Gender differences and influenza-associated mortality in hospitalized influenza A patients during the 2018/19 season
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ORIGINAL PAPER
Gender differences and influenza‑associated mortality in hospitalized influenza A patients during the 2018/19 season Mario Karolyi1 · E. Pawelka1 · H. Kelani2 · G. C. Funk3 · B. Lindner4 · C. Porpaczy4 · S. Publig3 · T. Seitz1 · M. Traugott1 · M. Unterweger5 · A. Zoufaly1 · C. Wenisch1 Received: 8 May 2020 / Accepted: 5 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background In this study we analyzed gender differences in the clinical presentation of patients with molecular confirmed influenza A. Additionally, we tried to identify predictors of influenza-associated mortality. Materials/methods In this prospective observational multi-center-study we included all influenza-positive patients ≥ 18 years who were hospitalized and treated on flu-isolation-wards in three hospitals in Vienna during the 2018/19 influenza season. Diagnoses were made via Cobas® Liat® POCT. Results 490 Patients (48.8% female) tested positive for influenza A. Female patients were older (median age 76 years vs. 70 years, p 75 years (OR 5.49, 95% CI 1.10–27.43), acute heart failure (OR 3.56, 95% CI 1.03–12.05) and ICU admission (OR 6.1, 95% CI 0.98–37.91) were predictors for in-hospital mortality for female patients, while any malignancy (OR 9.4, 95% CI 1.90–46.54) and ICU admission (OR 7.05, 95% CI 1.44–34.55) were predictors in male patients. Conclusions Gender is associated with differences in clinical presentation and complications of influenza A virus infection. Women with acute heart failure or aged > 75 years have an increased risk of influenza associated in-hospital mortality, while ICU admission and any malignancy are predictors for male patients. Mortality rates in patients > 75 years are 5–10 times higher compared to their non-hospitalized influenza-negative Austrian counterparts. Keywords Influenza · Flu · Mortality · 90-Day mortality · Predictors · Gender differences
Introduction
* Mario Karolyi [email protected] 1
Department for Infectious Diseases, Kaiser-Franz-JosefHospital (KFJ), Kundratstraße 3, 1100 Vienna, Austria
2
Medical University of Vienna (MUW), Vienna, Austria
3
Medical Department II and Karl‑Landsteiner Institute for Lung Research and Pulmonological Oncology, Wilheminen-Hospital (WSP), Vienna, Austria
4
Medical Department II, Center for Diagnosis and Treatment of Rheumatic Diseases, Hospital Hietzing, Vienna, Austria
5
Department for Anesthesia and Surgical Intensive Care, Kaiser-Franz-Josef-Hospital (KFJ), Vienna, Austria
Differences in epidemiology, clinical presentation and prognosis based on gender have been shown for various noninfectious [1–3] and infectious diseases [4–6]. During the 2009 influenza pandemic, young women of reproductive age had a higher risk of complications and worse outcome [7]. Japanese data from the influenza pandemics in 2005 and 2009 showed a gender difference regarding severely affected age groups: the risk for severe influenza peaked in male patients 80 years, while women aged 20–
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