Influenza virus and factors that are associated with ICU admission, pulmonary co-infections and ICU mortality

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Purpose:While most influenza patients have a self-limited respiratory illness, 5–10% of hospitalized patients develop severe disease requiring ICU admission. The aim of this study was to identify influenza-specific factors associated with ICU admission and mortality. Furthermore, influenza-specific pulmonary bacterial, fungal and viral co-infections were investigated.Methods:199 influenza patients, admitted to two academic hospitals in the Netherlands between 01–10–2015 and 01–04–2016 were investigated of which 45/199 were admitted to the ICU.Results:A history of Obstructive/Central Sleep Apnea Syndrome, myocardial infarction, dyspnea, influenza type A, BMI>30, the development of renal failure and bacterial and fungal co-infections, were observed more frequently in patients who were admitted to the ICU, compared with patients at the normal ward. Co-infections were evident in 55.6% of ICU-admitted patients, compared with 20.1% of patients at the normal ward, mainly caused by Staphylococcus aureus, Streptococcus pneumoniae, and Aspergillus fumigatus. Non-survivors suffered from diabetes mellitus and (pre-existent) renal failure more often.Conclusions:The current study indicates that a history of OSAS/CSAS, myocardial infarction and BMI>30 might be related to ICU admission in influenza patients. Second, ICU patients develop more pulmonary co-infections. Last, (pre-existent) renal failure and diabetes mellitus are more often observed in non-survivors.HIGHLIGHTSA history of OSAS/CSAS, myocardial infarction and BMI>30 are risk factors for ICU admission.Non-survivors suffer more often from diabetes mellitus and (pre-existent) renal failure.ICU patients develop renal failure and bacterial/fungal co-infections more often.

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