Influenza and morbidity and mortality risk in patients in Mexico with systemic arterial hypertension alone or with comorbidities: a retrospective, observational, cross-sectional study from 2014 to 2020

Abstract

ObjectivesIn Mexico, patients with systemic arterial hypertension (SAH) are excluded from the influenza vaccination programme despite their risk of cardiovascular events as influenza-related complications. We investigated the impact of influenza on morbidity and mortality in patients with SAH.DesignThis was a retrospective cross-sectional study that analysed data from early 2014 to mid-2020.SettingData were obtained from the Influenza Epidemiological Surveillance System in Mexico database.Participants32 663 cases of influenza in people aged ≥20 years with a confirmed case of influenza-like illness, severe respiratory infection and/or influenza death were investigated.Primary and secondary outcome measuresInfluenza deaths, hospitalisation frequency and the impact on hospitalisation and/or death due to influenza by the SAH variate alone and in combination with diabetes, obesity, chronic obstructive pulmonary disease, cardiovascular disease and/or smoking, and by vaccination status were assessed.ResultsThe hospitalisation frequency increased with age. Notably, 46.0% (15 033/32 663) of confirmed influenza cases had at least one comorbidity, with SAH (19.2%; 6260/32 663) and obesity (18.7%; 6106/32 663) being the most prevalent. Most confirmed SAH cases (80.8%; 5057/6260) were in those who had not been vaccinated against influenza. There were 3496 deaths due to influenza (mortality rate, 0.69×1 00 000 inhabitants), with the highest rates seen in those aged ≥80 years (80–89 years, 2.0%; ≥90 years, 3.6%). The case fatality rate due to influenza and SAH was significantly higher than those due to influenza without SAH in those aged <50 years, but not in the other age groups (20–29 years, 9.8%, p<0.0005; 30–39 years, 8.2%, p<0.035; 40–49 years, 17.8%, p<0.0005; vs 15.1%–20.0%, p=0.31–0.99 for those aged ≥50 years).ConclusionsOur findings support the need to include SAH in public policies of influenza vaccination as a secondary prevention measure to avoid fatal outcomes.

Severe acute respiratory syndrome by influenza and factors associated with death in older adults: a population study

“…Thus, those who were not vaccinated account for a considerably larger portion of the group with an unfavorable outcome (87.4%). This fact reinforces the findings of Villaseñor et al, who studied a population in Mexico, and concluded that there was a lower frequency of death among vaccinated participants than among unvaccinated participants [19]. A Brazilian study carried out in the state of Santa Catarina in 2012 analyzed 3,282 reported cases of SARS, with a higher prevalence of confirmed cases among people aged 60 years and older.…”

Impact of pulmonary hypertension on outcomes of influenza pneumonia patients: A nationwide analysis

“…As evident in our study and reported by previous studies, the risk of hospitalization, poorer outcomes, and death due to IP increases in the presence of other comorbidities. 18,15,19 Hence, these comorbidities do predict poorer outcomes; still, even after adjusting the comorbidities and demographics on multivariate regression analysis, PHDPC was an independent predictor for worse outcomes.…”