Search

Your search keyword '"Mayo‐Montero, Elga"' showing total 27 results
Start Over Author "Mayo‐Montero, Elga"
27 results on '"Mayo‐Montero, Elga"'

5. Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: an individual participant data meta-analysis

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P., Araújo, Wildo N., Azziz Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M., Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L., Hoeger, Peter H., Hoffmann, Matthias, Xiaoyun, Hu, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo Montero, Elga, Mcgeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skrȩt Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, Nguyen Van Tam, Jonathan S, de Lourdes Aguiar Oliveira, Maria, Al Khuwaitir, Tarig S. A., Al Masri, Malakita, Amin, Robed, Ballester Orcal, Elena, Bao, Jing, Basher, Ariful, Bautista, Edgar, Bertisch, Barbara, Bettinger, Julie, Booy, Robert, Bouza, Emilio, Bozkurt, Ilkay, Burgmann, Heinz, Čeljuska Tošev, Elvira, Chan, Kenny K. C., Chen, Yusheng, Chinbayar, Tserendorj, Cilloniz, Catia, Cox, Rebecca J., Sarrouf, Elena B., Cui, Wei, Dashti Khavidaki, Simin, Bin, Du, El Rhaffouli, Hicham, Escobar, Hernan, Florek Michalska, Agnieszka, Gerrard, John, Gormley, Stuart, Götberg, Sandra, Honarvar, Behnam, Jianming, Hu, Kemen, Christoph, Koay, Evelyn S. C., Kojic, Miroslav, Kudo, Koichiro, Kyaw, Win M., Leibovici, Leonard, Xiao li, Li, Hongru, Li, Libster, Romina, Loh, Tze P., Macbeth, Deborough, Maltezos, Efstratios, Marcone, Debora N., Marczynska, Magdalena, Mastalir, Fabiane P., Mickiene, Aukse, Moghadami, Mohsen, Moriconi, Lilian, Oliva, Maria E., Pečavar, Blaž, Poliquin, Philippe G., Rahman, Mahmudur, Rascon Pacheco, Alberto, Refaey, Samir, Schweiger, Brunhilde, Seale, Anna C., Sertogullarindan, Bunyamin, Smith, Fang G., Somer, Ayper, Souza, Thiago M. L., Stephan, Frank, Tabarsi, Payam, Tripathi, C. B., Viasus, Diego, Qin, Yu, Zhang, Wei, Zuo, Wei, Universitat de Barcelona, Ospedale 'Santa Maria della Misericordia' = University Hospital 'Santa Maria della Misericordia', Institut de Veille Sanitaire (INVS), Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Diseases, Department of physics, engineering physics and astronomy, Queen's University [Kingston, Canada], Peking University People's Hospital, Processus Infectieux en Milieu Insulaire Tropical (PIMIT), Centre National de la Recherche Scientifique (CNRS)-IRD-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de La Réunion (UR), National Perinatal Epidemiology Unit, University of Oxford [Oxford], Instituto Nacional de Enfermedades Respiratorias Dr. Emilio Coni [Santa Fe, Argentina] (INER), State Key Laboratory of Advanced Electromagnetic Engineering and Technology, Huazhong University of Science and Technology [Wuhan] (HUST), People's Hospital of Peking University (PKUPH), Université de La Réunion (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IRD-Centre National de la Recherche Scientifique (CNRS), University of Oxford, Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P., Araújo, Wildo N., Azziz Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlo, Barhoush, Mazen M., Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Fraser, Jame, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L., Hoeger, Peter H., Hoffmann, Matthia, Xiaoyun, Hu, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idri, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee Sin, Linko, Rita, Liu, Pei, Madanat, Fari, Manabe, Toshie, Mayo Montero, Elga, Mcgeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skrȩt Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelie, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, Nguyen Van Tam, Jonathan S, de Lourdes Aguiar Oliveira, Maria, Al Khuwaitir, Tarig S. A., Al Masri, Malakita, Amin, Robed, Ballester Orcal, Elena, Bao, Jing, Basher, Ariful, Bautista, Edgar, Bertisch, Barbara, Bettinger, Julie, Booy, Robert, Bouza, Emilio, Bozkurt, Ilkay, Burgmann, Heinz, Čeljuska Tošev, Elvira, Chan, Kenny K. C., Chen, Yusheng, Chinbayar, Tserendorj, Cilloniz, Catia, Cox, Rebecca J., Sarrouf, Elena B., Cui, Wei, Dashti Khavidaki, Simin, Bin, Du, El Rhaffouli, Hicham, Escobar, Hernan, Florek Michalska, Agnieszka, Gerrard, John, Gormley, Stuart, Götberg, Sandra, Honarvar, Behnam, Jianming, Hu, Kemen, Christoph, Koay, Evelyn S. C., Kojic, Miroslav, Kudo, Koichiro, Kyaw, Win M., Leibovici, Leonard, Xiao li, Li, Hongru, Li, Libster, Romina, Loh, Tze P., Macbeth, Deborough, Maltezos, Efstratio, Marcone, Debora N., Marczynska, Magdalena, Mastalir, Fabiane P., Mickiene, Aukse, Moghadami, Mohsen, Moriconi, Lilian, Oliva, Maria E., Pečavar, Blaž, Poliquin, Philippe G., Rahman, Mahmudur, Rascon Pacheco, Alberto, Refaey, Samir, Schweiger, Brunhilde, Seale, Anna C., Sertogullarindan, Bunyamin, Smith, Fang G., Somer, Ayper, Souza, Thiago M. L., Stephan, Frank, Tabarsi, Payam, Tripathi, C. B., Viasus, Diego, Qin, Yu, Zhang, Wei, Zuo, Wei, Pediatric surgery, and ICaR - Circulation and metabolism

