CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Departament de Medicina, Universitat de Barcelona, Barcelona, Spain.
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Departament de Medicina, Universitat de Barcelona, Barcelona, Spain.
Antiviral Res. 2020 Jun;178:104785. doi: 10.1016/j.antiviral.2020.104785. Epub 2020 Mar 29.
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.
季节性流感可导致≥65 岁人群发生严重的发病率和死亡率。抗病毒治疗可降低并发症和疾病严重程度。本研究的目的是调查≥65 岁因确诊流感住院的患者接受抗病毒治疗对预防入住重症监护病房（ICU）或死亡的效果。在 2013-2015 年期间，在西班牙 7 个地区的 20 家医院进行了一项回顾性队列研究，纳入≥65 岁的住院患者。选择了经实验室确诊的流感住院病例。为评估抗病毒治疗与 ICU 入住或死亡之间的关系，使用多变量逻辑回归计算了调整后的优势比（aOR）及其 95%置信区间（CI）。我们纳入了 715 例住院患者，其中 640 例（87.9%）接受了抗病毒治疗，77 例（10.8%）需要入住 ICU，66 例（9.2%）死亡。在 64-74 岁年龄组中，接受抗病毒治疗≤48 小时（aOR 0.20；95%CI 0.04-0.89）、3-4 天（aOR 0.23；95%CI 0.05-0.92）和 5-7 天（aOR 0.24；95%CI 0.03-0.91）与死亡率降低相关。发病后超过 7 天接受治疗与死亡率降低无关。在>74 岁年龄组或任何年龄组中，抗病毒治疗与死亡率降低均无关联。在因流感住院的 65-74 岁患者中，在症状出现后≤48 小时和未超过 7 天接受治疗时，抗病毒治疗具有避免死亡的保护作用。
