Timing of Influenza Antiviral Therapy and Risk of Death in Adults Hospitalized With Influenza-Associated Pneumonia, Influenza Hospitalization Surveillance Network (FluSurv-NET), 2012-2019.

Details

• Alternative Title:
  Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America, 2025, v. 80, no. 2: Timing of Influenza Antiviral Therapy and Risk of Death in Adults Hospitalized With Influenza-Associated Pneumonia, Influenza Hospitalization Surveillance Network (FluSurv-NET), 2012-2019.
• Journal Article:
  Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America
• Personal Author:
  Tenforde, Mark W. ; Noah, Kameela P. ; O'Halloran, Alissa C. ; Kirley, Pam Daily ; Hoover, Cora ; Alden, Nisha B. ; Armistead, Isaac ; Meek, James ; Yousey-Hindes, Kimberly ; Openo, Kyle P. ; Witt, Lucy S. ; Monroe, Maya L. ; Ryan, Patricia A. ; Falkowski, Anna ; Reeg, Libby ; Lynfield, Ruth ; McMahon, Melissa ; Hancock, Emily B. ; Hoffman, Marisa R. ; McGuire, Suzanne ; Spina, Nancy L. ; Felsen, Christina B. ; Gaitan, Maria A. ; Lung, Krista ; Shiltz, Eli ; Thomas, Ann ; Schaffner, William ; Talbot, H. Keipp ; Crossland, Melanie T. ; Price, Andrea ; Masalovich, Svetlana ; Adams, Katherine ; Holstein, Rachel ; Sundaresan, Devi ; Uyeki, Timothy M. ; Reed, Carrie ; Bozio, Catherine H. ; Garg, Shikha
• Description:
  Pneumonia is common in adults hospitalized with laboratory-confirmed influenza, but the association between timeliness of influenza antiviral treatment and severe clinical outcomes in patients with influenza-associated pneumonia is not well characterized.
  
  We included adults aged ≥18 years hospitalized with laboratory-confirmed influenza and a discharge diagnosis of pneumonia over 7 influenza seasons (2012-2019) sampled from a multistate population-based surveillance network. We evaluated 3 treatment groups based on timing of influenza antiviral initiation relative to admission date (day 0, day 1, days 2-5). Baseline characteristics and clinical outcomes were compared across groups using unweighted counts and weighted percentages accounting for the complex survey design. Logistic regression models were generated to evaluate the association between delayed treatment and 30-day all-cause mortality.
  
  A total of 26 233 adults were sampled in the analysis. Median age was 71 years and most (92.2%) had ≥1 non-immunocompromising condition. Overall, 60.9% started antiviral treatment on day 0, 29.5% on day 1, and 9.7% on days 2-5 (median, 2 days). Baseline characteristics were similar across groups. Thirty-day mortality occurred in 7.5%, 8.5%, and 10.2% of patients who started treatment on day 0, day 1, and days 2-5, respectively. Compared to those treated on day 0, adjusted odds ratio for death was 1.14 (95% confidence interval CI, 1.01-1.27) in those starting treatment on day 1 and 1.40 (95% CI, 1.17-1.66) in those starting on days 2-5.
  
  Delayed initiation of antiviral treatment in patients hospitalized with influenza-associated pneumonia was associated with higher risk of death, highlighting the importance of timely initiation of antiviral treatment at admission.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Influenza, Human
  • Antiviral Agents
  • Male
  • Female
  • Aged
  • Middle Aged
  • Hospitalization
  • Adult
  • Aged, 80 and over
  More +
• Keywords:
  • influenza
  • hospitalization
  • antiviral
  • oseltamivir
  • mortality
• Source:
  Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America, 2025, v. 80, no. 2
• DOI:
  https://doi.org/10.1093/cid/ciae427
• ISSN:
  1058-4838 ; 1537-6591
• Pubmed ID:
  39172994
• Pubmed Central ID:
  PMC11847407
• Document Type:
  Text
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; NU38OT000297-02-00/Council of State and Territorial Epidemiologists/ ; CK17-1701/CC/CDC HHSUnited States/
• Genre:
  Journal Article
• Pages in Document:
  461-468 (16 pdf pages)
• Volume:
  80
• Issue:
  2
• Download URL:
  https://stacks.cdc.gov/view/cdc/262044/cdc_262044_DS1.pdf
• File Type:
  [PDF - 578.59 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:cf2dfb20b6a9c3044afef40808668b7e0c41d063ebfa6ca3f216336e3fddfa62fb3ead0d2fdd80a75300e6d49169a7f163aff1beeb882d53946ae8dc68e976a1