Subjects
Hospitalisation, Individual participant data meta-analyses, Influenza-related pneumonia, Neuraminidase inhibitors, Adolescent, Adrenal Cortex Hormones, Adult, Anti-Bacterial Agents, Antiviral Agents, Child, Child, Preschool, Enzyme Inhibitors, Female, Humans, Influenza, Human, Male, Middle Aged, Neuraminidase, Odds Ratio, Pneumonia, Viral, Treatment Outcome, Young Adult, Influenza A Virus, H1N1 Subtype, 0301 basic medicine, Epidemiology, [SDV]Life Sciences [q-bio], viruses, Meta-análises de dados de participantes individuais, Antibiotics, Pneumònia, Adrenal Cortex Hormone, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit, influenza-related pneumonia, neuraminidase inhibitors, 0302 clinical medicine, individual participant data meta‐analyses, Influenza A Virus, Enzyme Inhibitor, 030212 general & internal medicine, Viral, Incidence (epidemiology), Inibidores da neuraminidase, virus diseases, 3. Good health, Hospitalization, Infectious Diseases, Meta-analysis, Original Article, Individual participant data meta-analyse, Public Health, Human, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Antagonists & inhibitors, medicine.drug_class, influenza-related pneumonia, 030106 microbiology, influenza‐related pneumonia, Neuraminidase inhibitor, Ingressos i altes en els hospitals, Public Health, Environmental and Occupational Health, 03 medical and health sciences, Open Access, Pneumonia relacionada à gripe, Pharmacotherapy, Internal medicine, Anti-Bacterial Agent, medicine, H1N1 Subtype, Preschool, Antiviral Agent, Hospitalização, Hospital admission and discharge, business.industry, Environmental and Occupational Health, individual participant data meta-analyses, Original Articles, Odds ratio, Pneumonia, medicine.disease, Influenza, respiratory tract diseases, El Niño, Immunology, business
Abstract

