scholarly journals Factors Associated With Fatality Due to Avian Influenza A(H7N9) Infection in China

2019 ◽  
Vol 71 (1) ◽  
pp. 128-132 ◽  
Author(s):  
Shufa Zheng ◽  
Qianda Zou ◽  
Xiaochen Wang ◽  
Jiaqi Bao ◽  
Fei Yu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Avian Influenza ◽  
Influenza A ◽  
Bacterial Infections ◽  
Neuraminidase Inhibitor ◽  
Inhibitor Therapy ◽  
H7n9 Virus ◽  
Factors Associated ◽  
Risk Of Death ◽  
Increased Risk

Abstract Background The high case fatality rate of influenza A(H7N9)-infected patients has been a major clinical concern. Methods To identify the common causes of death due to H7N9 as well as identify risk factors associated with the high inpatient mortality, we retrospectively collected clinical treatment information from 350 hospitalized human cases of H7N9 virus in mainland China during 2013–2017, of which 109 (31.1%) had died, and systematically analyzed the patients’ clinical characteristics and risk factors for death. Results The median age at time of infection was 57 years, whereas the median age at time of death was 61 years, significantly older than those who survived. In contrast to previous studies, we found nosocomial infections comprising Acinetobacter baumannii and Klebsiella most commonly associated with secondary bacterial infections, which was likely due to the high utilization of supportive therapies, including mechanical ventilation (52.6%), extracorporeal membrane oxygenation (14%), continuous renal replacement therapy (19.1%), and artificial liver therapy (9.7%). Age, time from illness onset to antiviral therapy initiation, and secondary bacterial infection were independent risk factors for death. Age >65 years, secondary bacterial infections, and initiation of neuraminidase-inhibitor therapy after 5 days from symptom onset were associated with increased risk of death. Conclusions Death among H7N9 virus–infected patients occurred rapidly after hospital admission, especially among older patients, followed by severe hypoxemia and multisystem organ failure. Our results show that early neuraminidase-inhibitor therapy and reduction of secondary bacterial infections can help reduce mortality. Characterization of 350 hospitalized avian influenza A(H7N9)-infected patients in China shows that age >65 years, secondary bacterial infections, and initiation of neuraminidase-inhibitor therapy after 5 days from symptom onset were associated with increased risk of death.

scholarly journals Factors associated with COVID-19 related hospitalisation, critical care admission and mortality using linked primary and secondary care data

2021 ◽  
Author(s):  
Lisa Cummins ◽  
Irene Ebyarimpa ◽  
Nathan Cheetham ◽  
Victoria Tzortziou Brown ◽  
Katie Brennan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Learning Disabilities ◽  
Secondary Care ◽  
Multivariate Logistic Regression Analysis ◽  
Additional Patient ◽  
Factors Associated ◽  
Icu Admission ◽  
Risk Of Death ◽  
North East ◽  
Increased Risk

AbstractBackgroundTo identify risk factors associated with increased risk of hospitalisation, intensive care unit (ICU) admission and mortality in inner North East London (NEL) during the first UK COVID-19 wave.MethodsMultivariate logistic regression analysis on linked primary and secondary care data from people aged 16 or older with confirmed COVID-19 infection between 01/02/2020-30/06/2020 determined odds ratios (OR), 95% confidence intervals (CI) and p-values for the association between demographic, deprivation and clinical factors with COVID-19 hospitalisation, ICU admission and mortality.ResultsOver the study period 1,781 people were diagnosed with COVID-19, of whom 1,195 (67%) were hospitalised, 152 (9%) admitted to ICU and 400 (23%) died. Results confirm previously identified risk factors: being male, or of Black or Asian ethnicity, or aged over 50. Obesity, type 2 diabetes and chronic kidney disease (CKD) increased the risk of hospitalisation. Obesity increased the risk of being admitted to ICU. Underlying CKD, stroke and dementia in-creased the risk of death. Having learning disabilities was strongly associated with increased risk of death (OR=4.75, 95%CI=(1.91,11.84), p=0.001). Having three or four co-morbidities increased the risk of hospitalisation (OR=2.34,95%CI=(1.55,3.54),p<0.001;OR=2.40, 95%CI=(1.55,3.73), p<0.001 respectively) and death (OR=2.61, 95%CI=(1.59,4.28), p<0.001;OR=4.07, 95% CI= (2.48,6.69), p<0.001 respectively).ConclusionsWe confirm that age, sex, ethnicity, obesity, CKD and diabetes are important determinants of risk of COVID-19 hospitalisation or death. For the first time, we also identify people with learning disabilities and multi-morbidity as additional patient cohorts that need to be actively protected during COVID-19 waves.

