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Clinical manifestations of adult patients requiring influenza-associated hospitalization: a prospective multicenter cohort study in Japan via internet surveillance
  • +17
  • Tadashi Ishida,
  • Masafumi Seki,
  • Kazunori Oishi,
  • Kazuhiro Tateda,
  • Jiro Fujita,
  • Jun-ichi Kadota,
  • Akihiko Kawana,
  • Koichi Izumikawa,
  • Toshiaki Kikuchi,
  • Norio Ohmagari,
  • MItsuhiro Yamada,
  • Takaya Maruyama,
  • Takahiro Takazono,
  • Makoto Miki,
  • Yoshitsugu MIyazaki,
  • Yoshitaka Yamazaki,
  • Hiroshi Kakeya,
  • Kenji Ogawa,
  • Hideaki Nagai,
  • Akira Watanabe
Tadashi Ishida
Kurashiki Central Hospital
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Masafumi Seki
Tohoku Medical and Pharmaceutical University
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Kazunori Oishi
Toyama Institute of Health
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Kazuhiro Tateda
Toho University School of Medicine
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Jiro Fujita
University of the Ryukyus
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Jun-ichi Kadota
Nagasaki Harbor Medical Center
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Akihiko Kawana
National Defense Medical College
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Koichi Izumikawa
Nagasaki Unviersity Graduate School of Biomedical Sciences
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Toshiaki Kikuchi
Niigata University Graduate School of Medical and Dental Sciences
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Norio Ohmagari
National Center for Global Health and Medicine
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MItsuhiro Yamada
Tohoku University Graduate School of Medicine
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Takaya Maruyama
National Hospital Organization Mie National Hospital
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Takahiro Takazono
Nagasaki University Graduate School of Biomedical Sciences
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Makoto Miki
Japanese Red Cross Sendai Hospital
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Yoshitsugu MIyazaki
National Institute of Infectious Diseases
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Yoshitaka Yamazaki
Shinshu Medical Center
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Hiroshi Kakeya
Osaka City University Graduate School of Medicine
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Kenji Ogawa
National Hospital Organization HIgashinagoya National Hospital
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Hideaki Nagai
National Hospital Organization Tokyo National Hospital
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Akira Watanabe
Tohoku Bunka Gakuen University
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Abstract

Background: Influenza remains a clinically heavy burden worldwide. However, evidence about clinical manifestation has been lacking among severely ill patients infected with influenza. Methods: The clinical data for patients who were severely ill with influenza, and required hospitalization were gathered and analyzed between November 2014 and August 2019 (5 influenza seasons) using an internet-surveillance system. Results: A total of 924 patients were enrolled and analyzed. The median age was 78 years (IQR, 67-84), and the patients in the 2015-2016 season were significantly younger than those in other seasons. Pneumonia was the most common disease indicated as a cause for hospitalization, followed by a poor general condition and exacerbation of underlying respiratory diseases. Antiviral drugs were administered in 97.0% of the patients with peramivir being the most-frequently use antiviral. In-hospital death was recorded for 44 patients (4.8%). Multivariate analysis indicated that nursing home resident (OR: 6.554) and obesity (OR: 24.343) were independent predictors of in-hospital mortality. Conclusion: Complications of influenza infection remain a heavy burden especially among the elderly. Continuous nationwide surveillance will be required to grasp the actual situation of influenza epidemics.