Stella G. Muthuri,1 Sudhir Venkatesan,1 Puja R. Myles,1 Jo Leonardi-Bee,1 Wei Shen Lim,2 Abdullah Al Mamun,3 Ashish P. Anovadiya,4 Wildo N. Ara ujo,5 Eduardo Azziz-Baumgartner,6 Clarisa B aez,7 Carlos Bantar,8 Mazen M. Barhoush,9 Matteo Bassetti,10 Bojana Beovic,11 Roland Bingisser,12 Isabelle Bonmarin,13 Victor H. Borja-Aburto,14 Bin Cao,15 Jordi Carratala,16 Mar ıa R. Cuezzo,17 Justin T. Denholm,18 Samuel R. Dominguez,19 Pericles A. D. Duarte,20 Gal Dubnov-Raz,21 Marcela Echavarria,22 Sergio Fanella,23 James Fraser,24 Zhancheng Gao,25 Patrick G erardin,26,27,28,29 Maddalena Giannella,30 Sophie Gubbels,31 Jethro Herberg,32 Anjarath L. Higuera Iglesias,33 Peter H. Hoeger,34 Matthias Hoffmann,35 Xiaoyun Hu,36 Quazi T. Islam,37 Mirela F. Jim enez,38 Amr Kandeel,39 Gerben Keijzers,40 Hossein Khalili,41 Gulam Khandaker,42 Marian Knight,43 Gabriela Kusznierz,44 Ilija Kuzman,45 Arthur M. C. Kwan,46 Idriss Lahlou Amine,47 Eduard Langenegger,48 Kamran B. Lankarani,49 Yee-Sin Leo,50 Rita Linko,51 Pei Liu,52 Faris Madanat,53 Toshie Manabe,54 Elga Mayo-Montero,55 Allison McGeer,56 Ziad A. Memish,57,58 Gokhan Metan,59 Dragan Miki c,60 Kristin G. I. Mohn,61,62 Ahmadreza Moradi,63,64 Pagbajabyn Nymadawa,65 Bulent Ozbay,66 Mehpare Ozkan,67 Dhruv Parekh,68 Mical Paul,69 Wolfgang Poeppl,70 Fernando P. Polack,71,72 Barbara A. Rath,73 Alejandro H. Rodr ıguez,74 Marilda M. Siqueira,75 Joanna Skre zt-Magierło,76 Ewa Talarek,77 Julian W. Tang,78,79,80 Antoni Torres,81 Selda H. T€ or€un,82 Dat Tran,83 Timothy M. Uyeki,84 Annelies van Zwol,85 Wendy Vaudry,86 Daiva Velyvyte,87 Tjasa Vidmar,88 Paul Zarogoulidis,89 PRIDE Consortium Investigators* Jonathan S. Nguyen-Van-Tam1 1Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK. 2Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK. 3International Centre for Diarrhoeal Diseases, Research Bangladesh (ICDDRB), Dhaka, Bangladesh. 4Department of Pharmacology, Government Medical College and Sir Takhtsinhji General Hospital, Bhavnagar, Gujarat, India. 5University of Bras ılia, Bras ılia, DF, Brazil. 6Centers for Disease Control and Prevention, Atlanta, GA, USA. 7Ministerio de Salud de la Provincia de Buenos Aires, Buenos Aires, Argentina. 8Department of Infection Control, Hospital San Mart ın de Paran a, Entre R ıos, Argentina. 9Department of Medicine, King Saud Medical City, Riyadh, Saudi Arabia. 10Santa Maria Misericordia Hospital, Udine, Italy. 11Department of Infectious Diseases, University Medical Centre, Ljubljana, Slovenia. 12Department of Emergency Medicine, University Hospital Basel, Basel, Switzerland. 13Institut de Veille Sanitaire, Saint-Maurice, France. 14Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico. 15Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China. 16Department of Infectious Diseases, Hospital Universitari de Bellvitge, Bellvitge Institute for Biomedical Research, L’Hospitalet de Llobregat, Red Espa~nola de Investigaci on en Patolog ıa Infecciosa, University of Barcelona, Barcelona, Spain. 17Ministerio de Salud de Tucum an, Tucum an, Argentina. 18Victorian Infectious Diseases Service and Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, Parkville, Vic., Australia. 19Department of Pediatric Infectious Diseases, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA. 20Universidade Estadual do Oeste do Parana ´, UNIOESTE, Cascavel, PR, Brazil. 21The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel-Hashomer, Israel. 22Clinical Virology Laboratory, CEMIC University Hospital, Buenos Aires, Argentina. 23Section of Pediatric Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada. 24Paediatric Intensive Care Unit, Bristol Children’s Hospital, Bristol, UK. 25Department of Respiratory & Critical Care Medicine, Peking University People’s Hospital, Beijing, China. 26NICU/PICU, PFME, CHU Saint Pierre, Saint Pierre, La R eunion, France. 27CIC 1410 (CHU/Inserm/University of La Re ´union/URML-OI), CHU Saint Pierre, Saint Pierre, La Réunion, France. 28UMR PIMIT (CHU/Inserm/University of La Re ´union/IRD/CNRS), CYROI, Saint Denis – Reunion Island, Saint Denis, France. 29NICU/PICU CHU of La Re ´union, Groupe Hospitalier Sud Re ´union, Saint Pierre, La Re ´union, France. 30Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Maran ˜o ´n, Madrid, Spain. 31Department of Infectious Disease Epidemiology, Sector for National Health Documentation and Research, Statens Serum Institut, Copenhagen, Denmark. 32Section of Paediatrics, Division of Infectious Disease, Imperial College, London, UK. 33Epidemiology Research Unit, Instituto Nacional de Enfermedades Respiratorias, Ismael Cosı ´o Villegas, Mexico City, Mexico. 34Cath. Children’s Hospital Wilhelmstift, Hamburg, Germany. 35Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital St. Gallen, St. Gallen, Switzerland. 36Peking Union Medical College Hospital, Beijing, China. 37Dhaka Medical College Hospital, Dhaka, Bangladesh. 38Departamento de Ginecologia e Obstetrı ´cia – UFCSPA, Preceptora da Reside ˆncia Me ´dica do Hospital Fe ˆmina, Porto Alegre, Brazil. 39Ministry of Health in Egypt, Cairo, Egypt. 40Gold Coast Hospital, Gold Coast, Qld, Australia. 41Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. 42National Centre for Immunisation Research and Surveillance (NCIRS), The Children’s Hospital at Westmead, University of Sydney, Sydney, NSW, Australia. 43National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. 44National Institute of Respiratory Diseases ‘Emilio Coni’ ANLIS “C. Malbran”, Santa Fe, Argentina. 