scholarly journals Risk factors associated with the severity of COVID-19 in a region of the Brazilian Amazon

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Daniele Melo Sardinha ◽  
Rosane do Socorro Pompeu de Loiola ◽  
Ana Lúcia da Silva Ferreira ◽  
Carmem Aliandra Freire de Sá ◽  
Yan Corrêa Rodrigues ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brazilian Amazon ◽  
The State ◽  
Metropolitan Region ◽  
Epidemiological Surveillance ◽  
Cross Sectional ◽  
Factors Associated ◽  
Risk Of Death ◽  
Increased Risk ◽  
Brazilian Amazon Region

AbstractThe Brazilian Northern region registered a high incidence of COVID-19 cases, particularly in the state of Pará. The present study investigated the risk factors associated with the severity of COVID-19 in a Brazilian Amazon region of 100,819 cases. An epidemiological, cross-sectional, analytical and demographic study, analyzing data on confirmed cases for COVID-19 available at the Brazilian Ministry of Health's surveillance platform, was conducted. Variables such as, municipalities of residence, age, gender, signs and symptoms, comorbidities were included and associated with COVID-19 cases and outcomes. The spatial distribution was performed using the ArcGIS program. A total of 100,819 cases were evaluated. Overall, patients had the mean age of 42.3 years, were female (51.2%) and with lethality reaching 4.79% of cases. Main symptoms included fever (66.5%), cough (61.9%) and sore throat (39.8%). Regarding comorbidities, most of the patients presented cardiovascular disease (5.1%) and diabetes (4.2%). Neurological disease increased risk of death by nearly 15 times, followed by obesity (5.16 times) and immunodeficiency (5.09 time). The municipalities with the highest incidence rate were Parauapebas, Canaã dos Carajás and Jacareacanga. Similarity between the Lower Amazon, Marajó and Southwest mesoregions of Pará state were observed concerning the highest morbidity rates. The obtained data demonstrated that the majority of cases occurred among young adults, females, with the classic influenza symptoms and chronic diseases. Finally, data suggest that the highest incidences were no longer in the metropolitan region of the state. The higher lethality rate than in Brazil may be associated with the greater impacts of the disease in this Amazonian population, or factors associated with fragile epidemiological surveillance in the notification of cases of cure.

scholarly journals Analysis of Risk Factors Determining Incidence and Outcome of Infections in Children and Adults after Hematopoietic Cell Transplantation

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 3364-3364
Author(s):  
Jan Styczynski ◽  
Krzysztof Czyzewski ◽  
Sebastian Giebel ◽  
Jowita Fraczkiewicz ◽  
Malgorzata Salamonowicz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Leukemia ◽  
Bacterial Infections ◽  
Acute Gvhd ◽  
Viral Infections ◽  
Chronic Gvhd ◽  
Multivariable Analysis ◽  
Risk Of Death ◽  
Increased Risk ◽  
Cmv Reactivation

