Effect of immunomodulatory therapies in patients with pandemic influenza A (H1N1) 2009 complicated by pneumonia

详细信息    查看全文

• 作者：Diego Viasus^a ; José ; Ram&#xf3 ; n Pa&#xf1 ; o-Pardo^b ; Elisa Cordero^c ; Antoni Campins^d ; Francisco L&#xf3 ; pez-Medrano^e ; Aroa Villoslada^f ; Maria C. Fari&#xf1 ; as^g ; Asunci&#xf3 ; n Moreno^h ; Jes&#xfa ; s Rodrí ; guez-Ba&#xf1 ; oⁱ ; José ; Antonio Oteo^j ; Joaquí ; n Martí ; nez-Montauti^k ; Juliá ; n Torre-Cisneros^l ; Ferrá ; n Segura^m ; Jordi Carratalà ; ^a ; ^{jcarratala@ub.edu} ; for the Novel Influenza A (H1N1) Study Group of the Spanish Network for Research in Infectious Diseases (REIPI)
• 关键词：Immunomodulation ; Pandemic influenza A (H1N1) 2009 ; Pneumonia ; Intensive care unit ; Mortality
• 刊名：Journal of Infection
• 出版年：2011
• 出版时间：March 2011
• 年：2011
• 卷：62
• 期：3
• 页码：193-199
• 全文大小：185 K

文摘

Summary

Objective

To determine the effect of immunomodulatory therapies on the development of severe disease in hospitalized adults with laboratory-confirmed pandemic influenza A (H1N1) 2009 complicated by pneumonia.

Methods

Observational, prospective cohort study at thirteen tertiary hospitals in Spain. The use of corticosteroids, macrolides and statins was recorded. The outcome of interest was severe disease, defined as the composite of intensive care unit admission or death after the first day of hospitalization.

Results

Of the 197 patients with pandemic influenza A (H1N1) 2009 complicated by pneumonia, 68 (34.5 % ) received some anti-inflammatory therapy since hospital admission (corticosteroids in 37, macrolides in 31 and statins in 12). Severe disease occurred in 29 (14.7 % ) patients. After adjustment for confounding factors, immunomodulatory therapies as a group were not associated with a lower risk for developing severe disease (odds ratio [OR] 0.64; 95 % confidence interval [CI] 0.22–1.86). In a further a priori analysis, corticosteroids, macrolides and statins were included in a multivariate model. None of these therapies was found to be associated with a lower risk for developing severe disease.

Conclusions

Immunomodulatory therapies use since hospital admission did not prevent the development of severe disease in adults with pandemic influenza A (H1N1) 2009 complicated by pneumonia.