker TA; WHO National Influenza Centre, Institute of Environmental Science and Research, Porirua, New Zealand.
  • Waite B; WHO National Influenza Centre, Institute of Environmental Science and Research, Porirua, New Zealand.
  • Thompson MG; Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • McArthur C; Department of Critical Care Medicine, Auckland District Health Board, Greenlane, Auckland, New Zealand.
  • Wong C; Department of Respiratory Medicine, Counties Manukau District Health Board, Papatoetoe, Auckland, New Zealand.
  • Baker MG; Department of Public Health, University of Otago, School of Medicine, Newtown, Wellington, New Zealand.
  • Wood T; Health Intelligence Team, Institute of Environmental Science and Research, Porirua, New Zealand.
  • Haubrock J; WHO National Influenza Centre, Institute of Environmental Science and Research, Porirua, New Zealand.
  • Roberts S; Department of Microbiology, Auckland District Health Board, Greenlane, Auckland, New Zealand.
  • Gross DK; Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Huang QS; WHO National Influenza Centre, Institute of Environmental Science and Research, Porirua, New Zealand.
  • Newbern EC; Health Intelligence Team, Institute of Environmental Science and Research, Porirua, New Zealand.
J Infect Dis ; 221(2): 183-190, 2020 01 02.
Article in English | MEDLINE | ID: covidwho-1452713
ABSTRACT

BACKGROUND:

Severe influenza illness is presumed more common in adults with chronic medical conditions (CMCs), but evidence is sparse and often combined into broad CMC categories.

METHODS:

Residents (aged 18-80 years) of Central and South Auckland hospitalized for World Health Organization-defined severe acute respiratory illness (SARI) (2012-2015) underwent influenza virus polymerase chain reaction testing. The CMC statuses for Auckland residents were modeled using hospitalization International Classification of Diseases, Tenth Revision codes, pharmaceutical claims, and laboratory results. Population-level influenza rates in adults with congestive heart failure (CHF), coronary artery disease (CAD), cerebrovascular accidents (CVA), chronic obstructive pulmonary disease (COPD), asthma, diabetes mellitus (DM), and end-stage renal disease (ESRD) were calculated by Poisson regression stratified by age and adjusted for ethnicity.

RESULTS:

Among 891 276 adults, 2435 influenza-associated SARI hospitalizations occurred. Rates were significantly higher in those with CMCs compared with those without the respective CMC, except for older adults with DM or those aged <65 years with CVA. The largest effects occurred with CHF (incidence rate ratio [IRR] range, 4.84-13.4 across age strata), ESRD (IRR range, 3.30-9.02), CAD (IRR range, 2.77-10.7), and COPD (IRR range, 5.89-8.78) and tapered with age.

CONCLUSIONS:

Our findings support the increased risk of severe, laboratory-confirmed influenza disease among adults with specific CMCs compared with those without these conditions.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Chronic Disease / Influenza, Human Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Oceania Language: English Journal: J Infect Dis Year: 2020 Document Type: Article Affiliation country: Infdis

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Chronic Disease / Influenza, Human Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Oceania Language: English Journal: J Infect Dis Year: 2020 Document Type: Article Affiliation country: Infdis