Abstract BACKGROUND: Recent EBMT analysis showed that infections are responsible for 21% of deaths after allo-HCT and 11% after auto-HCT. However, the risk, types and outcome of infections vary between age groups. The aim of the study is the direct comparison of risk factors of incidence and outcome of infections in children and adults. PATIENTS AND METHODS: We analyzed risk factors for the incidence and outcome of bacterial, fungal, and viral infections in 650 children and 3200 adults who received HCT between 2012-2015. The risk factors were determined by multivariable logistic regression analysis. RESULTS: A total number of 395/650 (60.8%) children and 1122/3200 (35.0%) adults were diagnosed for microbiologically confirmed infection, including 345/499 (69.1%) and 679/1070 (63.5%), respectively after allo-HCT, and 50/151 (33.1%) and 443/2130 (20.8%) respectively, after auto-HCT. At 2 years after HCT, the incidences of microbiologically documented bacterial infection were 36.0% and 27.6%, (p<0.001) for children and adults, respectively. Incidences of proven/probable invasive fungal disease (IFD) were 8.4% and 3.7% (p<0.001), respectively; and incidences of viral infection were 38.3%, and 13.5% (p<0.001), respectively. Overall, 31/650 (4.8%) children and 206/3200 adults (6.4%) have died after these infections. The distribution of deaths was different in children (35.5% bacterial, 48.4% fungal, 16.1% viral) and adults (61.7% bacterial, 24.7% fungal, 13.6% viral). BACTERIAL INFECTIONS: In multivariable analysis, the risk of infections was higher after allo-HCT (HR=1.8; p<0.001). In allo-HCT patients, the risk was higher in children (HR=2.1; p<0.001), in patients with acute leukemia (HR=1.6; p<0.001), matched unrelated (MUD) vs matched family-donor (MFD) HCT (HR=1.6; p<0.001), mismatched unrelated (MMUD) vs MFD HCT (HR=2.0; p<0.001), myeloablative vs reduced-intensity conditioning (RIC) (HR=1.3; p<0.001), delayed (>21d) hematological recovery (HR=3.3; p<0.001), acute GVHD before infection (HR=1.7; p<0.001), and chronic GVHD before infection (HR=1.4; p=0.014). In auto-HCT patients, the risk was higher in children (HR=1.7; p<0.001), and in patients with delayed hematological recovery (HR=2.8; p<0.001). In patients with multiple myeloma (MM) the risk was decreased (HR=0.7; p=0.005). FUNGAL INFECTIONS: The risk of proven/probable IFD was higher after allo-HCT (HR=5.4; p<0.001). In allo-HCT patients, the risk was higher in children (HR=3.9; p<0.001), in patients with acute leukemia (HR=3.8; p<0.001), MUD vs MFD HCT (HR=1.5; p=0.013), MMUD vs MFD HCT (HR=2.5; p<0.001), delayed hematological recovery (HR=3.3; p<0.001), acute GVHD before infection (HR=1.5; p=0.021), and chronic GVHD before infection (HR=2.2; p<0.001). In auto-HCT patients, the risk was higher in children (HR=1.8; p=0.025). Patients with MM were at decreased risk of IFD (HR=0.6; p=0.005). VIRAL INFECTIONS: In multivariable analysis, the risk of infections was higher after allo-HCT (HR=6.1; p<0.001). In allo-HCT patients, the risk was higher in children (HR=1.3; p=0.010), in patients with acute leukemia (HR=1.7; p<0.001), MUD vs MFD HCT (HR=2.0; p<0.001), MMUD vs MFD HCT (HR=3.3; p<0.001), myeloablative vs RIC (HR=1.8; p=0.050), acute GVHD before infection (HR=1.5; p<0.001) and chronic GVHD before infection (HR=2.7; p=0.014). Among auto-HCT patients, diagnosis of MM brought decreased risk of viral infections (HR=0.5; p<0.001). DEATH FROM INFECTION: In allo-HCT patients, adults (HR=3.3; p<0.001), recipients of MMUD-HCT (HR=3.8; p<0.001), patients with acute leukemia (HR=1.5; p=0.023), chronic GVHD before infection (HR=3.6; p=0.014), CMV reactivation (HR=1.4; p=0.038) and with duration of infection treatment >21 days (HR=1.4; p=0.038) were associated with increased risk of death from infection. Among patients with bacterial infections, the risk was higher in G- infections (HR=1.6; p=0.031). Among auto-HCT patients, no child died of infection. In adults, the risk of death was higher if duration of treatment of infection was >21 days (HR=1.7; p<0.001). In patients with MM the risk was decreased (HR=0.4; p<0.001). CONCLUSIONS: The profile of infections and related deaths varies between children and adults. MMUD transplants, diagnosis of acute leukemia, chronic GVHD, CMV reactivation and prolonged infection are relative risk factors for death from infection after HCT. Disclosures Kalwak: Sanofi: Other: travel grants; medac: Other: travel grants.

scholarly journals Invasive pulmonary aspergillosis in immunocompetent patients hospitalised with influenza A-related pneumonia: a multicenter retrospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Liang Chen ◽  
Xiudi Han ◽  
Yanli Li ◽  
Chunxiao Zhang ◽  
Xiqian Xing
Keyword(s):  
Risk Factors ◽  
Influenza A ◽  
Invasive Pulmonary Aspergillosis ◽  
Neuraminidase Inhibitor ◽  
Teaching Hospitals ◽  
Multivariate Logistic Regression Model ◽  
Pulmonary Aspergillosis ◽  
Hospitalised Patients ◽  
Increased Risk ◽  
Immunocompetent Patients

