Burden of primary influenza and respiratory syncytial virus pneumonia in hospitalised adults: insights from a 2-year multi-centre cohort study (2017–2018)

Matteo Boattini, Lorena Charrier, André Almeida, Eirini Christaki, Torcato Moreira Marques, Valentina Tosatto, Gabriele Bianco, Marco Iannaccone, Georgios Tsiolakkis, Christos Karagiannis, Panagiota Maikanti, Lourenço Cruz, Diogo Antão, Maria Inês Moreira, Rossana Cavallo, Cristina Costa

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Abstract

Background: Viral community-acquired pneumonia (CAP) is a potentially serious illness, particularly in adult patients with underlying chronic conditions. In addition to the most recent SARS-CoV-2, influenza, and respiratory syncytial virus (RSV) are considered the most relevant causes of viral CAP. Aims: To describe the clinical features of hospitalised adults admitted for influenza-A/B and RSV pneumonia and analyse, according to aetiology, factors associated with non-invasive ventilation (NIV) failure and in-hospital death (IHD). Methods: This was a retrospective and multi-centre study of all adults who were admitted for laboratory-confirmed influenza-A/B or RSV pneumonia, during two consecutive winter seasons (October–April 2017–2018 and 2018–2019) in three tertiary hospitals in Portugal, Italy and Cyprus. Results: A total of 356 adults were included in the study. Influenza-A, influenza-B and RSV were deemed to cause pneumonia in 197 (55.3%), 85 (23.9%) and 74 (20.8%) patients, respectively. Patients with both obstructive sleep apnoea or obesity hypoventilation syndrome and influenza-A virus pneumonia showed a higher risk for NIV failure (odds ratio (OR) 4.66; 95% confidence interval (CI) 1.42–15.30). Patients submitted to NIV showed a higher risk for IHD, regardless of comorbidities (influenza-A OR 3.00; 95% CI 1.35–6.65, influenza-B OR 4.52; 95% CI 1.13–18.01, RSV OR 5.61; 95% CI 1.26–24.93). Conclusion: The increased knowledge of influenza-A/B and RSV pneumonia burden may contribute to a better management of patients with viral CAP.

Original languageEnglish
JournalINTERNAL MEDICINE JOURNAL
DOIs
Publication statusE-pub ahead of print - 11 Oct 2021

Keywords

  • influenza
  • inhospital death
  • NIV failure
  • pneumonia
  • respiratory syncytial virus

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