Influenza in Malaysian adult patients hospitalized with community-acquired pneumonia, acute exacerbation of chronic obstructive pulmonary disease or asthma: A multicenter, active surveillance study
Document Type
Article
Publication Date
7-5-2021
Abstract
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 <= 10days before hospitalization. We estimated the rate of laboratory-confirmed influenza and associated complications over 13months (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.
Keywords
Influenza, Human, Hospitalization, Adults, Epidemiology, Influenza-like illness, Malaysia, Outcomes
Divisions
fac_med
Funders
Sanofi Pasteur
Publication Title
BMC Infectious Diseases
Volume
21
Issue
1
Publisher
BMC
Publisher Location
CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND