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Multicenter Study
. 2020 Sep 9;20(1):239.
doi: 10.1186/s12890-020-01257-w.

Invasive pulmonary aspergillosis in immunocompetent patients hospitalised with influenza A-related pneumonia: a multicenter retrospective study

Liang Chen  1 , Xiudi Han  2 , Yanli Li  3 , Chunxiao Zhang  4 , Xiqian Xing  5
Affiliations
Multicenter Study

Invasive pulmonary aspergillosis in immunocompetent patients hospitalised with influenza A-related pneumonia: a multicenter retrospective study

Liang Chen et al. BMC Pulm Med. .

Abstract

Background: Increasing cases of pulmonary aspergillosis (IPA) in immunocompetent patients with severe influenza have been reported. Howevere, the risk factors for occurence and death are largely unknown.

Methods: Data of hospitalised patients with influenza A-related pneumonia (FluA-p) obtained from five teaching hospitals from 2031 to 2018, were reviewed. Univariate and multivariate logistical regression analyses were performed to determine the risk factors involved in the acquisition and 60-day mortality in IPA patients.

Results: Of the 693 FluA-p patients included in the study, 3.0% (21/693) were IPA patients with a 60-day mortality of 42.9% (9/21). Adjusted for confounders, a Cox proportional hazard model showed that IPA was associated with increased risk for 60-day mortality [hazard ratio (HR) 4.336, 95% confidence interval (CI) 1.191-15.784, p = 0.026] in FluA-p patients. A multivariate logistic regression model confirmed that age (odd ratio (OR) 1.147, 95% CI 1.048-1.225, p = 0.003), systemic corticosteroids use before IPA diagnosis (OR 33.773, 95% CI 5.681-76.764, p < 0.001), leukocytes > 10 × 109/L (OR 1.988, 95% CI 1.028-6.454, p = 0.029) and lymphocytes < 0.8 × 109/L on admission (OR 34.813, 95% CI 1.676-73.006, p = 0.022), were related with the acquisition of IPA. Early neuraminidase inhibitor use (OR 0.290, 95% CI 0.002-0.584, p = 0.021) was associated with a decreased risk for a 60-day mortality in IPA patients.

Conclusions: Our results showed that IPA worsen the clinical outcomes of FluA-p patients. The risk factors for the acquisition and death were helpful for the clinicians in preventing and treating IPA.

Keywords: Influenza A; Invasive pulmonary aspergillosis; Pneumonia; Risk factor.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Patient screening algorithm for FluA-p
Fig. 2
Fig. 2
Kaplan-Meier survival graph for FluA-p patients with and without IPA (censored at 60d)
See this image and copyright information in PMC

References

    1. Peteranderl C, Herold S, Schmoldt C. Human influenza virus infections. Semin Respir Crit Care Med. 2006;37(4):487–500. - PMC - PubMed
    1. Neuzil KM, Bresee JS, de la Hoz F, Johansen K, Karron RA, Krishnan A, et al. Data and product needs for influenza immunization programs in low- and middle-income countries: rationale and main conclusions of the WHO preferred product characteristics for next-generation influenza vaccines. Vaccine. 2017;35(43):5734–5737. - PubMed
    1. Dahal S, Jenner M, Dinh L, Mizumoto K, Viboud C, Chowell G. Excess mortality patterns during 1918-1921 influenza pandemic in the state of Arizona, USA. Ann Epidemiol. 2016;28(5):273–280. - PMC - PubMed
    1. Kumar V. Influenza in Children. Indian J Pediatr. 2017;84(2):139–143. - PubMed
    1. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analfor the global burden of disease study 2010. Lancet. 2012;380(9859):2095–2128. - PMC - PubMed

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