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. 2019 Sep 2;9(3):142-147.
doi: 10.18683/germs.2019.1169. eCollection 2019 Sep.

Characteristics of influenza in elderly patients with and without diabetes, hospitalized for severe acute respiratory infection in a tertiary care hospital from Bucharest Romania - a three-year prospective epidemiological surveillance study

Daniela Pițigoi  1 , Maria Nițescu  2 , Anca Streinu-Cercel  3 , Rodica Bacruban  4 , Alina Elena Ivanciuc  5 , Mihaela Lazăr  6 , Carmen Maria Cherciu  7 , Maria Dorina Crăciun  8 , Victoria Aramă  9 , Adrian Streinu-Cercel  9 , Oana Săndulescu  3
Affiliations

Characteristics of influenza in elderly patients with and without diabetes, hospitalized for severe acute respiratory infection in a tertiary care hospital from Bucharest Romania - a three-year prospective epidemiological surveillance study

Daniela Pițigoi et al. Germs. .

Abstract

Introduction: Patients with diabetes may be at a higher risk of developing complicated influenza. We report the characteristics of influenza in hospitalized elderly patients with and without diabetes, in three consecutive influenza seasons.

Methods: The study included patients admitted for severe acute respiratory infection (SARI) in the National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, during a three-year active epidemiological surveillance study (2015/16, 2016/17, 2017/18), in the I-MOVE+ hospital network.

Results: A total of 349 patients were tested by PCR over the duration of the study. The percentage of patients with diabetes was comparable throughout the seasons: 34.7%, 28.3% and 30.4% (p=0.587). Influenza A was the main viral type circulating in 2015/16 and 2016/17 (100% and 97.6%) in our study population, while in 2017/18, B viruses predominated (90.0%). Diabetics presented a higher median number of comorbidities (3 vs. 2) p<0.001, and two-fold higher odds of also associating obesity (OR=2.1, 95%CI:1.3-3.4, p=0.003), compared to those without diabetes. Diabetics also tested positive for influenza more often (p=0.296). Only 6 patients with diabetes (5.4%) from our study had been vaccinated against influenza, and most (n=4) of those who had been vaccinated tested negative for influenza.

Conclusions: Our study is the first to describe the circulation of influenza viral types in elderly diabetic patients hospitalized for SARI. The results reinforce the national and international recommendation to vaccinate against influenza all patients with diabetes.

Keywords: Influenza; comorbidities; diabetes; elderly patients; viral types.

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Conflict of interest statement

Conflicts of interest: DP: Technical project manager for the GIHSN project funded by Sanofi Pasteur and Foundation for Influenza Epidemiology. Principal investigator of the I-MOVE+ study funded through the European Union’s HORIZON 2020 research and innovation programme. Technical project manager for the DRIVE study, that has received support from the EU/EFPIA Innovative Medicines Initiative 2 Joint Undertaking (DRIVE, grant n° 777363). No conflict of interest. MN: Principal investigator of the I-MOVE+ study 2016/17 funded through the European Union’s HORIZON 2020 research and innovation programme. No conflict of interest. AnSC: Principal investigator of the I-MOVE+ study 2017/18 funded through the European Union’s HORIZON 2020 research and innovation programme. Member of the research team of the DRIVE study, that has received support from the EU/EFPIA Innovative Medicines Initiative 2 Joint Undertaking (DRIVE, grant n° 777363). Subinvestigator in influenza clinical trials by Shionogi and Roche; no conflict of interest. RB: No conflict of interest. AEI: Coordinator of the molecular detection of influenza type and subtype by Real-Time Reverse Transcription PCR through IMOVE+ project. No conflict of interest ML: Coordinator of the genetic characterization of influenza strains. No conflict of interest. CMC: Coordinator of the isolation of influenza viruses in cell culture and antigenic characterization in IMOVE+ study. No conflict of interest MDC: No conflict of interest. VA: Member of the research team of the GIHSN project funded by Sanofi Pasteur and Foundation for Influenza Epidemiology. Member of the research team of the I-MOVE+ study funded through the European Union’s HORIZON 2020 research and innovation programme. No conflict of interest. ASC: Member of the research team of the GIHSN project funded by Sanofi Pasteur and Foundation for Influenza Epidemiology. Member of the research team of the DRIVE study, that has received support from the EU/EFPIA Innovative Medicines Initiative 2 Joint Undertaking (DRIVE, grant n° 777363). Principal investigator in influenza clinical trials by Shionogi and Roche. No conflict of interest. OS: Member of the research team of the GIHSN project funded by Sanofi Pasteur and Foundation for Influenza Epidemiology. Principal investigator for adults in the DRIVE study, that has received support from the EU/EFPIA Innovative Medicines Initiative 2 Joint Undertaking (DRIVE, grant n° 777363). Subinvestigator in influenza clinical trials by Shionogi and Roche. No conflict of interest.

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