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肥胖对季节性流感的影响:以色列单中心回顾性研究。

The impact of obesity on seasonal influenza: a single-center, retrospective study conducted in Israel.

机构信息

Infectious Disease Unit, Rabin Medical Center, Beilinson Hospital, Petach-Tikva, Israel.

Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.

出版信息

Eur J Clin Microbiol Infect Dis. 2021 Jul;40(7):1471-1476. doi: 10.1007/s10096-021-04174-w. Epub 2021 Feb 11.

Abstract

Obesity is associated with an increased susceptibility to infections. Several studies have reported adverse clinical outcomes of influenza among obese individuals. Our aim was to examine the association between obesity and the clinical outcomes of hospitalized adult patients ill with seasonal influenza. Consecutive hospitalized adult patients between 10/2017 and 4/2018 with laboratory confirmed influenza A and B were divided into an obese group (body mass index (BMI) ≥ 30 kg/m) and controls. The primary outcome was a composite endpoint of 30-day all-cause mortality, vasopressor use, mechanical ventilation, ICU admission, and severe influenza complication (myocarditis and encephalitis). Secondary outcomes encompassed all the components of the primary outcome, 90-day all-cause mortality, occurrence of pneumonia, length of hospital stay, and 90-day readmission rates. The study comprised 512 hospitalized adults diagnosed with laboratory-confirmed influenza A (195/512) and B (317/512). Within this group, 17% (86/512) were classified obese; the remaining 83% (426/512) were controls. Results of the composite outcome (7/85, 8% vs. 45/422, 11%; p=0.5) and the crude 30-day all-cause mortality rate (5/86, 6% vs. 34/426, 8%, p=0.5) were similar between the two groups. The multivariate analysis demonstrated that obesity was not a significant risk factor for influenza adverse events (OR=1.3, CI 95% 0.3-3.3; p=0.5), whereas advanced age, chronic kidney disease, and hypoalbuminemia were significant risk factors (OR=1.03, OR=2.7, and OR=5.4, respectively). Obesity was not associated with influenza-related morbidity and mortality among the hospitalized adults during the 2017-2018 influenza season. Further studies researching different influenza seasons are essential.

摘要

肥胖与感染的易感性增加有关。几项研究报告了肥胖个体流感的不良临床结局。我们的目的是研究肥胖与季节性流感住院成年患者临床结局之间的关系。2017 年 10 月至 2018 年 4 月期间,连续住院的甲型和乙型流感实验室确诊成年患者被分为肥胖组(体重指数(BMI)≥30kg/m )和对照组。主要结局是 30 天全因死亡率、血管加压素使用、机械通气、入住 ICU 和严重流感并发症(心肌炎和脑炎)的复合终点。次要结局包括主要结局的所有组成部分、90 天全因死亡率、肺炎的发生、住院时间和 90 天再入院率。研究纳入了 512 名诊断为实验室确诊甲型流感(195/512)和乙型流感(317/512)的住院成年人。在这一组中,17%(86/512)被归类为肥胖;其余 83%(426/512)为对照组。复合结局(7/85,8% vs. 45/422,11%;p=0.5)和粗 30 天全因死亡率(5/86,6% vs. 34/426,8%;p=0.5)在两组之间相似。多变量分析表明,肥胖不是流感不良事件的显著危险因素(OR=1.3,95%CI 0.3-3.3;p=0.5),而高龄、慢性肾脏病和低白蛋白血症是显著危险因素(OR=1.03、OR=2.7 和 OR=5.4)。肥胖与 2017-2018 流感季节住院成年人的流感相关发病率和死亡率无关。进一步研究不同流感季节的研究至关重要。

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