Clinical manifestations of adult patients requiring influenza-associated hospitalization: A prospective multicenter cohort study in Japan via internet surveillance

Tadashi Ishida; Masafumi Seki; Kazunori Oishi; Kazuhiro Tateda; Jiro Fujita; Jun-Ichi Kadota; Akihiko Kawana; Koichi Izumikawa; Toshiaki Kikuchi; Norio Ohmagari; Mitsuhiro Yamada; Takaya Maruyama; Takahiro Takazono; Makoto Miki; Yoshitsugu Miyazaki; Yoshitaka Yamazaki; Hiroshi Kakeya; Kenji Ogawa; Hideaki Nagai; Akira Watanabe

doi:10.1016/j.jiac.2020.10.021

Clinical manifestations of adult patients requiring influenza-associated hospitalization: A prospective multicenter cohort study in Japan via internet surveillance

J Infect Chemother. 2021 Mar;27(3):480-485. doi: 10.1016/j.jiac.2020.10.021. Epub 2020 Nov 12.

Authors

Tadashi Ishida¹, Masafumi Seki², Kazunori Oishi³, Kazuhiro Tateda⁴, Jiro Fujita⁵, Jun-Ichi Kadota⁶, Akihiko Kawana⁷, Koichi Izumikawa⁸, Toshiaki Kikuchi⁹, Norio Ohmagari¹⁰, Mitsuhiro Yamada¹¹, Takaya Maruyama¹², Takahiro Takazono⁸, Makoto Miki¹³, Yoshitsugu Miyazaki¹⁴, Yoshitaka Yamazaki¹⁵, Hiroshi Kakeya¹⁶, Kenji Ogawa¹⁷, Hideaki Nagai¹⁸, Akira Watanabe¹⁹

Affiliations

¹ Department of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central Hospital, 1-1-1, Kurashiki, Okayama, 710-8602, Japan. Electronic address: ishidat@kchnet.or.jp.
² Department of Infectious Diseases, Tohoku Medical and Pharmaceutical University, 4-4-1, Komatsushima, Aobaku, Sendai, Miyagi, 981-8558, Japan.
³ Toyama Institute of Health, 17-1, Nakataikouyama, Imizu, Toyama, 939-0363, Japan.
⁴ Department of Microbiology and Infectious Diseases, Toho University, 5-21-6, Omorinishi, Ota-ku, Tokyo, 143-8540, Japan.
⁵ Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, 207 Azaujihara, Nisiharacho, Nakatou, Okinawa, 903-0215, Japan.
⁶ Nagasaki City Hospital Organization, Nagasaki Harbor Medical Center, 6-39, Shinchicho, Nagasaki, 850-8555, Japan.
⁷ Division of Infectious Diseases and Respiratory Medicine, National Defense Medical College, Namiki, Tokorozawa, Saitama, 359-8513, Japan.
⁸ Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan.
⁹ Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, 751, Ichibancho, Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan.
¹⁰ Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
¹¹ Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, 1-1, Seiryocho, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
¹² Department of Respiratory Medicine, National Hospital Organization Mie National Hospital, 357, Kubotacho, Osato, Tsu, Mie, 514-0125, Japan.
¹³ Department of Pulmonary and Respiratory Medicine, Japanese Red Cross Sendai Hospital, 2-43-3, Yamamotocho, Yagi, Taihaku-ku, Sendai, 982-8501, Japan.
¹⁴ Department of Chemotherapy and Mycoses, Leprosy Research Center, National Institute of Infectious Diseases, 1-23-1, Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
¹⁵ Division of Infectious Diseases, Shinsyu Medical Center, 1332, Suzaka, Nagano, 382-0091, Japan.
¹⁶ Department of Infectious Control Science, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.
¹⁷ Department of Respiratory Medicine, National Hospital Organization Higashinagoya National Hospital, 5-101, Umemorizaka, Higashi-ku, Nagoya, Aichi, 465-8620, Japan.
¹⁸ Department of Infectious Diseases, National Hospital Organization, Tokyo National Hospital, 3-1-1, Takeoka, Kiyose, Tokyo, 204-8585, Japan.
¹⁹ Division for Development of Anti-infective Agents, Faculty of Medical Science and Welfare, Tohoku Bunka Gakuen University, 6-45-1, Kunimi, Aoba-ku, Sendai, 981-8551, Japan.

PMID: 33189538
DOI: 10.1016/j.jiac.2020.10.021

Abstract

Introduction: Influenza remains a clinically heavy burden worldwide. The objective of this study was to clarify clinical manifestations of severely ill patients infected with influenza.

Methods: The clinical data for patients who were severely ill with influenza, and required hospitalization were gathered and analyzed between November 2014 and August 2019 (5 influenza seasons) using an internet-surveillance system.

Results: A total of 924 patients were enrolled and analyzed. The median age was 78 years (IQR, 67-84), and the patients in the 2015-2016 season were significantly younger than those in other seasons. Pneumonia was the most common disease indicated as a cause for hospitalization, followed by a poor general condition and exacerbation of underlying respiratory diseases. Antiviral drugs were administered in 97.0% of the patients with peramivir being the most-frequently use antiviral. In-hospital death was recorded for 44 patients (4.8%). Multivariate analysis indicated that nursing home resident (OR: 6.554) and obesity (OR: 24.343) were independent predictors of in-hospital mortality.

Conclusions: Complications of influenza infection remain a heavy burden especially among the elderly. Continuous nationwide surveillance will be required to grasp the actual situation of influenza epidemics. (UMIN000015989).

Keywords: Elderly; Hospitalization; Influenza; Internet-surveillance system; Mortality.

Publication types

Multicenter Study

MeSH terms

Adult
Aged
Hospital Mortality
Hospitalization
Humans
Influenza, Human* / drug therapy
Influenza, Human* / epidemiology
Internet
Japan / epidemiology
Prospective Studies
Seasons