Abstract Background Increasing cases of pulmonary aspergillosis (IPA) in immunocompetent patients with severe influenza have been reported. Howevere, the risk factors for occurence and death are largely unknown. Methods Data of hospitalised patients with influenza A-related pneumonia (FluA-p) obtained from five teaching hospitals from 2031 to 2018, were reviewed. Univariate and multivariate logistical regression analyses were performed to determine the risk factors involved in the acquisition and 60-day mortality in IPA patients. Results Of the 693 FluA-p patients included in the study, 3.0% (21/693) were IPA patients with a 60-day mortality of 42.9% (9/21). Adjusted for confounders, a Cox proportional hazard model showed that IPA was associated with increased risk for 60-day mortality [hazard ratio (HR) 4.336, 95% confidence interval (CI) 1.191–15.784, p = 0.026] in FluA-p patients. A multivariate logistic regression model confirmed that age (odd ratio (OR) 1.147, 95% CI 1.048–1.225, p = 0.003), systemic corticosteroids use before IPA diagnosis (OR 33.773, 95% CI 5.681–76.764, p <  0.001), leukocytes > 10 × 109/L (OR 1.988, 95% CI 1.028–6.454, p = 0.029) and lymphocytes < 0.8 × 109/L on admission (OR 34.813, 95% CI 1.676–73.006, p = 0.022), were related with the acquisition of IPA. Early neuraminidase inhibitor use (OR 0.290, 95% CI 0.002–0.584, p = 0.021) was associated with a decreased risk for a 60-day mortality in IPA patients. Conclusions Our results showed that IPA worsen the clinical outcomes of FluA-p patients. The risk factors for the acquisition and death were helpful for the clinicians in preventing and treating IPA.

scholarly journals Risk Factors Associated with Subclinical Human Infection with Avian Influenza A (H5N1) Virus—Cambodia, 2006

2009 ◽  
Vol 199 (12) ◽  
pp. 1744-1752 ◽  
Author(s):  
Sirenda Vong ◽  
Sowath Ly ◽  
Maria D. Van Kerkhove ◽  
Jenna Achenbach ◽  
Davun Holl ◽  
...  
Keyword(s):  
Risk Factors ◽  
Avian Influenza ◽  
Influenza A ◽  
H5n1 Virus ◽  
Human Infection ◽  
Factors Associated

scholarly journals Invasive pulmonary aspergillosis in immunocompetent patients hospitalised with influenza A-related pneumonia: a multicenter retrospective study

2020 ◽  
Author(s):  
Liang Chen ◽  
Xiudi Han ◽  
YanLi Li ◽  
Chunxiao Zhang ◽  
Xiqian Xing
Keyword(s):  
Risk Factors ◽  
Influenza A ◽  
Invasive Pulmonary Aspergillosis ◽  
Neuraminidase Inhibitor ◽  
Teaching Hospitals ◽  
Multivariate Logistic Regression Model ◽  
Pulmonary Aspergillosis ◽  
Hospitalised Patients ◽  
Increased Risk ◽  
Immunocompetent Patients

Abstract Background Increasing cases of pulmonary aspergillosis (IPA) in immunocompetent patients with severe influenza have been reported. Howevere, the risk factors for occurence and death are largely unknown.Methods Data of hospitalised patients with influenza A-related pneumonia (FluA-p) obtained from five teaching hospitals from 2031 to 2018, were reviewed. Univariate and multivariate logistical regression analyses were performed to determine the risk factors involved in the acquisition and 60-day mortality in IPA patients. Results Of the 693 FluA-p patients included in the study, 3.0% (21/693) were IPA patients with a 60-day mortality of 42.9% (9/21). Adjusted for confounders, a Cox proportional hazard model showed that IPA was associated with increased risk for 60-day mortality [hazard ratio ( HR) 4.336, 95% confidence interval (CI) 1.191-15.784, p = 0.026] in FluA-p patients. A multivariate logistic regression model confirmed that age (odd ratio ( OR) 1.147, 95% CI 1.048-1.225, p = 0.003), systemic corticosteroids use before IPA diagnosis ( OR 33.773, 95% CI 5.681-76.764, p < 0.001), leukocytes > 10×10 9 /L ( OR 1.988, 95% CI 1.028-6.454, p = 0.029) and lymphocytes < 0.8×10 9 /L on admission ( OR 34.813, 95% CI 1.676-73.006, p = 0.022), were related with the acquisition of IPA. Early neuraminidase inhibitor use ( OR 0.290, 95% CI 0.002-0.584, p = 0.021) was associated with a decreased risk for a 60-day mortality in IPA patients. Conclusions Our results showed that IPA worsen the clinical outcomes of FluA-p patients. The risk factors for the acquisition and death were helpful for the clinicians in preventing and treating IPA.

scholarly journals Factors Associated With Prolonged Viral Shedding in Patients With Avian Influenza A(H7N9) Virus Infection

2018 ◽  
Vol 217 (11) ◽  
pp. 1708-1717 ◽  
Author(s):  
Yeming Wang ◽  
Qiang Guo ◽  
Zheng Yan ◽  
Daming Zhou ◽  
Wei Zhang ◽  
...  
Keyword(s):  
Virus Infection ◽  
Avian Influenza ◽  
Influenza A ◽  
H7n9 Virus ◽  
Factors Associated ◽  
Viral Shedding

scholarly journals Prognostic assessment in palliative cancer care: is there a difference between adult and older patients?

