Cent Eur J Public Health 2024, 32(3):155-159 | DOI: 10.21101/cejph.a7877

Course and complications of influenza A in seniors over 65 years of age

Dalibor Sedláček1, Robin Šín1, Patrik Christian Cmorej2, Miroslav Kubiska1
1 Department of Infectious Diseases and Travel Medicine, Faculty of Medicine in Pilsen and University Hospital Pilsen, Charles University, Pilsen, Czech Republic
2 Faculty of Health Studies, Jan Evangelista Purkyně University, Ústí nad Labem, Czech Republic

Objectives: Influenza A and B viruses cause epidemics every year, with approximately 3-5 million serious cases and about 290,000 to 650,000 deaths worldwide. Most patients die from bacterial complications of influenza. The aim of our study was to describe the clinical pictures of influenza and the development of the complications in seniors over 65 years of age, who were treated in University Hospital Pilsen. The course of the disease and changes in laboratory parameters were evaluated with regard to the method of treatment performed.

Methods: A descriptive retrospective study was performed. Clinical and laboratory data of seniors with the diagnosis of influenza were extracted from electronic medical records and later analysed. The data were processed with Excel 2016 and Statistica.

Results: A collection of 261 seniors, of whom 218 were hospitalized and 43 treated in an outpatient setting, has been studied. Patients who later developed complications had elevated values of CRP, procalcitonin, urea, and creatinine. The antiviral drug oseltamivir was administered to 226 of 261 seniors. Forty-seven seniors (18.0%) died from influenza and its complications (severe pneumonia with acute respiratory insufficiency or heart failure).

Conclusions: The course of influenza in seniors was usually more severe and required hospitalization along with antiviral treatment. The mortality rate in the monitored group exceeded 18%. Annual timely vaccination, but also other preventive measures, and maybe considering other risk groups are methods to prevent severe or even fatal cases of influenza.

Keywords: influenza, respiratory infections, seniors, complications, vaccination

Received: May 14, 2023; Revised: August 7, 2024; Accepted: August 7, 2024; Published: September 30, 2024  Show citation

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Sedláček D, Šín R, Cmorej PC, Kubiska M. Course and complications of influenza A in seniors over 65 years of age. Cent Eur J Public Health. 2024;32(3):155-159. doi: 10.21101/cejph.a7877. PubMed PMID: 39352089.
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    References

