Characteristics of influenza in elderly patients with and without diabetes, hospitalized for severe acute respiratory infection in a tertiary care hospital from Bucharest Romania – a three-year prospective epidemiological surveillance study

Pițigoi, Daniela; Nițescu, Maria; Streinu‐Cercel, Anca; Bacruban, Rodica; Ivanciuc, Alina Elena; Lazăr, Mihaela; Cherciu, Carmen Maria; Crăciun, Maria; Aramă, Victoria; Streinu‐Cercel, Adrian; Săndulescu, Oana

doi:10.18683/germs.2019.1169

Cited by 10 publications

(8 citation statements)

References 11 publications

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“…As for the risk of hospitalization, 18 studies were included in this part. To specify the effect of obesity classes on influenza hospitalization, 12 studies focused on the link between obesity and influenza hospitalization ( 32 , 38 , 41 , 42 , 46 , 47 , 50 , 51 , 55 , 58 , 59 , 62 ). Among these, 6 studies focused on the link between morbid obesity and influenza hospitalization ( 32 , 41 , 42 , 50 , 55 , 58 ).…”

Section: Resultsmentioning

confidence: 99%

Obesity Increases the Severity and Mortality of Influenza and COVID-19: A Systematic Review and Meta-Analysis

Zhao

Gang

et al. 2020

Front. Endocrinol.

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Since December 2019, COVID-19 has aroused global attention. Studies show the link between obesity and severe outcome of influenza and COVID-19. Thus, we aimed to compare the impacts of obesity on the severity and mortality of influenza and COVID-19 by performing a meta-analysis. A systematic search was performed in MEDLINE, EMASE, ClinicalTrials.gov, and Web of Science from January 2009 to July 2020. The protocol was registered onto PROSPERO (CRD42020201461). After selection, 46 studies were included in this meta-analysis. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were analyzed. We found obesity was a risk factor for the severity and mortality of influenza (ORsevere outcome = 1.56, CI: 1.28-1.90; ORmortality = 1.99, CI: 1.15-3.46). For COVID-19, obesity was a significant risk factor only for severe outcome (OR = 2.07, CI: 1.53-2.81) but not for mortality (OR = 1.57, CI: 0.85-2.90). Compared with obesity, morbid obesity was linked with a higher risk for the severity and mortality of both influenza (OR = 1.40, CI: 1.10-1.79) and COVID-19 (OR = 3.76, CI: 2.67-5.28). Thus, obesity should be recommended as a risk factor for the prognosis assessment of COVID-19. Special monitoring and earlier treatment should be implemented in patients with obesity and COVID-19.

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Section: Resultsmentioning

confidence: 99%

Obesity Increases the Severity and Mortality of Influenza and COVID-19: A Systematic Review and Meta-Analysis

Zhao

Gang

et al. 2020

Front. Endocrinol.

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“…Most patients aged over 65 years in our study had underlying medical conditions, most frequently cardiovascular disease, neuromuscular disease, or diabetes. A recent study from Romania has shown that elderly patients with diabetes require hospitalization for SARI at a higher rate compared to the general elderly population [16].…”

Section: Discussionmentioning

confidence: 99%

The 2017–2018 influenza season in Bucharest, Romania: epidemiology and characteristics of hospital admissions for influenza-like illness

