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. 2018 Sep 6:14:1615-1626.
doi: 10.2147/TCRM.S173834. eCollection 2018.

Impacts of age and gender at the risk of underlying medical conditions and death in patients with avian influenza A (H7N9): a meta-analysis study

Qinglin Cheng  1   2 , Gang Zhao  1 , Li Xie  1 , Xuchu Wang  1
Affiliations

Impacts of age and gender at the risk of underlying medical conditions and death in patients with avian influenza A (H7N9): a meta-analysis study

Qinglin Cheng et al. Ther Clin Risk Manag. .

Abstract

Objective: The objective of our study was to conduct a series of analyses that examined the impacts of age and gender at the risk of underlying medical conditions (UMCs) and death in patients with influenza A (H7N9).

Methods: We began by searching for potentially relevant articles in English or Chinese before February 28, 2018. Additionally, we reviewed our own files and reference lists of articles identified by this search.

Results: The association between death and UMCs was significant in H7N9 patients, with an OR of 1.49 (95% CI: 1.24-1.78). Subgroup analyses showed that having two or more UMCs of any type (OR: 2.24; P=0.044), chronic respiratory diseases (OR: 1.81; P=0.032), and chronic cardiovascular disease (OR: 1.63; P=0.013) had an association with increased fatality in H7N9 patients. Age (60 years or older) [adjusted OR (AOR): 1.86; P=0.032] and gender (male: AOR: 1.68, P=0.006; female: AOR: 1.88, P=0.044) were significantly associated with death in H7N9 patients with UMCs compared to H7N9 patients without any UMC. Stratification analyses found statistically significant increased death in H7N9 patients with UMCs who were 60 years of age and older (AOR: 2.72; P<0.001) and gender (male; AOR=1.64; P=0.033), compared to H7N9 patients without these respective conditions.

Conclusion: Impacts of age are substantial and significant at the risk of UMCs and death in H7N9 patients. This analysis did not find a significant difference in gender comparisons. Efforts should particularly focus on reducing fatality rates in patients with combined risks from UMCs and other significant impact factor such as age (60 years or older).

Keywords: H7N9; avian influenza virus; fatality; meta-analysis; underlying medical conditions.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow chart of selection of publications for inclusion in meta-analysis. Note: aFive authors were contacted for additional data to determine eligibility. Abbreviation: UMCs, underlying medical conditions.
Figure 2
Figure 2
Forest plots on effect sizes of underlying medical conditions associated with fatalities of H7N9-infected cases. Notes: (A) The pooled estimate. (B) Subgroup analyses of certain UMC types, age, and gender. Abbreviations: CCD, chronic cardiovascular diseases; CHD, coronary heart disease; CLD, chronic liver disease; CMD, chronic metabolic diseases; CRD, chronic respiratory diseases; RD, rheumatic diseases; UMC, underlying medical condition.
Figure 2
Figure 2
Forest plots on effect sizes of underlying medical conditions associated with fatalities of H7N9-infected cases. Notes: (A) The pooled estimate. (B) Subgroup analyses of certain UMC types, age, and gender. Abbreviations: CCD, chronic cardiovascular diseases; CHD, coronary heart disease; CLD, chronic liver disease; CMD, chronic metabolic diseases; CRD, chronic respiratory diseases; RD, rheumatic diseases; UMC, underlying medical condition.
Figure 3
Figure 3
Forest plot on estimates of combined effects of UMCs with age or gender in H7N9 patients. Abbreviation: UMC, underlying medical condition.
Figure 4
Figure 4
Funnel plots on meta-analyses of underlying medical conditions associated with fatalities of H7N9-infected cases. Notes: aEstimates by adjusting for the effects of age and gender. bThe estimate of combined effects of UMCs with age or gender. Abbreviation: UMC, underlying medical condition.
Figure 5
Figure 5
Sensitivity analysis plots on meta-analyses of underlying medical conditions associated with fatalities of H7N9-infected cases. Notes: (A) The pooled estimate. (B) The estimate of combined effects of underlying medical conditions with age or gender. (C) The estimates by adjusting for the effects of age and gender.
Figure 5
Figure 5
Sensitivity analysis plots on meta-analyses of underlying medical conditions associated with fatalities of H7N9-infected cases. Notes: (A) The pooled estimate. (B) The estimate of combined effects of underlying medical conditions with age or gender. (C) The estimates by adjusting for the effects of age and gender.
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References

    1. Zhang F, Bi Y, Wang J, et al. Human infections with recently-emerging highly pathogenic H7N9 avian influenza virus in China. J Infect. 2017;75(1):71–75. - PubMed
    1. Arima Y, Vong S. World Health Organization Outbreak Response Team. Human infections with avian influenza A (H7N9) virus in China: preliminary assessments of the age and sex distribution. Western Pac Surveill Response J. 2013;4(2):1–3. - PMC - PubMed
    1. Zhang YM, Liu JM, Yu L, et al. Prevalence and characteristics of hypoxic hepatitis in the largest single-centre cohort of avian influenza A (H7N9) virus-infected patients with severe liver impairment in the intensive care unit. Emerg Microbes Infect. 2016;5(1):e1. - PMC - PubMed
    1. Feng F, Jiang Y, Yuan M, et al. Association of radiologic findings with mortality in patients with avian influenza H7N9 pneumonia. PLoS One. 2014;9(4):e93885. - PMC - PubMed
    1. Ma W, Huang H, Chen J, et al. Predictors for fatal human infections with avian H7N9 influenza, evidence from four epidemic waves in Jiangsu Province, Eastern China, 2013–2016. Influenza Other Respir Viruses. 2017;11:418–424. - PMC - PubMed

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