45School of Medicine, University Hospital for Infectious Diseases, University of Zagreb, Zagreb, Croatia. 46Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong. 47Faculty of Medicine and Pharmacy, Mohammed V Military Teaching Hospital, Biosafety Level 3 and Research Laboratory, University Mohammed V-Souissi, Rabat, Morocco. 48Department of Obstetrics and Gynaecology, Stellenbosch University and Tygerberg, Stellenbosch, South Africa. 49Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. 50Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore. 51Helsinki University Hospital, Helsinki, Finland. 52Department of Infectious Diseases, The First Affiliated Hospital, China Medical University, Shenyang, China. 53Department of Pediatrics, King Hussein Cancer Center, Amman, Jordan. 54Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan. 55Instituto de Medicina Preventiva de la Defensa, Capitan Medico Ramon y Cajal (IMPDEF), Ministerio de Defensa, Madrid, Spain. 56Toronto Invasive Bacterial Diseases Network, University of Toronto, Toronto, ON, Canada. 57Ministry of Health, Riyadh, Saudi Arabia. 58College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. 59Department of Infectious Diseases and Clinical Microbiology, Erciyes University Faculty of Medicine, Kayseri, Turkey. 60Military Medical Academy, Clinic for Infectious and Tropical Diseases, Belgrade, Serbia. 61Section for Infectious Diseases, Medical Department, and Department of Research and Development, Haukeland University Hospital, Bergen, Norway. 62Department of Clinical Science, The Influenza Centre, University of Bergen, Bergen, Norway. 63The Division of Ocular Immunology, Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 64National Research Institute for Tuberculosis and Lung Disease, Massih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 65National Influenza Center, National Center of Communicable Diseases, Ministry of Health, Ulaanbaatar, Mongolia. 66Department of Pulmonary and Critical Care, Yuzuncu Yil University Medical Faculty, Van, Turkey. 67Clinic of Pediatric Neurology, Dr. Sami Ulus Research and Training Hospital of Women’s and Children’s Health and Diseases, Ankara, Turkey. 68Critical Care and Pain Perioperative, Critical Care and Trauma Trials Group, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK. 69Division of Infectious Diseases, Rambam Health Care Campus, Haifa, Israel. 70Medical University of Vienna, Vienna, Austria. 71Department of Pediatrics, Vanderbilt Vaccine Center, Vanderbilt University, Nashville, TN, USA. 72Fundacion INFANT, Buenos Aires, Argentina. 73Division of Pneumonology-Immunology, Department of Pediatrics, Charite ´ University Medical Center, Berlin, Germany. 74Critical Care Department, Hospital Joan XXIII, IISPV, URV, CIBERES, Tarragona, Spain. 75Laboratory of Respiratory Viruses, Oswaldo Cruz Institute/Fiocruz, Rio de Janeiro, Brazil. 76Uniwersytet Rzeszowski, Rzeszo ´w, Poland. 77Department of Children’s Infectious Diseases, Medical University of Warsaw, Warsaw, Poland. 78Division of Microbiology/Molecular Diagnostic Centre, Department of Laboratory Medicine, National University Hospital, Singapore, Singapore. 79Alberta Provincial Laboratory for Public Health, University of Alberta Hospital, Edmonton, Canada. 80Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada. 81Hospital Clinic, University of Barcelona, IDIBAPS, CIBERES, Barcelona, Spain. 82Department of Pediatric Infectious Diseases, Istanbul Medical Faculty, Istanbul, Turkey. 83Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Canada. 84Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. 85Department of Pediatric Intensive Care, VU University Medical Center, Amsterdam, The Netherlands. 86Division of Infectious Diseases, Department of Pediatrics, Stollery Children’s Hospital, University of Alberta, Edmonton, AB, Canada. 87Lithuanian University of Health Sciences, Kaunas, Lithuania. 88General Hospital, Slovenj Gradec, Slovenia. 89Unit of Infectious Diseases, University General Hospital of Alexandroupolis, Democritus University Thrace, Dragana, Greece. Correspondence: Jonathan S. Nguyen-Van-Tam, University of Nottingham, City Hospital, DM, Room A28b, Clinical Sciences Building, Nottingham NG5 1PB, UK. E-mail: jvt@nottingham.ac.uk *List of PRIDE Consortium Investigators are in Appendix 1. For affiliations, please see Table S1. Múltipla - ver em notas Background The impact of neuraminidase inhibitors (NAIs) on influenza-related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1) pdm09 virus infection. Methods A worldwide meta-analysis of individual participant data from 20 634 hospitalised patients with laboratory-confirmed A (H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) ‘pandemic influenza’. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. Results Of 20 634 included participants, 5978 (29 0%) had IRP; conversely, 3349 (16 2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0 83 (95% CI 0 64–1 06; P = 0 136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0 72 (0 44–1 17; P = 0 180)] or likelihood of requiring ventilatory support [adj. OR = 1 17 (0 71– 1 92; P = 0 537)], but early treatment versus later significantly reduced mortality [adj. OR = 0 70 (0 55–0 88; P = 0 003)] and likelihood of requiring ventilatory support [adj. OR = 0 68 (0 54– 0 85; P = 0 001)]. Conclusions Early NAI treatment of patients hospitalised with A (H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.

