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Differences between asthmatics and non-asthmatics hospitalised with influenza A infection

Differences between asthmatics and non-asthmatics hospitalised with influenza A infection
Differences between asthmatics and non-asthmatics hospitalised with influenza A infection
Asthmatics hospitalised because of influenza A infection are less likely to require intensive care or die compared to non-asthmatics. Reasons for this are unknown.A retrospective analysis of data on 1,520 patients admitted to 75 UK hospitals with confirmed influenza A/H1N1 2009 infection. A multivariable model was used to investigate reasons for the association between asthma and severe outcomes (intensive care unit support or death).Asthmatics were less likely than non-asthmatics to have severe outcome (11.2% vs 19.8%, unadjusted OR 0.51, 95%CI 0.36 to 0.72) despite a greater proportion requiring oxygen on admission (36.4% vs 26%, unadjOR 1.63) and similar rates of pneumonia (17.1% vs 16.6%, unadjOR 1.04). The results of multivariable logistic regression suggest the association of asthma with outcome (adjOR 0.62, 95%CI 0.36 to 1.05, p=0.075) is explained by pre-admission inhaled corticosteroid use (adjOR 0.34, 95%CI 0.18 to 0.66) and earlier admission (?4 days from symptom onset) (adjOR 0.60, 95%CI 0.38 to 0.94). In asthmatics, systemic corticosteroids were associated with a decreased likelihood of severe outcomes (adjusted OR 0.36, 95% CI 0.18 to 0.72).Corticosteroid use and earlier hospital admission explained the association of asthma with less severe outcomes in hospitalised patients.
asthma, influenza, corticosteroids, prognosis, inhaled corticosteroid therapy, mortality in asthma
0903-1936
Myles, Puja
dc16699e-f0de-4fda-93a6-d21e94a69c87
Nguyen-Van-Tam, Jonathan S.
1aac2164-f614-4c82-87f9-e123817bf128
Semple, Malcolm G.
15b207df-e044-4078-9b40-1af17b800ab1
Brett, Stephen J.
24863e86-fb61-428d-bac6-b517912145b2
Bannister, Barbara
1e81bb1d-6896-4478-9b66-40081712072f
Read, Robert C.
b5caca7b-0063-438a-b703-7ecbb6fc2b51
Taylor, Bruce L.
c955af0e-2cfa-4a12-aadf-0178260e5b9d
McMenamin, Jim
c62f80f2-788d-4a1a-919b-129fe2707da0
Enstone, Joanne E.
1e6488d9-b4ac-4c9c-9cd8-dd66e663752f
Nicholson, Karl G.
27948033-015f-4e4f-a8ed-1df896b42b0a
Openshaw, Peter J.
5866e4d6-bb9f-46f5-a157-74722f2f82f5
Lim, Wei Shen
89d4ce8c-fbc7-4f56-940e-e4c6533af05d
Myles, Puja
dc16699e-f0de-4fda-93a6-d21e94a69c87
Nguyen-Van-Tam, Jonathan S.
1aac2164-f614-4c82-87f9-e123817bf128
Semple, Malcolm G.
15b207df-e044-4078-9b40-1af17b800ab1
Brett, Stephen J.
24863e86-fb61-428d-bac6-b517912145b2
Bannister, Barbara
1e81bb1d-6896-4478-9b66-40081712072f
Read, Robert C.
b5caca7b-0063-438a-b703-7ecbb6fc2b51
Taylor, Bruce L.
c955af0e-2cfa-4a12-aadf-0178260e5b9d
McMenamin, Jim
c62f80f2-788d-4a1a-919b-129fe2707da0
Enstone, Joanne E.
1e6488d9-b4ac-4c9c-9cd8-dd66e663752f
Nicholson, Karl G.
27948033-015f-4e4f-a8ed-1df896b42b0a
Openshaw, Peter J.
5866e4d6-bb9f-46f5-a157-74722f2f82f5
Lim, Wei Shen
89d4ce8c-fbc7-4f56-940e-e4c6533af05d

Myles, Puja, Nguyen-Van-Tam, Jonathan S., Semple, Malcolm G., Brett, Stephen J., Bannister, Barbara, Read, Robert C., Taylor, Bruce L., McMenamin, Jim, Enstone, Joanne E., Nicholson, Karl G., Openshaw, Peter J. and Lim, Wei Shen (2012) Differences between asthmatics and non-asthmatics hospitalised with influenza A infection. European Respiratory Journal. (doi:10.1183/09031936.00015512). (PMID:22903963)

Record type: Article

Abstract

Asthmatics hospitalised because of influenza A infection are less likely to require intensive care or die compared to non-asthmatics. Reasons for this are unknown.A retrospective analysis of data on 1,520 patients admitted to 75 UK hospitals with confirmed influenza A/H1N1 2009 infection. A multivariable model was used to investigate reasons for the association between asthma and severe outcomes (intensive care unit support or death).Asthmatics were less likely than non-asthmatics to have severe outcome (11.2% vs 19.8%, unadjusted OR 0.51, 95%CI 0.36 to 0.72) despite a greater proportion requiring oxygen on admission (36.4% vs 26%, unadjOR 1.63) and similar rates of pneumonia (17.1% vs 16.6%, unadjOR 1.04). The results of multivariable logistic regression suggest the association of asthma with outcome (adjOR 0.62, 95%CI 0.36 to 1.05, p=0.075) is explained by pre-admission inhaled corticosteroid use (adjOR 0.34, 95%CI 0.18 to 0.66) and earlier admission (?4 days from symptom onset) (adjOR 0.60, 95%CI 0.38 to 0.94). In asthmatics, systemic corticosteroids were associated with a decreased likelihood of severe outcomes (adjusted OR 0.36, 95% CI 0.18 to 0.72).Corticosteroid use and earlier hospital admission explained the association of asthma with less severe outcomes in hospitalised patients.

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More information

Published date: 16 August 2012
Keywords: asthma, influenza, corticosteroids, prognosis, inhaled corticosteroid therapy, mortality in asthma
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 346730
URI: http://eprints.soton.ac.uk/id/eprint/346730
ISSN: 0903-1936
PURE UUID: d52df1c1-0e2e-4773-8ba5-178d25ed1231
ORCID for Robert C. Read: ORCID iD orcid.org/0000-0002-4297-6728

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Date deposited: 16 Jan 2013 14:14
Last modified: 15 Mar 2024 03:42

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Contributors

Author: Puja Myles
Author: Jonathan S. Nguyen-Van-Tam
Author: Malcolm G. Semple
Author: Stephen J. Brett
Author: Barbara Bannister
Author: Robert C. Read ORCID iD
Author: Bruce L. Taylor
Author: Jim McMenamin
Author: Joanne E. Enstone
Author: Karl G. Nicholson
Author: Peter J. Openshaw
Author: Wei Shen Lim

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