Influenza in Malaysian adult patients hospitalized with community-acquired pneumonia, acute exacerbation of chronic obstructive pulmonary disease or asthma: A multicenter, active surveillance study
BackgroundAvailable data on influenza burden across Southeast Asia are largely limited to pediatric populations, with inconsistent findings.MethodsWe conducted a multicenter, hospital-based active surveillance study of adults in Malaysia with community-acquired pneumonia (CAP), acute exacerbation of...
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| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
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BMC
2021
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| Online Access: | http://eprints.um.edu.my/34647/ |
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| Summary: | BackgroundAvailable data on influenza burden across Southeast Asia are largely limited to pediatric populations, with inconsistent findings.MethodsWe conducted a multicenter, hospital-based active surveillance study of adults in Malaysia with community-acquired pneumonia (CAP), acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and acute exacerbation of asthma (AEBA), who had influenza-like illness <= 10days before hospitalization. We estimated the rate of laboratory-confirmed influenza and associated complications over 13months (July 2018-August 2019) and described the distribution of causative influenza strains. We evaluated predictors of laboratory-confirmed influenza and severe clinical outcomes using multivariate analysis.ResultsOf 1106 included patients, 114 (10.3%) were influenza-positive; most were influenza A (85.1%), with A/H1N1pdm09 being the predominant circulating strain during the study following a shift from A/H3N2 from January-February 2019 onwards. In multivariate analyses, an absence of comorbidities (none versus any comorbidity OR (95%CI), 0.565 (0.329-0.970)], p =0.038) and of dyspnea (0.544 (0.341-0.868)], p =0.011) were associated with increased risk of influenza positivity. Overall, 184/1106 (16.6%) patients were admitted to intensive care or high-dependency units (ICU/HDU) (13.2% were influenza positive) and 26/1106 (2.4%) died (2.6% were influenza positive). Males were more likely to have a severe outcome (ICU/HDU admission or death).ConclusionsInfluenza was a significant contributor to hospitalizations associated with CAP, AECOPD and AEBA. However, it was not associated with ICU/HDU admission in this population.Study registration, NMRR ID: NMRR-17-889-35,174. |
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