Published
2016
Full Text
View/download PDF

6. Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: an IPD meta-analysis

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Mamun, Abdullah Al, Anovadiya, Ashish P., Araújo, Wildo N., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M., Bassetti, Matteo, Beović, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja-Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L., Hoeger, Peter H., Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt-Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan S.

Abstract

BACKGROUND: The impact of neuraminidase inhibitors (NAIs) on Influenza-related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. ----- METHODS: A worldwide meta-analysis of individual participant data (IPD) from 20,634 hospitalised patients with laboratory confirmed A(H1N1)pdm09 (n=20,021) or clinically diagnosed (n=613) 'pandemic influenza'. The primary outcome was radiologically confirmed influenza-related pneumonia (IRP). Odds ratios (OR) were estimated using generalized linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. ----- RESULTS: Among 20,634 included participants, 5,978 (29.0%) had IRP; conversely, 3,349 (16.2%) had confirmed absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0.83 (95%CI 0.64 - 1.06; p=0.136)]. Among the 5,978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR=0.72 (0.44-1.17; p=0.180)] or likelihood of requiring ventilatory support [adj. OR=1.17 (0.71-1.92; p=0.537)]; but early treatment versus later significantly reduced mortality [adj. OR=0.70 (0.55-0.88; p=0.003)] and likelihood of requiring ventilatory support [adj. OR=0.68 (0.54-0.85; p=0.001)]. ----- CONCLUSIONS: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.

Published
2015
Full Text
View/download PDF

7. Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Miki?, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skr?t-Magier?o, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan

Abstract

Neuraminidase inhibitors were widely used during the 2009/10 influenza A H1N1 pandemic, but evidence for their effectiveness in reducing mortality is uncertain. We did a meta-analysis of individual participant data to investigate the association between use of neuraminidase inhibitors and mortality in patients admitted to hospital with pandemic influenza A H1N1pdm09 virus infection. We assembled data for patients (all ages) admitted to hospital worldwide with laboratory confirmed or clinically diagnosed pandemic influenza A H1N1pdm09 virus infection. We identified potential data contributors from an earlier systematic review of reported studies addressing the same research question. In our systematic review, eligible studies were done between March 1, 2009 (Mexico), or April 1, 2009 (rest of the world), until the WHO declaration of the end of the pandemic (Aug 10, 2010); however, we continued to receive data up to March 14, 2011, from ongoing studies. We did a meta-analysis of individual participant data to assess the association between neuraminidase inhibitor treatment and mortality (primary outcome), adjusting for both treatment propensity and potential confounders, using generalised linear mixed modelling. We assessed the association with time to treatment using time-dependent Cox regression shared frailty modelling. We included data for 29?234 patients from 78 studies of patients admitted to hospital between Jan 2, 2009, and March 14, 2011. Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk (adjusted odds ratio [OR] 0·81; 95% CI 0·70?0·93; p=0·0024). Compared with later treatment, early treatment (within 2 days of symptom onset) was associated with a reduction in mortality risk (adjusted OR 0·48; 95% CI 0·41?0·56; p

Published
2014

8. Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: an individual participant data meta-analysis

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S. A., Al Mamun, Adbullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. H., Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Amine, Idriss L., Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Auksė, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K. W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T. C., Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan S., Département des maladies infectieuses, Institut de Veille Sanitaire (INVS), Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Diseases, Peking University People's Hospital, Réanimation médicale néonatale et pédiatrique, CHR la Reunion site Sud, CIC régional épidémiologie clinique/essais cliniques - Ile de la Réunion (CIC-EC), Institut National de la Santé et de la Recherche Médicale (INSERM), Processus Infectieux en Milieu Insulaire Tropical (PIMIT), Centre National de la Recherche Scientifique (CNRS)-IRD-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de La Réunion (UR), Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), National Perinatal Epidemiology Unit, University of Oxford [Oxford], People's Hospital of Peking University (PKUPH), Université de La Réunion (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IRD-Centre National de la Recherche Scientifique (CNRS), and University of Oxford

Subjects
[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology
Abstract

International audience; Background: Neuraminidase inhibitors were widely used during the 2009–10 influenza A H1N1 pandemic, but evidence for their effectiveness in reducing mortality is uncertain. We did a meta-analysis of individual participant data to investigate the association between use of neuraminidase inhibitors and mortality in patients admitted to hospital with pandemic influenza A H1N1pdm09 virus infection.Methods: We assembled data for patients (all ages) admitted to hospital worldwide with laboratory confirmed or clinically diagnosed pandemic influenza A H1N1pdm09 virus infection. We identified potential data contributors from an earlier systematic review of reported studies addressing the same research question. In our systematic review, eligible studies were done between March 1, 2009 (Mexico), or April 1, 2009 (rest of the world), until the WHO declaration of the end of the pandemic (Aug 10, 2010); however, we continued to receive data up to March 14, 2011, from ongoing studies. We did a meta-analysis of individual participant data to assess the association between neuraminidase inhibitor treatment and mortality (primary outcome), adjusting for both treatment propensity and potential confounders, using generalised linear mixed modelling. We assessed the association with time to treatment using time-dependent Cox regression shared frailty modelling.Findings: We included data for 29 234 patients from 78 studies of patients admitted to hospital between Jan 2, 2009, and March 14, 2011. Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk (adjusted odds ratio [OR] 0·81; 95% CI 0·70–0·93; p=0·0024). Compared with later treatment, early treatment (within 2 days of symptom onset) was associated with a reduction in mortality risk (adjusted OR 0·48; 95% CI 0·41–0·56; p

