CONTEXT: When the world falls apart, we still (thankfully) have studies focusing on the stuff (viruses) that impact us when we aren’t focusing on COVID | This is a retrospective analysis of 1191 immunocompetent hospitalized adult Flu-p patients from January 2012 to December 2018 in five teaching hospitals in China
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1. “Community-acquired pneumonia (CAP) remains a major infection-related driver of global morbidity and mortality despite many major medical advances.1 In the USA alone, an estimated 5 million adults are affected by CAP each year, resulting in 1.1 million hospital admissions and 60,000 deaths.2 A study from Japan estimated the incidence of CAP to be 16.9 per 1000 patient-years in patients above 15 years of age, with a hospitalization rate of 5.3 per 1000 patient-years, and an in-hospital mortality rate of 0.7 per 1000 patient-years.3 CAP was the fourth leading cause of death and the most common infectious disease globally in 2019.4 In prior work, acute cardiovascular events (CVEs) have been identified as common complications in CAP patients that are associated with higher rates of patient mortality.5 A meta-analysis of 25 studies reported a high incidence of cardiac events within 30 days with cumulative respective rates of heart failure, arrhythmia, and acute coronary syndrome of 14% (range: 7–33%), 5% (range: 1–11%), and 5% (range: 1–11%).6 One Spanish study of 1405 patients over a 1-year follow-up period determined that 20% of patient deaths were attributable to CVEs.7 However, prior studies have largely failed to differentiate between the pathogens responsible for individual CAP cases, making the specific etiology of CVEs among CAP patients relatively poorly defined.”
2. “Community-acquired co-infecting respiratory pathogens were those detected using standard microbiological techniques ( ) within 48 h following admission.16. A standardized case report form was utilized to extract data from patient medical records including demographic details, patient comorbidities ( ), patient symptoms, vital signs, laboratory results, radiographic findings at the time of admission, community-acquired co-infecting respiratory pathogens, patient management, and outcomes (including the administration of NAIs, systemic corticosteroids, angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers [ACEIs/ARBs], statins, anticoagulants, antiplatelet agents, and β-receptor blockers, noninvasive/invasive ventilation, admission to intensive care unit [ICU], and 30-day mortality).”
3. “Multivariate analyses were also performed to assess the relationship between CVEs and outcomes after adjusting for patient age, sex, time between disease onset and hospital admission, influenza virus type, comorbidities, pregnancy, obesity, smoking history, systemic corticosteroid administration, early NAI therapy, and coinfection as those factors have previously been linked to influenza patient outcomes.”
4. “In total, 3405 hospitalized patients who tested positive for influenza viral RNA over the course of this study were assessed for eligibility, of whom 1191 were identified as immunocompetent adults with laboratory-confirmed, community-acquired Flu-p and were enrolled in the present study, of whom 64.4% were infected with influenza A virus 64.4% (767/1191) and 35.6% were infected with influenza B virus 35.6% (464/1191) (Figure 1).”
5. “At least one type of CVE occurred in 24.6% (293/1191) of Flu-p patients, with the most common CVEs being arrhythmia (17.4%, 207/1191), heart failure (15.5%, 185/1191), myocardial infarction (4.6%, 55/1191), stroke (4.2%, 50/1191), and pulmonary embolism (1.0%, 12/1191) (Figure 2).”