Severe lymphopenia in hospitalized patients with influenza virus infection as a marker of a poor outcome

Lalueza, Antonio; Folgueira, Dolores; Díaz‐Pedroche, Carmen; Hernández-Jiménez, Pilar; Ayuso, Blanca; Castillo, Cristina; Laureiro, Jaime; Trujillo, Hernando; Torres, Marta; Lumbreras, Carlos

doi:10.1080/23744235.2019.1598572

Cited by 35 publications

(24 citation statements)

References 10 publications

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“…Finally, the rate of mortality was elevated; however, this hypothesis needs further substantiation. A lymphocyte count of <300 lymphocytes/mL was observed in a subgroup of patients with poor outcome in a study encompassing 239 inpatients with con rmed in uenza virus infection [10]. Thus, we can conclude that the proportion of elevated CK, LDH, DD, and lymphocytopenia was positively relative to the severity of in uenza.…”

Section: Discussionmentioning

confidence: 74%

A Comparison of Demographic, Epidemiological and Clinical Characteristics of Hospital Influenza-related Viral Pneumonia Patients

Huang

et al. 2020

Preprint

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Objective: Through the comparison of the demographic, epidemiological, and clinical characteristics of hospital human influenza (influenza A (H1N1) pdm09, H3N2, and B) -related and hospitalized avian-origin influenza A (H7N9)-related viral pneumonia patients , find the different between them.Methods: A retrospective study was conducted in hospitalized influenza-related viral pneumonia patients.Results: Human influenza A -related patients in the 35–49-year-old group were more than those with B pneumonia patients (p=0.027), and relatively less in the ≥65-year-old group than B pneumonia patients (p=0.079). The proportion of comorbid condition to human influenza A pneumonia was lower than B pneumonia and H7N9 pneumonia patients (78% vs. 77.8%; p=0.013). The proportion of invasive mechanical ventilation (IMV), lymphocytopenia, elevated lactate dehydrogenase to hospitalized human influenza A-related viral pneumonia patients was higher than B pneumonia patients (p<0.05), but lower than H7N9 pneumonia patients (p<0.05). In the multivariate analysis, pulmonary consolidation (odds ratio (OR): 13.67; 95% confidence interval (CI): 1.54–121.12; p=0.019) and positive bacterial culture (sputum) (OR: 7.71; 95% CI: 2.48–24.03; p<0.001) were independently associated with IMV , while shock (OR: 13.16; 95% CI: 2.06–84.07; p=0.006), white blood cell count >10,000/mm3 (OR: 7.22; 95% CI: 1.47–35.58; p=0.015) and positive bacterial culture(blood or sputum) (OR: 6.27; 95% CI: 1.36–28.85; p=0.018) were independently associated with death in the three types hospitalized influenza-related viral pneumonia patientsConclusions: Hospital influenza B-related viral pneumonia mainly affects the elderly and people with underlying diseases, while human influenza A pneumonia mainly affects the young adults; however, the mortality was similar. The hospitalized human influenza A-related viral pneumonia patients was severer than B pneumonia patients,but milder than H7N9 pneumonia patients. Pulmonary consolidation and positive bacterial culture (sputum) were independently associated with IMV, while shock, white blood cell count >10,000/mm3, and positive bacterial culture (blood or sputum) were independently associated with death to three types hospitalized influenza-related viral pneumonia patients.

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Section: Discussionmentioning

confidence: 74%

A Comparison of Demographic, Epidemiological and Clinical Characteristics of Hospital Influenza-related Viral Pneumonia Patients

Huang

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Finally, the rate of mortality was elevated; however, this hypothesis needs further substantiation. A lymphocyte count of < 300 lymphocytes/∝L was observed in a subgroup of patients with poor outcome in a study encompassing 239 inpatients with confirmed influenza virus infection [15]. Thus, we can conclude that the proportion of elevated CK, LDH, DD, and lymphocytopenia was positively relative to the severity of influenza.…”

Section: Discussionmentioning

confidence: 77%

A Comparison of Demographic, Epidemiological and Clinical Characteristics of Hospital Influenza-related Viral Pneumonia Patients

Huang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background The comparison of the demographic, epidemiological, and clinical characteristics of hospital human influenza (influenza A (H1N1) pdm09, H3N2, and B) -related and hospitalized avian-origin influenza A (H7N9)-related viral pneumonia patients has not been reported. Methods A retrospective study was conducted in hospitalized influenza-related viral pneumonia patients. Results The average age of hospitalized human influenza A -related viral pneumonia patients was lower than B pneumonia patients(p<0.05), human influenza A -related patients in the 35–49-year-old group were more than those with B pneumonia patients (p<0.05), and relatively less in the ≥65-year-old group than B pneumonia patients (p=0.079). The proportion of patients who have at least one comorbid condition to human influenza A pneumonia was lower than B and H7N9 pneumonia (p<0.05). The proportion of invasive mechanical ventilation (IMV), lymphocytopenia, elevated lactate dehydrogenase, and d-dimer to hospitalized human influenza A-related viral pneumonia patients was higher than B pneumonia patients (p<0.05), but lower than H7N9 pneumonia patients (p<0.05). Conclusions Hospital influenza B-related viral pneumonia mainly affects the elderly and people with underlying diseases, while human influenza A pneumonia mainly affects the young adults; however, the mortality was similar. The proportion of severe cases to hospital human influenza A-related viral pneumonia patients was higher than those of B pneumonia patients but lower than H7N9 pneumonia patients. Pulmonary consolidation and positive bacterial culture (sputum) were independently associated with IMV, while shock, white blood cell count >10,000/mm 3 , and positive bacterial culture (blood or sputum) were independently associated with death to three types hospitalized influenza-related viral pneumonia patients.

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“…Another factor that could have contributed to lymphopenia in our patient is the influenza virus infection. However, grade 4 lymphopenia such as the one experienced by our patient is rare in otherwise immunocompetent patients with influenza virus infection [ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Severe lymphopenia after subcutaneous cladribine in a patient with multiple sclerosis: To vaccinate or not?

et al. 2020

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Objective To describe a fatal case of influenza A pneumonia in a patient with severe lymphopenia after receiving subcutaneous cladribine to treat her multiple sclerosis (MS). Methods Case report. Results A 53-year-old woman developed fatal influenza pneumonia associated with grade 4 lymphopenia two months after receiving a total dose of 60mg subcutaneous cladribine. Despite treatment with oseltamivir, her condition deteriorated and the patient passed away after developing respiratory failure. Conclusion Cladribine-related lymphopenia is usually mild to moderate, however severe lymphopenia may occur. People with MS, especially those who are immunosuppressed, should be offered the inactivated influenza vaccine annually.

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Severe lymphopenia in hospitalized patients with influenza virus infection as a marker of a poor outcome

Cited by 35 publications

References 10 publications

A Comparison of Demographic, Epidemiological and Clinical Characteristics of Hospital Influenza-related Viral Pneumonia Patients

A Comparison of Demographic, Epidemiological and Clinical Characteristics of Hospital Influenza-related Viral Pneumonia Patients

A Comparison of Demographic, Epidemiological and Clinical Characteristics of Hospital Influenza-related Viral Pneumonia Patients

Severe lymphopenia after subcutaneous cladribine in a patient with multiple sclerosis: To vaccinate or not?

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