National retrospective cohort study to identify age-specific fatality risks of comorbidities among hospitalised patients with influenza-like illness in Taiwan

Abstract

ObjectivesThis study aimed to examine comprehensively the prognostic impact of underlying comorbidities among hospitalised patients with influenza-like illness (ILI) in different age groups and provide recommendations targeting the vulnerable patients.Setting and participantsA retrospective cohort of 83 227 hospitalised cases with ILI were identified from Taiwan’s National Health Insurance Research Database from January 2005 to December 2010. Cases were stratified into three different age groups: paediatric (0–17 years), adult (18–64 years) and elderly (≧65 years), and their age, sex, comorbidity and past healthcare utilisation were analysed for ILI-associated fatality.Main outcome measuresORs for ILI-related fatality in different age groups were performed using multivariable analyses with generalised estimating equation models and adjusted by age, sex and underlying comorbidities.ResultsHospitalised ILI-related fatality significantly increased with comorbidities of cancer with metastasis (adjusted OR (aOR)=3.49, 95% CI: 3.16 to 3.86), haematological malignancy (aOR=3.02, 95% CI: 2.43 to 3.74), cancer without metastasis (aOR=1.72, 95% CI: 1.54 to 1.91), cerebrovascular (aOR=1.24, 95% CI: 1.15 to 1.33) and heart diseases (aOR=1.19, 95% CI: 1.11 to 1.27) for all age groups. Adult patients with AIDS; adult and elderly patients with chronic kidney disease, tuberculosis and diabetes were significantly associated with elevated risk of death. Severe liver diseases and hypothyroidism among elderly, and dementia/epilepsy among elderly and paediatrics were distinctively associated with likelihood of ILI-related fatality.ConclusionsDifferent age-specific comorbidities were associated with increasing risk of death among hospitalised ILI patients. These findings may help update guidelines for influenza vaccination and other prevention strategies in high-risk groups for minimising worldwide ILI-related deaths.

Diseased lungs may hinder COVID-19 development: A possible reason for the low prevalence of COPD in COVID-19 patients

“…Interestingly, the odd phenomenon of low COPD rates among patients seems unique to COVID-19 ( Table 1 ), as well as SARS and MERS [3] , [4] , [5] , [6] , [7] , [8] . In contrast, the prevalence of COPD and other pulmonary diseases were often higher than other medical comorbidities among patients with influenza or respiratory syncytial virus infections at about 20-40% [9] , [10] , [11] , [12] , [13] , [14] . Deciphering why host susceptible factors vary in response to different respiratory viral infections would also be an area of research interest.…”

“…Importantly, their causative agents, SARS-CoV-1 and MERS-CoV, also mainly target the alveolar epithelial cells in the lower respiratory tract to cause diseases [82] , [101] , [102] . In contrast, COPD is more prevalent among patients infected with influenza and respiratory syncytial viruses at 20-40% of cases [9] , [10] , [11] , [12] , [13] , [14] , higher than the general population at 10-15% [17] , [18] . Notably, influenza and respiratory syncytial viruses primarily cause upper respiratory tract diseases [103] , [104] , [105] , [106] .…”

“…The same phenomenon can be observed in other pathogenic human coronaviruses that cause severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), where COPD was rarely found (i.e., 0.4-2%) as medical comorbidity among patients [3] , [4] , [5] , [6] , [7] , [8] . In contrast, the prevalence of COPD is often higher than other comorbidities at 20-40% among patients with other common respiratory viral infections, such as influenza and respiratory syncytial viruses [9] , [10] , [11] , [12] , [13] , [14] . Fig 1.…”

Reporte de caso: Presentación clínica e importancia de coinfecciones durante pandemia por COVID-19 en pacientes con neoplasias malignas

“…La mortalidad estimada en pacientes hospitalizados con enfermedad similar a la influenza es significativamente mayor en la presencia de comorbilidades, principalmente, neoplasia de órgano sólido con metástasis (OR: 3,49), malignidad hematológica (OR: 3,04) y neoplasia oncológica sin metástasis (OR: 1,72) para todos los grupos de edad (10). Datos similares han sido descritos para pacientes con diferentes tipos de cáncer, difiriendo según el agente etiológico y la presencia o no de coinfección virus-bacteria o virus-virus (5,6,11).…”

Clinical presentation, disease course and outcome of COVID-19 in hospitalized patients with and without pre-existing cardiac disease – a cohort study across eighteen countries

“…13 These observations are in line with previous studies among patients with influenza and other respiratory tract infections. 14-15…”