et al. 2019

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BackgroundSeasonal influenza causes a considerable burden to healthcare services every year. To better measure the impact of severe influenza cases in Romania, we analyzed active surveillance data collected during the 2017–2018 season from patients admitted for influenza-like illness (ILI) at a tertiary care hospital in Bucharest.MethodsPatients admitted for acute ILI were included if they were resident in the Bucharest-Ilfov region, had been hospitalized for at least 24 h, and had onset of symptoms within 7 days before admission. Patient demographics, healthcare use, vaccination status, and outcome data were collected by questionnaire or by searching clinical records. Respiratory swabs were also obtained from each patient to confirm influenza A (A/H1 and A/H3 subtypes) or influenza B (Yamagata and Victoria lineages) infection by real-time reverse-transcription polymerase chain reaction assay.ResultsThe study included 502 patients, many (45.2%) of whom were aged < 5 years. Overall, 108 patients (21.5%) had one or more comorbidities. Seventeen adults aged 18–64 years (3.4%) had been vaccinated against influenza. Patients were hospitalized for a median of 5 days and most (90.4%) were prescribed antiviral treatment. More than one-half of the patients (n = 259, 51.6%) were positive for influenza. Most influenza cases were caused by B viruses (172/259, 66.4%), which were mostly of the B/Yamagata lineage (85 of 94 characterized, 90.4%). Most of the subtyped A viruses were A/H1 (59/74, 79.7%). A/H1 viruses were frequently detected in influenza-positive admissions throughout the 2017–2018 season, whereas the predominant B/Yamagata viruses were detected around the middle of the season, with a peak in cases at week 7 of 2018. Eleven patients were admitted to an intensive care unit; of these, one patient with confirmed B/Yamagata infection died.ConclusionsThese results show that seasonal influenza results in considerable hospitalization in Bucharest-Ilfov, Romania and suggest vaccine coverage should be extended, especially to the youngest age groups. The data from this study should help inform and optimize national influenza healthcare policies.

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“…For each consenting patient, a standardized medical questionnaire was filled out by study investigators through review of medical (hospital or general practitioner) records and patient/relative interview, collecting demographic variables, a complete medical history, influenza vaccination status in the respective season, and data related to the current SARI episode's onset, characteristics and outcome, as previously described 6 . Two respiratory specimens (a nasal swab and a pharyngeal swab) were collected according to the methodology for national surveillance of influenza, ARI, and SARI, 3 placed at 4°C immediately, and transported within 24 hours at 2‐8°C to the National Reference Laboratory (NRL) at the “Cantacuzino” National Medico‐Military Institute for Research and Development, Bucharest, Romania.…”

Section: Methodsmentioning

confidence: 99%

Surveillance of medically‐attended influenza in elderly patients from Romania—data from three consecutive influenza seasons (2015/16, 2016/17, and 2017/18)

Pițigoi

Streinu‐Cercel

Ivanciuc³

et al. 2020

Influenza Resp Viruses

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Background Influenza is an acute infection affecting all age groups; however, elderly patients are at an increased risk. We aim to describe the clinical characteristics and the circulation of influenza virus types in elderly patients admitted for severe acute respiratory infection (SARI) to a tertiary care hospital in Bucharest, Romania, part of the I‐MOVE+ hospital network. Methods We conducted an active surveillance study at the National Institute for Infectious Diseases “Prof. Dr Matei Balș,” Bucharest, Romania, during three consecutive influenza seasons: 2015/16, 2016/17, and 2017/18. All patients aged 65 and older admitted to our hospital for SARI were tested for influenza by PCR. Results A total of 349 eligible patients were tested during the study period, and 149 (42.7%) were confirmed with influenza. Most patients, 321 (92.5%) presented at least one underlying condition at the time of hospital admission, the most frequent being cardiovascular disease, 270 (78.3%). The main influenza viral subtype circulating in 2015/16 was A(H1N1)pdm09, followed by A(H3N2) in 2016/17 and B influenza in 2017/18. Case fatality was highest in the 2015/16 season (3.7%), 0% in 2016/17, and 1.0% in 2017/18. Vaccination coverage in elderly patients with SARI from our study population was 22 (6.3%) over the three seasons. Conclusions Our study has highlighted a high burden of comorbidities in elderly patients presenting with SARI during winter season in Romania. The influenza vaccine coverage rate needs to be substantially increased in the elderly population, through targeted interventions.

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Characteristics of influenza in elderly patients with and without diabetes, hospitalized for severe acute respiratory infection in a tertiary care hospital from Bucharest Romania – a three-year prospective epidemiological surveillance study

Cited by 10 publications

References 11 publications

Obesity Increases the Severity and Mortality of Influenza and COVID-19: A Systematic Review and Meta-Analysis

Obesity Increases the Severity and Mortality of Influenza and COVID-19: A Systematic Review and Meta-Analysis

The 2017–2018 influenza season in Bucharest, Romania: epidemiology and characteristics of hospital admissions for influenza-like illness

Surveillance of medically‐attended influenza in elderly patients from Romania—data from three consecutive influenza seasons (2015/16, 2016/17, and 2017/18)

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