Influenza virus and factors that are associated with ICU admission, pulmonary co-infections and ICU mortality

M. C. Beumer, R. M. Koch*, D. van Beuningen, A. M. OudeLashof, F. L. van de Veerdonk, E. Kolwijck, J. G. van der Hoeven, D. C. Bergmans, C. W. E. Hoedemaekers

*Corresponding author for this work

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Abstract

Purpose: While most influenza patients have a self-limited respiratory illness, 5-10% of hospitalized patients develop severe disease requiring ICU admission. The aim of this study was to identify influenza-specific factors associated with ICU admission and mortality. Furthermore, influenza-specific pulmonary bacterial, fungal and viral co-infections were investigated.

Methods: 199 influenza patients, admitted to two academic hospitals in the Netherlands between 01-10-2015 and 01-04-2016 were investigated of which 45/199 were admitted to the ICU.

Results: A history of Obstructive/Central Sleep Apnea Syndrome, myocardial infarction, dyspnea, influenza type A, BMI > 30, the development of renal failure and bacterial and fungal co-infections, were observed more frequently in patients who were admitted to the ICU, compared with patients at the normal ward. Co-infections were evident in 55.6% of ICU-admitted patients, compared with 20.1% of patients at the normal ward, mainly caused by Staphylococcus aureus, Streptococcus pneumoniae, and Aspergillus fumigatus. Non-survivors suffered from diabetes mellitus and (pre-existent) renal failure more often.

Conclusions: The current study indicates that a history of OSAS/CSAS, myocardial infarction and BMI> 30 might be related to ICU admission in influenza patients. Second. ICU patients develop more pulmonary co-infections. Last, (pre-existent) renal failure and diabetes mellitus are more often observed in non-survivors. (C) 2018 Elsevier Inc. All rights reserved.

Original languageEnglish
Pages (from-to)59-65
Number of pages7
JournalJournal of Critical Care
Volume50
DOIs
Publication statusPublished - Apr 2019

Keywords

  • Influenza virus
  • Co-infections
  • Bacterial
  • Fungal
  • Viral
  • ICU mortality
  • Risk factors
  • ICU admission
  • CRITICALLY-ILL PATIENTS
  • PANDEMIC INFLUENZA
  • INVASIVE ASPERGILLOSIS
  • BACTERIAL COINFECTION
  • A VIRUS
  • PNEUMONIA
  • INFECTION

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