Ishida Tadashi, Seki Masafumi, Oishi Kazunori, Tateda Kazuhiro, Fujita Jiro, Kadota Jun-Ichi, Kawana Akihiko, Izumikawa Koichi, Kikuchi Toshiaki, Ohmagari Norio, Yamada Mitsuhiro, Maruyama Takaya, Takazono Takahiro, Miki Makoto, Miyazaki Yoshitsugu, Yamazaki Yoshitaka, Kakeya Hiroshi, Ogawa Kenji, Nagai Hideaki, Watanabe Akira
Department of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central Hospital, 1-1-1, Kurashiki, Okayama, 710-8602, Japan.
Department of Infectious Diseases, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyaginoku-ku, Sendai, Miyagi, 983-8536, Japan.
J Infect Chemother. 2022 Jul;28(7):853-858. doi: 10.1016/j.jiac.2022.02.001. Epub 2022 Apr 20.
Influenza remains a clinically heavy burden worldwide. It is well known that some populations are at high risk of complications from influenza, whereas, even previously healthy people might suffer from severe influenza. The objective of this study was to clarify clinical manifestations of hospitalized patients without risk factors infected with influenza.
The clinical data for patients who were severely ill with influenza, and required hospitalization were gathered and analyzed between November 2014 and August 2020 (6 influenza seasons) using an internet-surveillance system. Among them, the patients who had no risk factors of complications from influenza were extracted.
Finally, a total of 91 patients (9.0% of all influenza-related hospitalizations) without risk factors were analyzed. The no risk group was younger than the risk group, though other significant differences of clinical characteristics were not recognized between the groups. Pneumonia was the most common cause of hospitalization in the no risk group, and primary influenza viral pneumonia was the most common pneumonia. Antiviral drugs were administered in 96.7% of the no-risk group, and artificial ventilation was performed in 18.7%. In-hospital death was recorded for 3 patients without risk factors.
Severe complications of influenza which required hospitalization may occur in a certain degree of patients with no risk factors. Efforts are needed to diagnose and treat influenza appropriately even in previously healthy younger patients. Continuous nationwide surveillance will be required to clarify risk factors for severe influenza even in previously healthy younger patients. (UMIN000015989).
流感在全球范围内仍是一项沉重的临床负担。众所周知，某些人群患流感并发症的风险较高，然而，即使是此前健康的人也可能患上重症流感。本研究的目的是阐明无危险因素的流感感染住院患者的临床表现。
利用互联网监测系统收集并分析了2014年11月至2020年8月（6个流感季节）期间因重症流感需要住院治疗的患者的临床资料。其中，提取了无流感并发症危险因素的患者。
最终，共分析了91例无危险因素的患者（占所有流感相关住院病例的9.0%）。无危险因素组比有危险因素组年轻，不过两组之间未发现其他临床特征的显著差异。肺炎是无危险因素组最常见的住院原因，原发性流感病毒性肺炎是最常见的肺炎类型。96.7%的无危险因素组患者接受了抗病毒药物治疗，18.7%的患者进行了人工通气。3例无危险因素的患者在住院期间死亡。
在一定比例的无危险因素患者中可能会发生需要住院治疗的严重流感并发症。即使是此前健康的年轻患者，也需要努力进行流感的恰当诊断和治疗。需要持续进行全国范围的监测，以明确即使是此前健康的年轻患者发生重症流感的危险因素。（UMIN000015989）
