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Effect of antiviral treatment in older patients hospitalized with confirmed influenza.
Antiviral Research ( IF 4.5 ) Pub Date : 2020-03-29 , DOI: 10.1016/j.antiviral.2020.104785
Núria Soldevila 1 , Diana Toledo 1 , Raúl Ortiz de Lejarazu 2 , Sonia Tamames 3 , Jesús Castilla 4 , Jenaro Astray 5 , Maria Amelia Fernández 6 , Vicente Martín 7 , Mikel Egurrola 8 , María Morales Suárez-Varela 9 , Àngela Domínguez 10 ,
Affiliation  

Seasonal influenza causes significant morbidity and mortality in people aged ≥65 years. Antiviral treatment can reduce complications and disease severity. The objective of this study was to investigate the effect of antiviral treatment in patients aged ≥65 years hospitalized with confirmed influenza in preventing intensive care unit (ICU) admission or death. A retrospective cohort study was carried out in 20 hospitals from seven Spanish regions during 2013-2015 in patients aged ≥65 years. Hospitalized cases of laboratory-confirmed influenza were selected. To assess the association between antiviral treatment and ICU admission or death, the adjusted odds ratios (aOR) and their 95% confidence intervals (CI) were calculated using multivariate logistic regression. We included 715 hospitalized patients, of whom 640 (87.9%) received antiviral treatment, 77 (10.8%) required ICU admission and 66 (9.2%) died. In the 64-74 years age group, receipt of antiviral treatment ≤48 h (aOR 0.20; 95% CI 0.04-0.89), 3-4 days (aOR 0.23; 95% CI 0.05-0.92) and 5-7 days (aOR 0.24; 95% CI 0.03-0.91) after clinical symptom onset was associated with reduced mortality. Receipt of treatment >7 days after symptom onset was not associated with reduced mortality. No association of antiviral treatment with reduced mortality was observed in the >74 years age group or with the prevention of ICU admission in any age group. Antiviral treatment had a protective effect in avoiding death in patients aged 65-74 years hospitalized due to influenza when administered ≤48 h after symptom onset and when no more than 7 days had elapsed.

中文翻译:

抗病毒治疗对确诊流感住院的老年患者的影响。

季节性流感在65岁以上的人群中会导致很大的发病率和死亡率。抗病毒治疗可以减少并发症和疾病严重程度。这项研究的目的是研究抗病毒治疗对≥65岁确诊流感住院患者在预防重症监护病房(ICU)入院或死亡中的作用。在2013-2015年期间,对西班牙七个地区的20家医院进行了一项回顾性队列研究,研究对象为65岁以上的患者。选择住院的实验室确诊流感病例。为了评估抗病毒治疗与ICU入院或死亡之间的关联,使用多元logistic回归计算调整后的优势比(aOR)及其95%置信区间(CI)。我们纳入715名住院患者,其中640(87.9%)名接受了抗病毒治疗,需要接受ICU的有77名(10.8%),有66名(9.2%)死亡。在64-74岁年龄组中,接受抗病毒治疗≤48小时(aOR 0.20; 95%CI 0.04-0.89),3-4天(aOR 0.23; 95%CI 0.05-0.92)和5-7天(aOR症状发作后0.24; 95%CI 0.03-0.91)与死亡率降低相关。症状发作后> 7天接受治疗与死亡率降低无关。在> 74​​岁年龄组中,未观察到抗病毒治疗与死亡率降低相关,在任何年龄组中,均未发现预防ICU入院。当症状发作后≤48h且不超过7天时,抗病毒治疗具有避免因流感住院的65-74岁患者死亡的保护作用。接受抗病毒治疗≤48小时(aOR 0.20; 95%CI 0.04-0.89),3-4天(aOR 0.23; 95%CI 0.05-0.92)和5-7天(aOR 0.24; 95%CI 0.03-0.91)临床症状发作后与死亡率降低相关。症状发作后> 7天接受治疗与死亡率降低无关。在> 74​​岁年龄组中,未观察到抗病毒治疗与死亡率降低相关,在任何年龄组中,均未发现预防ICU入院。当症状发作后≤48h且不超过7天时,抗病毒治疗具有避免因流感住院的65-74岁患者死亡的保护作用。接受抗病毒治疗≤48小时(aOR 0.20; 95%CI 0.04-0.89),3-4天(aOR 0.23; 95%CI 0.05-0.92)和5-7天(aOR 0.24; 95%CI 0.03-0.91)临床症状发作后与死亡率降低相关。症状发作后> 7天接受治疗与死亡率降低无关。在> 74​​岁年龄组中,未观察到抗病毒治疗与死亡率降低相关,在任何年龄组中,均未发现预防ICU入院。当症状发作后≤48h且不超过7天时,抗病毒治疗具有避免因流感住院的65-74岁患者死亡的保护作用。91)临床症状发作后与死亡率降低相关。症状发作后> 7天接受治疗与死亡率降低无关。在> 74​​岁年龄组中,未观察到抗病毒治疗与死亡率降低相关,在任何年龄组中,均未发现预防ICU入院。当症状发作后≤48h且不超过7天时,抗病毒治疗具有避免因流感住院的65-74岁患者死亡的保护作用。91)临床症状发作后与死亡率降低相关。症状发作后> 7天接受治疗与死亡率降低无关。在> 74​​岁年龄组中,未观察到抗病毒治疗与死亡率降低相关,在任何年龄组中,均未发现预防ICU入院。当症状发作后≤48h且不超过7天时,抗病毒治疗具有避免因流感住院的65-74岁患者死亡的保护作用。
更新日期:2020-04-20
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