Risk Factors for Mortality among 2009 A/H1N1 Influenza Hospitalizations in Maricopa County, Arizona, April 2009 to March 2010

Chowell, Gerardo; Ayala, Aurimar; Berisha, Vjollca; Viboud, Cécile; Schumacher, Mare

doi:10.1155/2012/914196

Cited by 21 publications

(23 citation statements)

References 31 publications

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“…Risk of death among A/H1N1 influenza inpatients increased by a factor of 2.66 (95% CI: 2.11, 3.35) with admission delays >2 days after adjusting for other covariates, which is in line with previous studies [48], [49], [50], [51]. Overall the distribution of admission delays in our study is similar to that reported in other studies [50], [52], [53], [54].…”

Section: Discussionsupporting

confidence: 91%

Epidemiological Characteristics and Underlying Risk Factors for Mortality during the Autumn 2009 Pandemic Wave in Mexico

et al. 2012

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BackgroundElucidating the role of the underlying risk factors for severe outcomes of the 2009 A/H1N1 influenza pandemic could be crucial to define priority risk groups in resource-limited settings in future pandemics.MethodsWe use individual-level clinical data on a large series of ARI (acute respiratory infection) hospitalizations from a prospective surveillance system of the Mexican Social Security medical system to analyze clinical features at presentation, admission delays, selected comorbidities and receipt of seasonal vaccine on the risk of A/H1N1-related death. We considered ARI hospitalizations and inpatient-deaths, and recorded demographic, geographic, and medical information on individual patients during August-December, 2009.ResultsSeasonal influenza vaccination was associated with a reduced risk of death among A/H1N1 inpatients (OR = 0.43 (95% CI: 0.25, 0.74)) after adjustment for age, gender, geography, antiviral treatment, admission delays, comorbidities and medical conditions. However, this result should be interpreted with caution as it could have been affected by factors not directly measured in our study. Moreover, the effect of antiviral treatment against A/H1N1 inpatient death did not reach statistical significance (OR = 0.56 (95% CI: 0.29, 1.10)) probably because only 8.9% of A/H1N1 inpatients received antiviral treatment. Moreover, diabetes (OR = 1.6) and immune suppression (OR = 2.3) were statistically significant risk factors for death whereas asthmatic persons (OR = 0.3) or pregnant women (OR = 0.4) experienced a reduced fatality rate among A/H1N1 inpatients. We also observed an increased risk of death among A/H1N1 inpatients with admission delays >2 days after symptom onset (OR = 2.7). Similar associations were also observed for A/H1N1-negative inpatients.ConclusionsGeographical variation in identified medical risk factors including prevalence of diabetes and immune suppression may in part explain between-country differences in pandemic mortality burden. Furthermore, access to care including hospitalization without delay and antiviral treatment and are also important factors, as well as vaccination coverage with the 2008–09 trivalent inactivated influenza vaccine.

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Section: Discussionsupporting

confidence: 91%

Epidemiological Characteristics and Underlying Risk Factors for Mortality during the Autumn 2009 Pandemic Wave in Mexico

et al. 2012

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“…Further, rates of respiratory viral infections are higher for Apache Indians, Alaska Natives and Blacks than for NHWs 45 . These aforementioned differences align with the larger trend that influenza-associated pneumonia and pandemic influenza-related deaths are more common in racial and ethnic minority populations 16,40,46,47 .…”

Section: Elevated Risk For Severe Sars-cov-2 For Racial and Ethnic MIsupporting

confidence: 60%

Compounding Health Risks and Increased Vulnerability to SARS-CoV-2 for Racial and Ethnic Minorities and Low Socioeconomic Status Individuals in the United States

Em¹

2020

Preprint

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Recent clinical SARS-CoV-2 studies link diabetes, cardiovascular disease, and hypertension to increased disease severity. In the US, racial and ethnic minorities and low socioeconomic status (SES) individuals are more likely to have increased rates of these comorbidities, lower baseline health, limited access to care, increased perceived discrimination, and limited resources, all of which increase their vulnerability to severe disease and poor health outcomes from SARS-CoV-2. Previous studies demonstrated the disproportionate impact of pandemic and seasonal influenza on these populations, due to these risk factors. This paper reviews increased health risks and documented health disparities of racial and ethnic minorities and low SES individuals in the US. Pandemic response must prioritize these marginalized communities to minimize the negative, disproportionate impacts of SARS-CoV-2 on them and manage spread throughout the entire population. This paper concludes with recommendations applicable to healthcare facilities and public officials at various government levels.