Published
2014
Full Text
View/download PDF

9. Evolución de las coberturas vacunales antigripales entre 1993-2001 en España: Análisis por Comunidades Autónomas

Author

Mayo Montero, Elga, Hernandez Barrera, Valentin, Sierra Moros, Maria Jose, Pachon Del Amo, Isabel, Carrasco Garrido, Pilar, Gil Miguel, Angel, and Rodrigo Jimenez Garcia

Subjects
Vacunas, Gripe, Immunizations Coverage, Encuestas de salud, Coberturas vacunales, Health Surveys, Influenza
Abstract

Fundamento: La gripe es una enfermedad con una elevada morbilidad y que ocasiona un alto coste sanitario, para la que además se dispone de una vacuna eficaz. El objetivo de este trabajo es evaluar la evolución de las coberturas vacunales antigripales en España por Comunidades Autónomas entre 1993 y 2001. Métodos: Se han analizado un total de 42.123 registros de la Encuesta Nacional de Salud (ENS) de los años 1993 (n=21.051) y 2001(n=21.072). Todos ellos corresponden a adultos españoles mayores de 15 años no institucionalizados. Ambas encuestas son representativas a nivel de Comunidad Autónoma. Resultados: Para el total de la muestra se estima una cobertura vacunal en 1993 de 17,94% (IC 95% 17,42-18,46) y de 19,30% (18,77-19,83) en 2001. En el modelo de regresión logística, ajustado por edad, género y enfermedad crónica asociada, se observan mejoras significativas en las coberturas del grupo de mayores de 64 años (OR= 1,28 IC 95% 1,10-1,50) para el total de España y para cinco de las 17 Comunidades Autónomas entre 1993 y 2001. Sin embargo, no encontramos cambios significativos en las coberturas para el grupo de menores de 65 años con enfermedad crónica asociada que supone una indicación para la vacunación. Conclusiones: Tanto en España como en la mayoría de las Comunidades Autónomas entre 1993 y 2001 se observa una ligera pero insuficiente mejoría en las coberturas de vacunación en los grupos de riesgo estudiados. Las Comunidades Autónomas muestran coberturas dispares entre sí. Los sujetos menores de 65 años con enfermedades crónicas asociadas que incrementan el riesgo de sufrir las complicaciones de la gripe no han mejorado las coberturas de esta vacuna durante el periodo de estudio. La dificultad para mejorar las coberturas en este tipo de pacientes podría hacernos considerar la opción y el beneficio potencial de rebajar la edad limite de las actuales recomendaciones de indicación de vacuna antigripal en España. Background: Influenza (flu) is a disease involving a high morbidity which takes a high toll on healthcare costs for which there is an effective vaccine available. This study is aimed at evaluating the evolution of the different degrees of influenza vaccine (flu shot) coverage in Spain by Autonomous Communities during the 1993-2001 period. Methods: A total of 42,123 cases from the National Health Survey (NHS) for the years 1993 (n=21,051) and 2001(n=21,072) were analysed, all of which corresponded to non-institutionalised Spanish adults over 15 years of age. Both surveys are representative at the Autonomous Community level. Results: For the total sample, a vaccine coverage of 17.94% (CI 95% 17.42-18.46) in 1993 and of 19.30% (18.77-19.83) en 2001 was estimated. In the logic regression model, adjusted by age, sex and related chronic disease, significant improvements were found in the degrees of coverage of individuals over 64 years of age (OR = 1.28 CI 95% 1.10-1.50) for Spain as a whole and for five of the seventeen Autonomous Communities between 1993 and 2001. However, no significant changes were found in the degrees of coverage for the group under age 65 with related chronic disease entailing an indication for being administered the vaccine. Conclusions: A slight yet insufficient improvement in the degrees of coverage among the high-risk groups studied were found to exist both nation-wide in Spain as a whole as well as in the majority of the Autonomous Communities between 1993 and 2001. Degrees of coverage varied greatly among Autonomous Communities. The individual under age 65 with related chronic diseases heightening the risks of suffering from flu-related complications have not improved their degrees of coverage regarding this vaccine during the period studied. The difficulty involved in improving the degrees of coverage among this type of patients might lead us to consider the alternative and potential benefit of lowering the age limit of the current influenza vaccine (flu shot) indication-related recommendations in Spain.

