Risk factors for serious outcomes associated with influenza illness in high‐ versus low‐ and middle‐income countries: Systematic literature review and meta‐analysis

Coleman, Brenda L.; Fadel, Shaza A; Fitzpatrick, Tiffany; Thomas, Sera-Melisa

doi:10.1111/irv.12504

Cited by 102 publications

(114 citation statements)

References 42 publications

(39 reference statements)

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“…Early administration of NAI therapy is associated with better outcomes in severe influenza [40,41]. Old age, obesity, pregnancy and chronic medical conditions, such as COPD, diabetes mellitus, and chronic kidney disease, have been associated with poorer outcomes in patients with influenza [35,42,43]. However, in our study only cardiovascular disease was identified as a risk factor for mortality in FluA-p patients.…”

Section: Discussionmentioning

confidence: 50%

FluA-p score: a novel prediction rule for mortality in influenza A-related pneumonia patients

Liang

Han

et al. 2020

Respir Res

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Background: The pneumonia severity index (PSI) and the CURB-65 (confusion, urea, respiratory rate, blood pressure, age ≥ 65 years) score have been shown to predict mortality in community-acquired pneumonia. Their ability to predict influenza-related pneumonia, however, is less well-established. Methods: A total of 693 laboratory-confirmed FluA-p patients diagnosed between Jan 2013 and Dec 2018 and recruited from five teaching hospitals in China were included in the study. The sample included 494 patients in the derivation cohort and 199 patients in the validation cohort. The prediction rule was established based on independent risk factors for 30-day mortality in FluA-p patients from the derivation cohort. Results: The 30-day mortality of FluA-p patients was 19.6% (136/693). The FluA-p score was based on a multivariate logistic regression model designed to predict mortality. Results indicated the following significant predictors (regression statistics and point contributions toward total score in parentheses): blood urea nitrogen > 7 mmol/L (OR 1.604, 95% CI 1.150-4.492, p = 0.040; 1 points), pO 2 /F i O 2 ≤ 250 mmHg (OR 2.649, 95% CI 1.103-5.142, p = 0.022; 2 points), cardiovascular disease (OR 3.967, 95% CI 1.269-7.322, p < 0.001; 3 points), arterial PH < 7.35 (OR 3.959, 95% CI 1.393-7.332, p < 0.001; 3 points), smoking history (OR 5.176, 95% CI 2.604-11.838, p = 0.001; 4 points), lymphocytes < 0.8 × 10 9 /L (OR 8.391, 95% CI 3.271-16.212, p < 0.001; 5 points), and early neurominidase inhibitor therapy (OR 0.567, 95% CI 0.202-0.833, p = 0.005; − 2 points). Seven points was used as the cut-off value for mortality risk stratification. The model showed a sensitivity of 0.941, a specificity of 0.762, and overall better predictive performance than the PSI risk class (AUROC = 0.908 vs 0.560, p < 0.001) and the CURB-65 score (AUROC = 0.908 vs 0.777, p < 0.001). Conclusions: Our results showed that a FluA-p score was easy to derive and that it served as a reliable prediction rule for 30-day mortality in FluA-p patients. The score could also effectively stratify FluA-p patients into relevant risk categories and thereby help treatment providers to make more rational clinical decisions.

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Section: Discussionmentioning

confidence: 50%

FluA-p score: a novel prediction rule for mortality in influenza A-related pneumonia patients

Liang

Han

et al. 2020

Respir Res

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“…Several papers have showed an association between influenza infection and myocardial infarction, chronic obstructive pulmonary disease exacerbations and diabetic crises [18,23,24,27,48,49]. This also means that at least half of the study population were probably at higher risk for severe influenza disease and outcome including death [50].…”

Section: Discussionmentioning

confidence: 98%

The burden of laboratory-confirmed influenza infection in Lebanon between 2008 and 2016: a single tertiary care center experience

et al. 2020

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Background: Influenza is a major cause of morbidity and mortality worldwide. Following the 2009 pandemic, there was widened interest in studying influenza burden in all regions. However, since data from the World Health Organization (WHO) Middle East and North Africa (MENA) region remain limited, we aimed to contribute to the understanding of influenza burden in Lebanon. Methods: A retrospective chart review extending over a period of 8 seasons from Jan 1st, 2008 till June 30th, 2016 at a tertiary care center in Beirut was performed. All cases confirmed to have influenza based on rapid antigen detection or/and polymerase chain reaction on a respiratory sample were included for analysis. Data on epidemiology, clinical presentation, complications, antiviral use and mortality were collected for analysis.

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“…Another study assessed risk factors for poor outcomes in patients with influenza and found that pregnant women, patients with HIV, children under 5 years old, and children with neurologic disorders who live in low-and middle-income countries experience worse outcomes than those who live in high-income countries. 17 Nonetheless, the authors also reported that poor outcomes in patients with comorbidities were observed in both high-and lowresource settings. Field et al 18 published an updated guideline on cough due to tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Global Emergency Medicine: A Review of the Literature From 2017

Becker

Trehan²,

Hayward

et al. 2018

Academic Emergency Medicine

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Objectives: The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peerreviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a global audience of academics and clinical practitioners.Methods: This year, 17,722 articles written in three languages were identified by our electronic search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. Another two reviewers searched the gray literature, yielding an additional 11 articles. All articles that were deemed appropriate by at least one reviewer and approved by their editor underwent formal scoring of overall quality and importance. Two independent reviewers scored all articles.Results: A total of 848 articles met our inclusion criteria and underwent full review. Sixty-three percent were categorized as emergency care in resource-limited settings, 23% as disaster and humanitarian response, and 14% as EM development. Twenty-one articles received scores of 18.5 or higher out of a maximum score 20 and were selected for formal summary and critique. Inter-rater reliability testing between reviewers revealed a Cohen's kappa of 0.344. Conclusions:In 2017, the total number of articles identified by our search continued to increase. Studies and reviews with a focus on infectious diseases, pediatrics, and trauma represented the majority of top-scoring articles.T he Global Emergency Medicine Literature Review (GEMLR) strives to improve the global practice of emergency medicine (EM) by facilitating emergency care practitioners' identification of the most current and important research conducted on relevant topics around the world. Our review began in 2005 in an attempt to identify and consolidate the relevant global EM literature into a format that is readily available to academics and clinicians. [1][2][3][4][5][6][7][8][9][10][11][12] This year, our panel of reviewers and editors included physicians from Australia, Canada, Ethiopia, Ghana, Laos, Rwanda, and the United States.Our group strives to identify the most relevant practice-changing articles, by scouring both the peerreviewed and the gray literature via a comprehensive search strategy. Gray literature has been defined as any material produced by an organization whose primary function is not peer-reviewed academic publication. 13Our goal in performing a gray literature search is to identify new global EM research conducted by government agencies, local or international nongovernmental organizations, or other entities that may not have been published in peer-reviewed journals.The primary goals of the review are to illustrate best practices, stimulate research, and promote further professionalization in the field of global EM through the identification of important new publications that focus on emergency care in the global context, especially emergency care provision in limited-resource settings, disaster and hum...

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Risk factors for serious outcomes associated with influenza illness in high‐ versus low‐ and middle‐income countries: Systematic literature review and meta‐analysis

Cited by 102 publications

References 42 publications

FluA-p score: a novel prediction rule for mortality in influenza A-related pneumonia patients

FluA-p score: a novel prediction rule for mortality in influenza A-related pneumonia patients

The burden of laboratory-confirmed influenza infection in Lebanon between 2008 and 2016: a single tertiary care center experience

Global Emergency Medicine: A Review of the Literature From 2017

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