Effectiveness of Influenza Vaccination and Early Antiviral Treatment in Reducing Pneumonia Risk in Severe Influenza Cases

Overview

Journal Vaccines (Basel)

Date 2024 Feb 24

PMID 38400156

Authors

Pere Godoy

Nuria Soldevila

Ana Martinez

Sofia Godoy

Mireia Jane

Nuria Torner

Lesly Acosta

Cristina Rius

Angela Dominguez

The Surveillance Of Hospitalized Cases Of Severe Influenza In Catalonia Working Group

Affiliations

Soon will be listed here.

Abstract

Introduction: Influenza vaccination may be effective in preventing influenza infection and may reduce the risk of influenza-associated pneumonia. The study aim was to evaluate the effect of influenza vaccination in preventing pneumonia when it failed to prevent influenza hospitalization.

Methods: This was a case-control study comparing hospitalized cases of influenza with and without pneumonia in patients aged ≥18 years in 16 hospitals in Catalonia over 10 influenza seasons (2010-11 to 2019-20). Data on sociodemographic, virological characteristics, comorbidities, vaccination history, and antiviral treatment were collected and analysed. The crude odds ratio (OR) and adjusted OR (aOR) with the corresponding 95% confidence interval (CI) values were calculated.

Results: In total, 5080 patients hospitalized for severe influenza were included, 63.5% (3224/5080) of whom had pneumonia-mostly men (56.8%; 1830/3224) and mostly in the ≥75 age group (39.3%; 1267/3224)-and of whom 14.0% died (451/3224). Virus A and virus B accounted for 78.1% (2518/3224) and 21.9% (705/3224) of influenza types, respectively. Starting antiviral treatment ≤48 h after symptom onset (aOR = 0.69; 95%CI: 0.53-0.90) and a history of seasonal influenza vaccination (aOR = 0.85; 95%CI: 0.72-0.98) were protective factors in developing pneumonia.

Conclusions: Adherence to seasonal influenza vaccination and starting antiviral treatment within 48 h of symptom onset can reduce pneumonia risk in severe influenza cases.

References

Adlhoch C, Gomes Dias J, Bonmarin I, Hubert B, Larrauri A, Oliva Dominguez J . Determinants of Fatal Outcome in Patients Admitted to Intensive Care Units With Influenza, European Union 2009-2017. Open Forum Infect Dis. 2020; 6(11):ofz462. PMC: 7105050. DOI: 10.1093/ofid/ofz462. View

Iuliano A, Roguski K, Chang H, Muscatello D, Palekar R, Tempia S . Estimates of global seasonal influenza-associated respiratory mortality: a modelling study. Lancet. 2017; 391(10127):1285-1300. PMC: 5935243. DOI: 10.1016/S0140-6736(17)33293-2. View

Godoy P, Romero A, Soldevila N, Torner N, Jane M, Martinez A . Influenza vaccine effectiveness in reducing severe outcomes over six influenza seasons, a case-case analysis, Spain, 2010/11 to 2015/16. Euro Surveill. 2018; 23(43). PMC: 6208006. DOI: 10.2807/1560-7917.ES.2018.23.43.1700732. View

Castilla J, Guevara M, Martinez-Baz I, Ezpeleta C, Delfrade J, Irisarri F . Enhanced Estimates of the Influenza Vaccination Effect in Preventing Mortality: A Prospective Cohort Study. Medicine (Baltimore). 2015; 94(30):e1240. PMC: 4554121. DOI: 10.1097/MD.0000000000001240. View

Katzen J, Kohn R, Houk J, Ison M . Early Oseltamivir After Hospital Admission Is Associated With Shortened Hospitalization: A 5-Year Analysis of Oseltamivir Timing and Clinical Outcomes. Clin Infect Dis. 2018; 69(1):52-58. DOI: 10.1093/cid/ciy860. View

Musher D, Thorner A . Community-acquired pneumonia. N Engl J Med. 2014; 371(17):1619-28. DOI: 10.1056/NEJMra1312885. View

Venkatesan S, Myles P, Leonardi-Bee J, Muthuri S, Al Masri M, Andrews N . Impact of Outpatient Neuraminidase Inhibitor Treatment in Patients Infected With Influenza A(H1N1)pdm09 at High Risk of Hospitalization: An Individual Participant Data Metaanalysis. Clin Infect Dis. 2017; 64(10):1328-1334. PMC: 5411393. DOI: 10.1093/cid/cix127. View