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“…For each county in our study, we compiled the total number of influenza hospitalizations over the study period and summaries of several county-level variables. From a non-exhaustive review of the literature, we identified potential confounders: insurance coverage, 12,13 number of primary care physicians per 100 000 population, 14,15 environmental humidity, 11,16 chronic disease and pregnancy rates, [17][18][19][20] percentage of the county population living below the poverty level, 12,21,22 vaccination uptake, [23][24][25] racial composition, [26][27][28][29] population density, 30,31 and prevalence of smoking. [32][33][34] A concise description of data sources and variable definitions for all covariates is provided in Table 1.…”

Section: Datamentioning

confidence: 99%

Relationship between community prevalence of obesity and associated behavioral factors and community rates of influenza‐related hospitalizations in the United States

Charland

Buckeridge

Hoen

et al. 2012

Influenza Resp Viruses

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Please cite this paper as: Charland et al.(2012) Relationship between community prevalence of obesity and associated behavioral factors and community rates of influenza‐related hospitalizations in the United States. Influenza and Other Respiratory Viruses DOI: 10.1111/irv.12019. Background Findings from studies examining the association between obesity and acute respiratory infection are inconsistent. Few studies have assessed the relationship between obesity‐related behavioral factors, such as diet and exercise, and risk of acute respiratory infection. Objective To determine whether community prevalence of obesity, low fruit/vegetable consumption, and physical inactivity are associated with influenza‐related hospitalization rates. Methods Using data from 274 US counties, from 2002 to 2008, we regressed county influenza‐related hospitalization rates on county prevalence of obesity (BMI ≥ 30), low fruit/vegetable consumption (<5 servings/day), and physical inactivity (<30 minutes/month recreational exercise), while adjusting for community‐level confounders such as insurance coverage and the number of primary care physicians per 100 000 population. Results A 5% increase in obesity prevalence was associated with a 12% increase in influenza‐related hospitalization rates [adjusted rate ratio (ARR) 1·12, 95% confidence interval (CI) 1·07, 1·17]. Similarly, a 5% increase in the prevalence of low fruit/vegetable consumption and physical inactivity was associated with an increase of 12% (ARR 1·12, 95% CI 1·08, 1·17) and 11% (ARR 1·11, 95% CI 1·07, 1·16), respectively. When all three variables were included in the same model, a 5% increase in prevalence of obesity, low fruit/vegetable consumption, and physical inactivity was associated with 6%, 8%, and 7% increases in influenza‐related hospitalization rates, respectively. Conclusions Communities with a greater prevalence of obesity were more likely to have high influenza‐related hospitalization rates. Similarly, less physically active populations, with lower fruit/vegetable consumption, tended to have higher influenza‐related hospitalization rates, even after accounting for obesity.

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Risk Factors for Mortality among 2009 A/H1N1 Influenza Hospitalizations in Maricopa County, Arizona, April 2009 to March 2010

Cited by 21 publications

References 31 publications

Epidemiological Characteristics and Underlying Risk Factors for Mortality during the Autumn 2009 Pandemic Wave in Mexico

Epidemiological Characteristics and Underlying Risk Factors for Mortality during the Autumn 2009 Pandemic Wave in Mexico

Compounding Health Risks and Increased Vulnerability to SARS-CoV-2 for Racial and Ethnic Minorities and Low Socioeconomic Status Individuals in the United States

Relationship between community prevalence of obesity and associated behavioral factors and community rates of influenza‐related hospitalizations in the United States

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