    1. Havlíčková M. [Influenza, its' variety, prophylaxis]. Pediatr Praxi. 2008;9(1):42-4. Czech.
    2. World Health Organization. Influenza (seasonal) [Internet]. Geneva: WHO; 2023 [cited 2023 Oct 3]. Available from: https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal).
    3. Paget J, Iuliano AD, Taylor RJ, Simonsen L, Viboud C, Spreeuwenberg P; Global Seasonal Influenza-associated Mortality Collaborator Network and GLaMOR Collaborating Teams. Estimates of mortality associated with seasonal influenza for the European Union from the GLaMOR project. Vaccine. 2022;40(9):1361-9. Go to original source... Go to PubMed...
    4. Zaraket H, Hurt AC, Clinch B, Barr I, Lee N. Burden of influenza B virus infection and considerations for clinical management. Antiviral Res. 2021 Jan:185:104970. doi: 10.1016/j.antiviral.2020.104970. Go to original source... Go to PubMed...
    5. Li L, Yan ZL, Luo L, Liu W, Yang Z, Shi C, et al. Influenza-associated excess mortality by age, sex, and subtype/lineage: population-based time-series study with a distributed-lag nonlinear model. JMIR Public Health Surveill. 2023 Jan 11;9:e42530. doi: 10.2196/42530. Go to original source... Go to PubMed...
    6. Hatzifoti C, Heath AW. Influenza in the elderly. In: Percival SL. Microbiology and aging: clinical manifestation. New York: Springer;2009. p. 113-30. Go to original source...
    7. Rolfes MA, Flannery B, Chung JR, O'Halloran A, Garg S, Belongia EA, et al. Effects of influenza vaccination in the United States during the 2017-2018 influenza season. Clin Infect Dis. 2019 Nov 13;69(11):1845-53. Go to original source... Go to PubMed...
    8. Shahid Z, Kleppinger A, Gentleman B, Falsey AR, McElhaney JE. Clinical and immunologic predictors of influenza illness among vaccinated older adults. Vaccine. 2010 Aug 31;28(38):6145-51. Go to original source... Go to PubMed...
    9. Lam PP, Coleman BL, Green K, Powis J, Richardson D, Katz K, et al. Predictors of influenza among older adults in the emergency department. BMC Infect Dis. 2016 Oct 28;16(1):615. doi: 10.1186/s12879-016-1966-4. Go to original source... Go to PubMed...
    10. Govaert TM, Dinant GJ, Aretz K, Knottnerus JA. The predictive value of influenza symptomatology in elderly people. Fam Pract. 1998 Feb;15(1):16-22. Go to original source... Go to PubMed...
    11. Walsh EE, Cox C, Flasey AR. Clinical features of influenza A virus infection in older hospitalized persons. J Am Geriatr Soc. 2002;50(9):1498-503. Go to original source... Go to PubMed...
    12. Coleman BL, Fadel SA, Fitzpatrick T, Thomas SM. Risk factors for serious outcomes associated with influenza illness in high- versus low- and middle-income countries: systematic literature review and meta-analysis. Influenza Other Respir Viruses. 2018;12(1):22-9. Go to original source... Go to PubMed...
    13. Chow EJ, Rolfes MA, O'Halloran A, Anderson EJ, Bennett NM, Billing L, et al. Acute cardiovascular events associated with influenza in hospitalized adults: a cross-sectional study. Ann Intern Med. 2020;173(8):605-13. Go to original source... Go to PubMed...
    14. Morens DM, Taubenberger JK, Fauci AS. Predominant role of bacterial pneumonia as a cause of death in pandemic influenza: implications for pandemic influenza preparedness. J Infect Dis. 2008;198(7):962-70. Go to original source... Go to PubMed...
    15. Ishiguro T, Kojima A, Shimizu T, Mita N, Kuroiwa S, Takayanagi N. Combined hemophagocytic syndrome and thrombotic microangiopathy due to mixed infection with influenza virus and pneumococcal pneumonia. Clin Case Rep. 2018 Nov 22;7(1):131-4. Go to original source... Go to PubMed...
    16. Dawood FS, Chaves SS, Perez A, Reingold A, Meek J, Farley MM, et al. Complications and associated bacterial coinfections among children hospitalized with seasonal or pandemic influenza, United States, 2003-2010. J Infect Dis. 2014;209(5):686-94. Go to original source... Go to PubMed...
    17. Bagshaw SM, Sood MM, Long J, Fowler RA, Adhikari NK; Canadian Critical Care Trials Group H1N1 Collaborative. Acute kidney injury among critically ill patients with pandemic H1N1 influenza A in Canada: cohort study. BMC Nephrol. 2013;14:123. doi: 10.1186/1471-2369-14-123. Go to original source... Go to PubMed...
    18. Zhang J, Wang J, Gong Y, Gu Y, Xiang Q, Tang LL. Interleukin-6 and granulocyte colony-stimulating factor as predictors of the prognosis of influenza-associated pneumonia. BMC Infect Dis. 2022;22(1):343. doi: 10.1186/s12879-022-07321-6. Go to original source... Go to PubMed...
    19. Tjendra Y, Al Mana AF, Espejo AP, Akgun Y, Millan NC, Gomez-Fernandez C, et al. Predicting disease severity and outcome in COVID-19 patients: a review of multiple biomarkers. Arch Pathol Lab Med. 2020 Dec 1;144(12):1465-74. Go to original source... Go to PubMed...
    20. Gao Y, Li T, Han M, Li X, Wu D, Xu Y, et al. Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19. J Med Virol. 2020;92(7):791-6. Go to original source... Go to PubMed...
    21. Šín R, Sedláček D, Cmorej PC, Kubiska M. Symptoms and complications of influenza a in the elderly upon arrival at the hospital. Am J Biomed Sci Res. 2022;17(4):454-9. Go to original source...
    22. Baz M, Abed Y, Papenburg J, Bouhy X, Hamelin ME, Boivin G. Emergence of oseltamivir-resistant pandemic H1N1 virus during prophylaxis. N Engl J Med. 2009;361(23):2296-7. Go to original source... Go to PubMed...
    23. Roussy JF, Abed Y, Bouhy X, Boivin G. Emergence of an oseltamivir-resistant influenza A/H3N2 virus in an elderly patient receiving a suboptimal dose of antiviral prophylaxis. J Clin Microbiol. 2013 Dec;51(12):4234-6. Go to original source... Go to PubMed...
    24. Han K, Ma H, An X, Su Y, Chen J, Lian Z, et al. Early use of glucocorticoids was a risk factor for critical disease and death from pH1N1 infection. Clin Infect Dis. 2011 Aug;53(4):326-33. Go to original source... Go to PubMed...
    25. Li H, Yang SG, Gu L, Zhang Y, Yan XX, Liang ZA, et al. National Influenza A(H1N1)pdm09 Clinical Investigation Group of China. Effect of low-to-moderate-dose corticosteroids on mortality of hospitalized adolescents and adults with influenza A(H1N1)pdm09 viral pneumonia. Influenza Other Respir Viruses. 2017 Jul;11(4):345-54. Go to original source... Go to PubMed...
    26. Linko R, Pettilä V, Ruokonen E, Varpula T, Karlsson S, Tenhunen J, et al.; FINNH1N1-Study Group. Corticosteroid therapy in intensive care unit patients with PCR-confirmed influenza A(H1N1) infection in Finland. Acta Anaesthesiol Scand. 2011 Sep;55(8):971-9. Go to original source... Go to PubMed...
    27. Lee N, Leo YS, Cao B, Chan PKS, Kyaw WM, Uyeki TM, et al. Neuraminidase inhibitors, superinfection and corticosteroids affect survival of influenza patients. Eur Respir J. 2015 Jun;45(6):1642-52. Go to original source... Go to PubMed...
    28. Lee N, Cockram CS, Chan PK, Hui DS, Choi KW, Sung JJ. Antiviral treatment for patients hospitalized with severe influenza infection may affect clinical outcomes. Clin Infect Dis. 2008 Apr 15;46(8):1323-4. Go to original source... Go to PubMed...
    29. Czech Vaccinology Society. [Recommendation of the Czech Vaccinology Society to influenza vaccination] [Internet]. CVS; 2003 [cited 2023 Jun 28]. Available from: https://www.vakcinace.eu/doporuceni-a-stanoviska/doporuceni-ceske-vakcinologicke-spolecnosti-cls-jep-k-ockovani-proti-chripce-3. Czech.
    30. Novotný P, Hedlová D. [Influenza and its complications]. Med Praxi. 2020;17(1):13-7. Czech. Go to original source...

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