Differences between asthmatics and nonasthmatics hospitalised with influenza A infection

Ernst, Pierre; Ariel, Amnon; Suissa, Samy

doi:10.1183/09031936.00137812

Cited by 1 publication

(1 citation statement)

References 17 publications

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“…Different indication may easily confound the effect of the corticosteroid. Some evidences supported the use of corticosteroids for asthma or COPD or septic shock in the context of influenza infection [36][37][38] . In order to minimize the influences of different indications, subgroup analysis of the mortality in three studies (n = 3347) was performed after excluding patients receiving corticosteroids as rescue therapy or due to COPD/asthma exacerbation, and found no statistically significant difference between the steroid therapy groups and control groups and the heterogeneity was high (I² = 77%).…”

Section: Discussionmentioning

confidence: 99%

Use of corticosteroids in influenza-associated acute respiratory distress syndrome and severe pneumonia: a systemic review and meta-analysis

Zhou

Liu

et al. 2020

Sci Rep

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Influenza-related severe pneumonia and acute respiratory distress syndrome (ARDS) are severe threats to human health. The objective of this study was to assess the effects of systematic corticosteroid therapy in patients with pneumonia or ARDS. The PubMed, EMBASE, Web of Science and SCOPUS databases were searched up to July, 2019. Nineteen studies including 6637 individuals were identified, and fifteen studies (6427 patients) were included in the meta-analysis of mortality. Eighteen were observational studies and one was a randomized controlled trial (RCT). The meta-analysis results showed that corticosteroid therapy was associated with significantly higher mortality (OR 1.53, 95% CI [1.16, 2.01]) and incidence of nosocomial infection (OR 3.15, 95% CI [1.54, 6.45]). Subgroup analysis showed that among patients with unadjusted estimates, the odds of mortality were higher in patients receiving corticosteroid treatment (OR 1.98, 95% CI [1.23, 3.17]), however, among patients with adjusted estimates, the result showed no statistically significant difference between corticosteroid group and control group (OR 1.31, 95% CI [0.95, 1.80]). Current data do not support the routine use of corticosteroids in patients with influenza severe pneumonia or ARDS. RCTs are needed to provide more robust evidence. MethodsStudy eligibility criteria. This systematic review included studies fulfilling the following inclusion criteria: (a) the studies were RCTs, quasi-experimental studies, or observational studies; (b) patients had confirmed influenza-related pneumonia, ARDS (PaO 2 /FiO 2 < 300 mmHg); (c) the intervention group used corticosteroids, and the comparison group did not, with no restriction set on the dose or duration of the intervention; and (d) the outcomes were mortality, nosocomial infection, length of stay or other clinical outcomes. A study was excluded if it met any of the following criteria: (a) the study was a review article, conference abstract, case report or case series, case-control study; (b) the majority of included patients were immunocompromised; (c) insufficient data were available; (d) overlapping population; (e) studies with fewer than 20 participants. There were no restrictions on influenza subtype, patient age or study setting. If only some of the individuals included in a study fit the eligibility criteria and these individuals had extractable results corresponding to the objective of this study, then the study was included.Clinical outcomes including mortality, nosocomial infection, duration of mechanical ventilation, length of stay, time to fever alleviation and clinical stability and viral shedding were evaluated. Scientific RepoRtS |(2020) 10:3044 | https://doi.

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Section: Discussionmentioning

confidence: 99%