Weakened immunity in aged hosts with comorbidities as a risk factor for the emergence of influenza A H7N9 mutants

Bermejo-Martín, Jesús F.; Almansa, Raquel; Lejarazu, Raúl Ortíz de

doi:10.3855/jidc.3810

Cited by 8 publications

(9 citation statements)

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“…With increasing age, the prognosis deteriorates, especially among the elderly population, due to the decline in immune organ function and the combination of chronic diseases. Under a certain degree of hypoxia, the heart, lung and kidney function of very elderly patients worsens, making them prone to multiple organ failure and increasing the risk of mortality [19]. Jing Han et al…”

Section: Discussionmentioning

confidence: 99%

Analysis of factors affecting the prognosis of COVID-19 patients and viral shedding duration

et al. 2020

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Abstract The clinical characteristics of patients with COVID-19 were analysed to determine the factors influencing the prognosis and virus shedding time to facilitate early detection of disease progression. Logistic regression analysis was used to explore the relationships among prognosis, clinical characteristics and laboratory indexes. The predictive value of this model was assessed with receiver operating characteristic curve analysis, calibration and internal validation. The viral shedding duration was calculated using the Kaplan–Meier method, and the prognostic factors were analysed by univariate log-rank analysis and the Cox proportional hazards model. A retrospective study was carried out with patients with COVID-19 in Tianjin, China. A total of 185 patients were included, 27 (14.59%) of whom were severely ill at the time of discharge and three (1.6%) of whom died. Our findings demonstrate that patients with an advanced age, diabetes, a low PaO2/FiO2 value and delayed treatment should be carefully monitored for disease progression to reduce the incidence of severe disease. Hypoproteinaemia and the fever duration warrant special attention. Timely interventions in symptomatic patients and a time from symptom onset to treatment <4 days can shorten the duration of viral shedding.

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Section: Discussionmentioning

confidence: 99%

Analysis of factors affecting the prognosis of COVID-19 patients and viral shedding duration

et al. 2020

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“…However, it is known that both hypertension and chronic lung disease are related to age. Therefore, a high proportion of elderly patients with severe H7N9 virus infection may due to decreased immune function or to underlying chronic disease [21], and the immunological status of the elderly host with co-morbidities could increase the risk of death [22].…”

Section: Discussionmentioning

confidence: 99%

Epidemiological and Clinical Characteristics and Risk Factors for Death of Patients with Avian Influenza A H7N9 Virus Infection from Jiangsu Province, Eastern China

Chen

et al. 2014

PLoS ONE

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BackgroundA novel avian influenza A (H7N9) virus has caused great morbidity as well as mortality since its emergence in Eastern China in February 2013. However, the possible risk factors for death are not yet fully known.Methods and FindingsPatients with H7N9 virus infection between March 1 and August 14, 2013 in Jiangsu province were enrolled. Data were collected with a standard form. Mean or percentage was used to describe the features, and Fisher's exact test or t-test test was used to compare the differences between fatal and nonfatal cases with H7N9 virus infection. A total of 28 patients with H7N9 virus infection were identified among whom, nine (32.1%) died. The median age of fatal cases was significant higher than nonfatal cases (P<0.05). Patients with older age were more strongly associated with increased odds of death (OR = 30.0; 95% CI, 2.85–315.62). Co-morbidity with chronic lung disease and hypertension were risk factors for mortality (OR = 14.40; 95% CI, 1.30–159.52, OR = 6.67; 95% CI, 1.09–40.43, respectively). Moreover, the presence of either bilateral lung inflammation or pulmonary consolidation on chest imaging on admission was related with fatal outcome (OR = 7.00; 95%CI, 1.10–44.61). Finally, dynamic monitoring showed that lymphopenia was more significant in fatal group than in nonfatal group from day 11 to week five (P<0.05). The decrease in oxygenation indexes were observed in most cases and more significantly in fatal cases after week three (P<0.05), and the value of nearly all fatal cases were below 200 mmHg during our evaluation period.ConclusionsAmong cases with H7N9 virus infection, increased age accompanied by co-morbidities was the risk of death. The severity of lung infection at admission, the persistence of lymphocytopenia, and the extended duration of lower oxygenation index all contributed to worsened outcomes of patients with H7N9 virus infection.

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“…Infections (acute and chronic conditions) are often associated to comorbidity that increases the risk of medical conditions which can lead to further morbidity and mortality. Comorbidities related to flu have been recently investigated [51]. Comorbidities for tuberculosis have also been studied recently [52,53].…”

Section: Introductionmentioning

confidence: 99%

Network-based analysis of comorbidities risk during an infection: SARS and HIV case studies

2014

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BackgroundInfections are often associated to comorbidity that increases the risk of medical conditions which can lead to further morbidity and mortality. SARS is a threat which is similar to MERS virus, but the comorbidity is the key aspect to underline their different impacts. One UK doctor says "I’d rather have HIV than diabetes" as life expectancy among diabetes patients is lower than that of HIV. However, HIV has a comorbidity impact on the diabetes.ResultsWe present a quantitative framework to compare and explore comorbidity between diseases. By using neighbourhood based benchmark and topological methods, we have built comorbidity relationships network based on the OMIM and our identified significant genes. Then based on the gene expression, PPI and signalling pathways data, we investigate the comorbidity association of these 2 infective pathologies with other 7 diseases (heart failure, kidney disorder, breast cancer, neurodegenerative disorders, bone diseases, Type 1 and Type 2 diabetes). Phenotypic association is measured by calculating both the Relative Risk as the quantified measures of comorbidity tendency of two disease pairs and the ϕ-correlation to measure the robustness of the comorbidity associations. The differential gene expression profiling strongly suggests that the response of SARS affected patients seems to be mainly an innate inflammatory response and statistically dysregulates a large number of genes, pathways and PPIs subnetworks in different pathologies such as chronic heart failure (21 genes), breast cancer (16 genes) and bone diseases (11 genes). HIV-1 induces comorbidities relationship with many other diseases, particularly strong correlation with the neurological, cancer, metabolic and immunological diseases. Similar comorbidities risk is observed from the clinical information. Moreover, SARS and HIV infections dysregulate 4 genes (ANXA3, GNS, HIST1H1C, RASA3) and 3 genes (HBA1, TFRC, GHITM) respectively that affect the ageing process. It is notable that HIV and SARS similarly dysregulated 11 genes and 3 pathways. Only 4 significantly dysregulated genes are common between SARS-CoV and MERS-CoV, including NFKBIA that is a key regulator of immune responsiveness implicated in susceptibility to infectious and inflammatory diseases.ConclusionsOur method presents a ripe opportunity to use data-driven approaches for advancing our current knowledge on disease mechanism and predicting disease comorbidities in a quantitative way.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2105-15-333) contains supplementary material, which is available to authorized users.

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Weakened immunity in aged hosts with comorbidities as a risk factor for the emergence of influenza A H7N9 mutants

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Cited by 8 publications

References 12 publications

Analysis of factors affecting the prognosis of COVID-19 patients and viral shedding duration

Analysis of factors affecting the prognosis of COVID-19 patients and viral shedding duration

Epidemiological and Clinical Characteristics and Risk Factors for Death of Patients with Avian Influenza A H7N9 Virus Infection from Jiangsu Province, Eastern China

Network-based analysis of comorbidities risk during an infection: SARS and HIV case studies

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