2021 ◽  
Vol 15 ◽  
Author(s):  
Simone Garruth dos Santos Machado Sampaio ◽  
Livia Costa Oliveira ◽  
Karla Santos da Costa Rosa
Keyword(s):  
Risk Factors ◽  
Older People ◽  
Older Patients ◽  
Protective Factor ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Nutritional Risk ◽  
Factors Associated ◽  
Risk Of Death ◽  
Increased Risk

OBJECTIVE: To compare factors associated with death in adults and older people with advanced cancer who were hospitalized in a palliative care unit (PCU). METHODS: Case-control study with patients (adults vs older people) admitted to a PCU of National Cancer Institute José Alencar Gomes da Silva (INCA), in Rio de Janeiro, Brazil. Logistic regressions (odds ratio [OR] and 95% confidence interval [95%CI]) were used to identify factors associated with death. RESULTS: The study included 205 patients, most of which were aged over 60 years old (60.5%). Among the adult patients, a Karnofsky Performance Status ≤ 40% (OR 2.54 [95%CI 1.11–3.45]) and neutrophil-to-lymphocyte ratio (NLR) (OR 1.09 [95%CI 1.02–1.24]) were risk factors for death, while albumin (OR 0.30 [95%CI 0.12–0.78]) was a protective factor. Among older patients, NLR (OR: 1.13 [95%CI 1.02–1.24]), C-reactive protein (CRP) (OR 1.09 [95%CI 1.02–1.17]), modified Glasgow Prognostic Score (mGPS) 1 and 2 (OR 4.66 [95%CI 1.35–16.06]), CRP-to-albumin ratio (CAR) (OR 1.27 [95%CI 1.03–1.58]), and nutritional risk (OR 1.11 [95%CI 1.03–1.19]) were risk factors, whereas albumin (OR 0.23 [95%CI 0.09–0.57]) was a protective factor against death. CONCLUSIONS: Prognostic factors differed between groups. The NLR was a risk factor, and albumin was a protective factor regarding death in both groups. Additionally, CRP, mGPS, CAR, and nutritional risk were associated with an increased risk of death only among older people.

Identification of meteorological factors associated with human infection with avian influenza A H7N9 virus in Zhejiang Province, China

2018 ◽  
Vol 644 ◽  
pp. 696-709 ◽  
Author(s):  
Steven Yuk-Fai Lau ◽  
Xiaoxiao Wang ◽  
Maggie Wang ◽  
Shelan Liu ◽  
Benny Chung-Ying Zee ◽  
...  
Keyword(s):  
Avian Influenza ◽  
Influenza A ◽  
Meteorological Factors ◽  
Human Infection ◽  
Zhejiang Province ◽  
H7n9 Virus ◽  
Factors Associated

Case-control study of risk factors for human infection with avian influenza A(H7N9) virus in Shanghai, China, 2013

2014 ◽  
Vol 143 (9) ◽  
pp. 1826-1832 ◽  
Author(s):  
J. LI ◽  
J. CHEN ◽  
G. YANG ◽  
Y. X. ZHENG ◽  
S. H. MAO ◽  
...  
Keyword(s):  
Risk Factors ◽  
Avian Influenza ◽  
Influenza A ◽  
Case Control Study ◽  
Case Control ◽  
Human Infection ◽  
H7n9 Virus ◽  
Live Poultry ◽  
H7n9 Infection ◽  
Control Study

SUMMARYThe first human infection with avian influenza A(H7N9) virus was reported in Shanghai, China in March 2013. An additional 32 cases of human H7N9 infection were identified in the following months from March to April 2013 in Shanghai. Here we conducted a case-control study of the patients with H7N9 infection (n = 25) using controls matched by age, sex, and residence to determine risk factors for H7N9 infection. Our findings suggest that chronic disease and frequency of visiting a live poultry market (>10 times, or 1–9 times during the 2 weeks before illness onset) were likely to be significantly associated with H7N9 infection, with the odds ratios being 4·07 [95% confidence interval (CI) 1·32–12·56], 10·61 (95% CI 1·85–60·74), and 3·76 (95% CI 1·31–10·79), respectively. Effective strategies for live poultry market control should be reinforced and ongoing education of the public is warranted to promote behavioural changes that can help to eliminate direct or indirect contact with influenza A(H7N9) virus.

Sign in / Sign up

Export Citation Format

Share Document