Muthuri S, Venkatesan S, Myles P, Leonardi-Bee J, Al Khuwaitir T, Al Mamun A . Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data. Lancet Respir Med. 2014; 2(5):395-404. PMC: 6637757. DOI: 10.1016/S2213-2600(14)70041-4. View

Ono A, Okada F, Takata S, Hiramatsu K, Ando Y, Nakayama T . A comparative study of thin-section CT findings between seasonal influenza virus pneumonia and Streptococcus pneumoniae pneumonia. Br J Radiol. 2014; 87(1039):20140051. PMC: 4075588. DOI: 10.1259/bjr.20140051. View

10.

Adlhoch C, Delgado-Sanz C, Carnahan A, Larrauri A, Popovici O, Bossuyt N . Effect of neuraminidase inhibitor (oseltamivir) treatment on outcome of hospitalised influenza patients, surveillance data from 11 EU countries, 2010 to 2020. Euro Surveill. 2023; 28(4). PMC: 9881178. DOI: 10.2807/1560-7917.ES.2023.28.4.2200340. View

11.

Dominguez A, Romero-Tamarit A, Soldevila N, Godoy P, Jane M, Martinez A . Effectiveness of antiviral treatment in preventing death in severe hospitalised influenza cases over six seasons. Epidemiol Infect. 2018; 146(7):799-808. PMC: 9184950. DOI: 10.1017/S0950268818000663. View

12.

Jain S, Self W, Wunderink R, Fakhran S, Balk R, Bramley A . Community-Acquired Pneumonia Requiring Hospitalization among U.S. Adults. N Engl J Med. 2015; 373(5):415-27. PMC: 4728150. DOI: 10.1056/NEJMoa1500245. View

13.

Jones M, Hama R, Del Mar C . Antivirals for treatment of influenza. Ann Intern Med. 2012; 157(5):385. DOI: 10.7326/0003-4819-157-5-201209040-00016. View

14.

Mandell L . Community-acquired pneumonia: An overview. Postgrad Med. 2015; 127(6):607-15. PMC: 7103686. DOI: 10.1080/00325481.2015.1074030. View

15.

Van Kerkhove M, Cooper M, Cost A, Sanchez J, Riley S . Risk factors for severe outcomes among members of the United States military hospitalized with pneumonia and influenza, 2000-2012. Vaccine. 2015; 33(49):6970-6. PMC: 4822334. DOI: 10.1016/j.vaccine.2015.09.115. View

16.

Gomez-Gomez A, Magana-Aquino M, Bernal-Silva S, Araujo-Melendez J, Comas-Garcia A, Alonso-Zuniga E . Risk factors for severe influenza A-related pneumonia in adult cohort, Mexico, 2013-14. Emerg Infect Dis. 2014; 20(9):1554-8. PMC: 4178407. DOI: 10.3201/eid2009.140115. View

17.

Basile L, Torner N, Martinez A, Mosquera M, Marcos M, Jane M . Seasonal influenza surveillance: Observational study on the 2017-2018 season with predominant B influenza virus circulation. Vacunas. 2020; 20(2):53-59. PMC: 7140273. DOI: 10.1016/j.vacun.2019.09.003. View

18.

Tessmer A, Welte T, Schmidt-Ott R, Eberle S, Barten G, Suttorp N . Influenza vaccination is associated with reduced severity of community-acquired pneumonia. Eur Respir J. 2010; 38(1):147-53. DOI: 10.1183/09031936.00133510. View

19.

Alimi Y, Lim W, Lansbury L, Leonardi-Bee J, Nguyen-Van-Tam J . Systematic review of respiratory viral pathogens identified in adults with community-acquired pneumonia in Europe. J Clin Virol. 2017; 95:26-35. PMC: 7185624. DOI: 10.1016/j.jcv.2017.07.019. View

20.

Shah N, Greenberg J, McNulty M, Gregg K, Riddell 4th J, Mangino J . Bacterial and viral co-infections complicating severe influenza: Incidence and impact among 507 U.S. patients, 2013-14. J Clin Virol. 2016; 80:12-9. PMC: 7185824. DOI: 10.1016/j.jcv.2016.04.008. View