Chen Liang, Han Xiudi, Li YanLi, Zhang Chunxiao, Xing Xiqian
Department of Infectious Diseases, Beijing Jishuitan Hospital, 4th Medical College of Peking University, Beijing, People's Republic of China.
Department of Pulmonary and Critical Care Medicine, Qingdao Municipal Hospital, Qingdao City, People's Republic of China.
Infect Drug Resist. 2021 Apr 9;14:1363-1373. doi: 10.2147/IDR.S305509. eCollection 2021.
Influenza virus infections are a key cause of community-acquired pneumonia (CAP). Cardiovascular events (CVEs) are common among CAP and influenza patients, but there have been few population-based studies of influenza-related pneumonia (Flu-p) patients published to date.
A retrospective analysis of 1191 immunocompetent hospitalized adult Flu-p patients from January 2012 to December 2018 in five teaching hospitals in China was conducted.
A total of 24.6% (293/1191) of patients developed at least one form of CVE-related complication while hospitalized. In a multivariate logistic regression analysis, hypertension, cerebrovascular disease, coronary artery disease, preexisting heart failure, systolic blood pressure <90 mmHg, respiratory rates ≥30 breaths/min, a lymphocyte count <0.8×10/L, PaO/FiO <300 mmHg, and systemic corticosteroid administration were independently associated with the incidence of CVEs; while early neuraminidase inhibitor treatment and angiotensin converting enzyme inhibitors/angiotensin II receptor blocker treatment were associated with a lower risk of CVEs. After controlling for potential confounding variables, we determined that CVEs were linked to a higher risk of 30-day mortality (OR 3.307, 95% CI 2.198-4.975, p < 0.001) in Flu-p patients.
CVE-related complications are common among hospitalized Flu-p patients and are associated with negative patient outcomes. Clarifying these CVE-related risk factors can aid in their clinical prevention and management.
流感病毒感染是社区获得性肺炎（CAP）的一个关键病因。心血管事件（CVE）在CAP和流感患者中很常见，但迄今为止，很少有基于人群的流感相关性肺炎（Flu-p）患者研究发表。
对2012年1月至2018年12月在中国五家教学医院住院的1191例免疫功能正常的成年Flu-p患者进行回顾性分析。
共有24.6%（293/1191）的患者在住院期间发生了至少一种形式的CVE相关并发症。在多因素逻辑回归分析中，高血压、脑血管疾病、冠状动脉疾病、既往心力衰竭、收缩压<90 mmHg、呼吸频率≥30次/分钟、淋巴细胞计数<0.8×10⁹/L、PaO₂/FiO₂<300 mmHg以及全身使用糖皮质激素与CVE的发生率独立相关；而早期神经氨酸酶抑制剂治疗和血管紧张素转换酶抑制剂/血管紧张素II受体阻滞剂治疗与较低的CVE风险相关。在控制了潜在的混杂变量后，我们确定CVE与Flu-p患者30天死亡率较高相关（比值比3.307，95%置信区间2.198-4.975，p<0.001）。
CVE相关并发症在住院的Flu-p患者中很常见，并且与不良患者结局相关。明确这些与CVE相关的危险因素有助于其临床预防和管理。
