Pleșca Vlad Ștefan, Marinescu Adrian Gabriel, Voiosu Cătălina, Drăgănescu Anca Cristina, Streinu-Cercel Anca, Vilaia Alexandra, Hainăroșie Răzvan, Pleșca Doina Anca, Săndulescu Oana
MD, PhDc, Carol Davila University of Medicine and Pharmacy Bucharest, Romania and National Institute for Infectious Diseases "Prof. Dr. Matei Balș", No. 1 Dr. Calistrat Grozovici street, Bucharest 021105, Romania.
MD, PhD, Lecturer, Carol Davila University of Medicine and Pharmacy Bucharest, No. 37 Dionisie Lupu street, Bucharest, Romania.
Germs. 2024 Mar 31;14(1):38-44. doi: 10.18683/germs.2024.1416. eCollection 2024 Mar.
Acute otitis and sinusitis are common complications in patients with influenza and are responsible for increased hospitalization rates.
A five-year retrospective study (2018-2023) was conducted including all patients hospitalized for influenza (etiologic diagnosis by RT-PCR) to identify the incidence and characteristics of cases complicated with otitis and/or sinusitis. Cases associated with other viral co-infections were excluded from the analysis.
We identified a cumulative rate of 20.6% (324 cases) of acute otitis (AO) and acute sinusitis (AS) among patients with influenza. Of these, 62.3% had AO, 28.1% AS, and 9.6% concomitant AO and AS. Cases of AO were predominant in the pediatric population (97.0%), while cases of AS were more common in adults (56.1%). Influenza A viruses were identified in 67.2% of patients. The infection with influenza B viruses increased the risk of acute congestive otitis media 2.1-fold (p=0.020), and influenza A viruses increased the risk of acute maxillary sinusitis 2.7-fold (p=0.029). Late presentation to the hospital, with a median of 4 days from the onset of influenza symptoms, was identified as a factor in the occurrence of AO and AS.
The risk of AO and AS is increased in patients with influenza, especially in the pediatric population and in late hospital presentations. These findings highlight the importance of proper monitoring and management of patients with influenza to prevent the development of complications, as well as the need to better understand the mechanisms whereby influenza viruses contribute to these secondary conditions.
急性中耳炎和鼻窦炎是流感患者常见的并发症，会导致住院率上升。
进行了一项为期五年的回顾性研究（2018 - 2023年），纳入所有因流感住院的患者（通过逆转录聚合酶链反应进行病因诊断），以确定并发中耳炎和/或鼻窦炎病例的发生率及特征。分析中排除了与其他病毒合并感染相关的病例。
我们在流感患者中确定急性中耳炎（AO）和急性鼻窦炎（AS）的累积发生率为20.6%（324例）。其中，62.3%患有AO，28.1%患有AS，9.6%同时患有AO和AS。AO病例在儿科人群中占主导（97.0%），而AS病例在成人中更为常见（56.1%）。67.2%的患者检测出甲型流感病毒。感染乙型流感病毒使急性充血性中耳炎的风险增加2.1倍（p = 0.020），甲型流感病毒使急性上颌窦炎的风险增加2.7倍（p = 0.029）。从流感症状出现到入院的中位时间为4天，延迟就医被确定为AO和AS发生的一个因素。
流感患者发生AO和AS的风险增加，尤其是在儿科人群以及延迟就医的情况下。这些发现凸显了对流感患者进行适当监测和管理以预防并发症发生的重要性，以及更好地理解流感病毒导致这些继发疾病的机制的必要性。
