Influenza in Malaysian adult patients hospitalized with community-acquired pneumonia, acute exacerbation of chronic obstructive pulmonary disease or asthma: a multicenter, active surveillance study

BMC Infectious Diseases

Yoke Fun Chan¹  Yoong Min Chong¹  Joanne Zhi Han Lau¹  Lilian Phei Lian Wang¹  I-Ching Sam¹  Mohd Arif Mohd Zim²  Ahmad Izuanuddin Ismail²  Aisya Natasya Musa²  Paras Doshi³  Kee Sing Ng³  Chee Loon Leong³  Jiunn Liang Tan⁴  Yong Kek Pang⁴  Mau Ern Poh⁴  Jean Khor⁵  Adelina Cheong⁵  Anne-Frieda Taurel⁶ 

[1] Department of Medical Microbiology, Faculty of Medicine, University Malaya, 50603, Kuala Lumpur, Malaysia;Department of Medicine, Faculty of Medicine, Universiti Teknologi Mara, Selayang Campus, Jalan Prima Selayang, Batu Caves, Selangor, Malaysia;Department of Medicine, Kuala Lumpur General Hospital, Jalan Pahang, 50586, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia;Department of Medicine, University Malaya Medical Centre, 59100, Kuala Lumpur, Malaysia;Medical Department, Sanofi Pasteur, Plaza 33, 46200, Petaling Jaya, Selangor, Malaysia;Vaccine Epidemiology and Modeling Department, Sanofi Pasteur, Singapore, Singapore;

关键词: Influenza;    Human;    Hospitalization;    Adults;    Epidemiology;    Influenza-like illness;    Malaysia;    Outcomes;   

DOI  :  10.1186/s12879-021-06360-9

来源: Springer

【 摘 要 】

BackgroundAvailable data on influenza burden across Southeast Asia are largely limited to pediatric populations, with inconsistent findings.MethodsWe conducted a multicenter, hospital-based active surveillance study of adults in Malaysia with community-acquired pneumonia (CAP), acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and acute exacerbation of asthma (AEBA), who had influenza-like illness ≤10 days before hospitalization. We estimated the rate of laboratory-confirmed influenza and associated complications over 13 months (July 2018–August 2019) and described the distribution of causative influenza strains. We evaluated predictors of laboratory-confirmed influenza and severe clinical outcomes using multivariate analysis.ResultsOf 1106 included patients, 114 (10.3%) were influenza-positive; most were influenza A (85.1%), with A/H1N1pdm09 being the predominant circulating strain during the study following a shift from A/H3N2 from January–February 2019 onwards. In multivariate analyses, an absence of comorbidities (none versus any comorbidity [OR (95%CI), 0.565 (0.329–0.970)], p = 0.038) and of dyspnea (0.544 (0.341–0.868)], p = 0.011) were associated with increased risk of influenza positivity. Overall, 184/1106 (16.6%) patients were admitted to intensive care or high-dependency units (ICU/HDU) (13.2% were influenza positive) and 26/1106 (2.4%) died (2.6% were influenza positive). Males were more likely to have a severe outcome (ICU/HDU admission or death).ConclusionsInfluenza was a significant contributor to hospitalizations associated with CAP, AECOPD and AEBA. However, it was not associated with ICU/HDU admission in this population.Study registration, NMRR ID: NMRR-17-889-35,174.

【 授权许可】

CC BY