Published
2004

10. Brote de gripe pandémica (H1N1) 2009 en una academia militar: inicio de la circulación comunitaria en España

Author

Ballester Orcal, Elena, Piñeyroa Sierra, Antonio Joaquín, Fé Marqués, Antonio, Santa Olalla Peralta, P., Sierra Moros, Mª José, Mayo Montero, Elga, Ballester Orcal, Elena, Piñeyroa Sierra, Antonio Joaquín, Fé Marqués, Antonio, Santa Olalla Peralta, P., Sierra Moros, Mª José, and Mayo Montero, Elga

Abstract

Fundamento: El 19 de mayo de 2009 se declararon 21 casos de soldados con síntomas de infección respiratoria aguda en la Academia Militar de Ingenieros (ACING) en Hoyo de Manzanares, España. En el contexto de una alerta mundial por gripe A(H1N1) 2009, se decide investigar la posible aparición de un brote por este virus. El objetivo es describir un posible brote de gripe (H1N1) 2009 en un Centro de Formación Militar y describir las medidas adoptadas, en la fase de contención, para evitar su transmisión. Métodos: Se administró un cuestionario específico y se recogieron muestras biológicas a todos los casos en investigación. Se recomendaron aislamiento y cuarentena, respectivamente de los casos y contactos. Resultados: Se confirmaron 81 casos de infección por virus de la gripe A (H1N1)2009. De las 52 muestras procesadas 31 fueron positivas para virus influenza A/California/7/2009. La edad media de los casos fue 22,0 años (rango, 18-31). El 84% eran varones. Los síntomas más comunes fueron tos y fiebre. Todos los casos permanecieron aislados y fueron tratados con oseltamivir, con buena evolución. La tasa de ataque global fue 12,42%. Ningún caso tenía antecedentes de viaje a zonas de riesgo o vinculo epidemiológico con un caso diagnosticado previamente fuera de la ACING. Se identificaron 31 casos relacionados con este brote fuera de la ACING, 24 casos eran contactos familiares y amigos. Conclusiones: Este brote alertó del inicio de la circulación comunitaria del virus pandémico en España. La detección precoz del mismo favoreció la puesta en marcha de medidas para la contención de su trasmisión.

Published
2010

11. Brote de gripe pandémica (H1N1) 2009 en una academia militar: inicio de la circulación comunitaria en España

Author

Ballester Orcal, L.E., Piñeyroa Sierra, Antonio Joaquín, Fé Marqués, Antonio, Santa Olalla Peralta, P., Sierra Moros, Mª José, Mayo Montero, Elga, Ballester Orcal, L.E., Piñeyroa Sierra, Antonio Joaquín, Fé Marqués, Antonio, Santa Olalla Peralta, P., Sierra Moros, Mª José, and Mayo Montero, Elga

Abstract

Fundamento: El 19 de mayo de 2009 se declararon 21 casos de soldados con síntomas de infección respiratoria aguda en la Academia Militar de Ingenieros (ACING) en Hoyo de Manzanares, España. En el contexto de una alerta mundial por gripe A(H1N1) 2009, se decide investigar la posible aparición de un brote por este virus. El objetivo es describir un posible brote de gripe (H1N1) 2009 en un Centro de Formación Militar y describir las medidas adoptadas, en la fase de contención, para evitar su transmisión. Métodos: Se administró un cuestionario específico y se recogieron muestras biológicas a todos los casos en investigación. Se recomendaron aislamiento y cuarentena, respectivamente de los casos y contactos. Resultados: Se confirmaron 81 casos de infección por virus de la gripe A (H1N1)2009. De las 52 muestras procesadas 31 fueron positivas para virus influenza A/California/7/2009. La edad media de los casos fue 22,0 años (rango, 18-31). El 84% eran varones. Los síntomas más comunes fueron tos y fiebre. Todos los casos permanecieron aislados y fueron tratados con oseltamivir, con buena evolución. La tasa de ataque global fue 12,42%. Ningún caso tenía antecedentes de viaje a zonas de riesgo o vinculo epidemiológico con un caso diagnosticado previamente fuera de la ACING. Se identificaron 31 casos relacionados con este brote fuera de la ACING, 24 casos eran contactos familiares y amigos. Conclusiones: Este brote alertó del inicio de la circulación comunitaria del virus pandémico en España. La detección precoz del mismo favoreció la puesta en marcha de medidas para la contención de su trasmisión.

Published
2010

14. Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09‐related pneumonia: an individual participant data meta‐analysis

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P, Araújo, Wildo N, Azziz‐Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M, Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja‐Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T, Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov‐Raz, Gal, Echavarria,, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L, Hoeger, Peter H, Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T, Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili,, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee‐Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo‐Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P, Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt‐Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan S., Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P, Araújo, Wildo N, Azziz‐Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M, Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja‐Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T, Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov‐Raz, Gal, Echavarria,, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L, Hoeger, Peter H, Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T, Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili,, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee‐Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo‐Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P, Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt‐Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan S.

