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1.
Antiviral Res ; 178: 104785, 2020 06.
Article in English | MEDLINE | ID: mdl-32234540

ABSTRACT

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.


Subject(s)
Antiviral Agents/therapeutic use , Influenza, Human/drug therapy , Oseltamivir/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Aged , Female , Hospitalization , Humans , Influenza, Human/mortality , Intensive Care Units , Male , Retrospective Studies , Time-to-Treatment , Treatment Outcome
2.
Euro Surveill ; 22(34)2017 08 24.
Article in English | MEDLINE | ID: mdl-28857047

ABSTRACT

Influenza vaccination may limit the impact of influenza in the community. The aim of this study was to assess the effectiveness of influenza vaccination in preventing hospitalisation in individuals aged ≥ 65 years in Spain. A multicentre case-control study was conducted in 20 Spanish hospitals during 2013/14 and 2014/15. Patients aged ≥ 65 years who were hospitalised with laboratory-confirmed influenza were matched with controls according to sex, age and date of hospitalisation. Adjusted vaccine effectiveness (VE) was calculated by multivariate conditional logistic regression. A total of 728 cases and 1,826 matched controls were included in the study. Overall VE was 36% (95% confidence interval (CI): 22-47). VE was 51% (95% CI: 15-71) in patients without high-risk medical conditions and 30% (95% CI: 14-44) in patients with them. VE was 39% (95% CI: 20-53) in patients aged 65-79 years and 34% (95% CI: 11-51) in patients aged ≥ 80 years, and was greater against the influenza A(H1N1)pdm09 subtype than the A(H3N2) subtype. Influenza vaccination was effective in preventing hospitalisations of elderly individuals.


Subject(s)
Hospitalization/statistics & numerical data , Influenza A Virus, H1N1 Subtype/immunology , Influenza A Virus, H3N2 Subtype/immunology , Influenza Vaccines/administration & dosage , Influenza, Human/prevention & control , Vaccine Potency , Aged , Aged, 80 and over , Case-Control Studies , Female , Humans , Influenza A Virus, H1N1 Subtype/isolation & purification , Influenza A Virus, H3N2 Subtype/isolation & purification , Influenza Vaccines/immunology , Influenza, Human/epidemiology , Influenza, Human/virology , Logistic Models , Male , Outcome Assessment, Health Care , Population Surveillance , Seasons , Spain/epidemiology , Vaccination/statistics & numerical data
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