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Abstract

Background

Timely treatment with neuraminidase inhibitors (NAI) can reduce severe outcomes in influenza patients.

Aim

We assessed the impact of antiviral treatment on in-hospital deaths of laboratory-confirmed influenza patients in 11 European Union countries from 2010/11 to 2019/20.

Methods

Case-based surveillance data from hospitalised patients with known age, sex, outcome, ward, vaccination status, timing of antiviral treatment, and hospitalisation were obtained. A mixed effect logistic regression model using country as random intercept was applied to estimate the adjusted odds ratio (aOR) for in-hospital death in patients treated with NAIs vs not treated.

Results

Of 19,937 patients, 31% received NAIs within 48 hours of hospital admission. Older age (60–79 years aOR 3.0, 95% CI: 2.4–3.8; 80 years 8.3 (6.6–10.5)) and intensive care unit admission (3.8, 95% CI: 3.4–4.2) increased risk of dying, while early hospital admission after symptom onset decreased risk (aOR 0.91, 95% CI: 0.90–0.93). NAI treatment initiation within 48 hours and up to 7 days reduced risk of dying (0–48 hours aOR 0.51, 95% CI: 0.45–0.59; 3–4 days 0.59 (0.51–0.67); 5–7 days 0.64 (0.56–0.74)), in particular in patients 40 years and older (e.g. treatment within 48 hours: 40–59 years aOR 0.43, 95% CI: 0.28–0.66; 60–79 years 0.50 (0.39–0.63); ≥80 years 0.51 (0.42–0.63)).

Conclusion

NAI treatment given within 48 hours and possibly up to 7 days after symptom onset reduced risk of in-hospital death. NAI treatment should be considered in older patients to prevent severe outcomes.

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2023-01-26
2024-12-25
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Effect of neuraminidase inhibitor (oseltamivir) treatment on outcome of hospitalised influenza patients, surveillance data from 11 EU countries, 2010 to 2020
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Cornelia+Adlhoch&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Adlhoch Cornelia</a>, <a href="/search?value1=Concepci%C3%B3n+Delgado-Sanz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Delgado-Sanz Concepción</a>, <a href="/search?value1=AnnaSara+Carnahan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Carnahan AnnaSara</a>, <a href="/search?value1=Amparo+Larrauri&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Larrauri Amparo</a>, <a href="/search?value1=Odette+Popovici&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Popovici Odette</a>, <a href="/search?value1=Nathalie+Bossuyt&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bossuyt Nathalie</a>, <a href="/search?value1=Isabelle+Thomas&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Thomas Isabelle</a>, <a href="/search?value1=Jan+Kyn%C4%8Dl&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kynčl Jan</a>, <a href="/search?value1=Pavel+Slezak&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Slezak Pavel</a>, <a href="/search?value1=Mia+Brytting&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Brytting Mia</a>, <a href="/search?value1=Raquel+Guiomar&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Guiomar Raquel</a>, <a href="/search?value1=Monika+Redlberger-Fritz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Redlberger-Fritz Monika</a>, <a href="/search?value1=Jackie+Maistre+Melillo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Maistre Melillo Jackie</a>, <a href="/search?value1=Tanya+Melillo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Melillo Tanya</a>, <a href="/search?value1=Arianne+B.+van+Gageldonk-Lafeber&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van Gageldonk-Lafeber Arianne B.</a>, <a href="/search?value1=Sierk+D.+Marbus&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Marbus Sierk D.</a>, <a href="/search?value1=Joan+O%E2%80%99Donnell&option1=author&noRedirect=true" class="nonDisambigAuthorLink">O’Donnell Joan</a>, <a href="/search?value1=Lisa+Domegan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Domegan Lisa</a>, <a href="/search?value1=Joana++Gomes+Dias&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gomes Dias Joana </a>, <a href="/search?value1=Sonja+J.+Olsen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Olsen Sonja J.</a></span>. Effect of neuraminidase inhibitor (oseltamivir) treatment on outcome of hospitalised influenza patients, surveillance data from 11 EU countries, 2010 to 2020. <a href="/content/ecdc">Euro Surveill.</a> 2023;28(4):pii=2200340. <a href="https://doi.org/10.2807/1560-7917.ES.2023.28.4.2200340" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2023.28.4.2200340</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 14 Apr 2022;&nbsp;&nbsp; <span class="generated">Accepted</span>: 29 Aug 2022 </span> </p>
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