Abstract

BACKGROUND: The impact of neuraminidase inhibitors (NAIs) on influenza‐related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. METHODS: A worldwide meta‐analysis of individual participant data from 20 634 hospitalised patients with laboratory‐confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) ‘pandemic influenza’. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. RESULTS: Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64–1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44–1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71–1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55–0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54–0·85; P = 0·001)]. CONCLUSIONS: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.

Full Text
View/download PDF

15. Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikić, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan, Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikić, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan

Abstract

Neuraminidase inhibitors were widely used during the 2009/10 influenza A H1N1 pandemic, but evidence for their effectiveness in reducing mortality is uncertain. We did a meta-analysis of individual participant data to investigate the association between use of neuraminidase inhibitors and mortality in patients admitted to hospital with pandemic influenza A H1N1pdm09 virus infection. We assembled data for patients (all ages) admitted to hospital worldwide with laboratory confirmed or clinically diagnosed pandemic influenza A H1N1pdm09 virus infection. We identified potential data contributors from an earlier systematic review of reported studies addressing the same research question. In our systematic review, eligible studies were done between March 1, 2009 (Mexico), or April 1, 2009 (rest of the world), until the WHO declaration of the end of the pandemic (Aug 10, 2010); however, we continued to receive data up to March 14, 2011, from ongoing studies. We did a meta-analysis of individual participant data to assess the association between neuraminidase inhibitor treatment and mortality (primary outcome), adjusting for both treatment propensity and potential confounders, using generalised linear mixed modelling. We assessed the association with time to treatment using time-dependent Cox regression shared frailty modelling. We included data for 29?234 patients from 78 studies of patients admitted to hospital between Jan 2, 2009, and March 14, 2011. Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk (adjusted odds ratio [OR] 0·81; 95% CI 0·70?0·93; p=0·0024). Compared with later treatment, early treatment (within 2 days of symptom onset) was associated with a reduction in mortality risk (adjusted OR 0·48; 95% CI 0·41?0·56; p<0·0001). Early treatment versus no treatment was also associated with a reduction in mortality (adjusted OR 0·50; 95% CI 0·37?0·67; p<0·0001). These associat

Full Text
View/download PDF

16. Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09‐related pneumonia: an individual participant data meta‐analysis

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P, Araújo, Wildo N, Azziz‐Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M, Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja‐Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T, Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov‐Raz, Gal, Echavarria,, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L, Hoeger, Peter H, Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T, Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili,, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee‐Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo‐Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P, Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt‐Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan S., Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P, Araújo, Wildo N, Azziz‐Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M, Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja‐Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T, Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov‐Raz, Gal, Echavarria,, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L, Hoeger, Peter H, Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T, Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili,, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee‐Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo‐Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P, Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt‐Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan S.

Abstract

BACKGROUND: The impact of neuraminidase inhibitors (NAIs) on influenza‐related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. METHODS: A worldwide meta‐analysis of individual participant data from 20 634 hospitalised patients with laboratory‐confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) ‘pandemic influenza’. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. RESULTS: Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64–1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44–1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71–1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55–0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54–0·85; P = 0·001)]. CONCLUSIONS: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.

Full Text
View/download PDF

17. Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikić, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan, Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikić, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan

Abstract

Neuraminidase inhibitors were widely used during the 2009/10 influenza A H1N1 pandemic, but evidence for their effectiveness in reducing mortality is uncertain. We did a meta-analysis of individual participant data to investigate the association between use of neuraminidase inhibitors and mortality in patients admitted to hospital with pandemic influenza A H1N1pdm09 virus infection. We assembled data for patients (all ages) admitted to hospital worldwide with laboratory confirmed or clinically diagnosed pandemic influenza A H1N1pdm09 virus infection. We identified potential data contributors from an earlier systematic review of reported studies addressing the same research question. In our systematic review, eligible studies were done between March 1, 2009 (Mexico), or April 1, 2009 (rest of the world), until the WHO declaration of the end of the pandemic (Aug 10, 2010); however, we continued to receive data up to March 14, 2011, from ongoing studies. We did a meta-analysis of individual participant data to assess the association between neuraminidase inhibitor treatment and mortality (primary outcome), adjusting for both treatment propensity and potential confounders, using generalised linear mixed modelling. We assessed the association with time to treatment using time-dependent Cox regression shared frailty modelling. We included data for 29?234 patients from 78 studies of patients admitted to hospital between Jan 2, 2009, and March 14, 2011. Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk (adjusted odds ratio [OR] 0·81; 95% CI 0·70?0·93; p=0·0024). Compared with later treatment, early treatment (within 2 days of symptom onset) was associated with a reduction in mortality risk (adjusted OR 0·48; 95% CI 0·41?0·56; p<0·0001). Early treatment versus no treatment was also associated with a reduction in mortality (adjusted OR 0·50; 95% CI 0·37?0·67; p<0·0001). These associat

Full Text
View/download PDF

18. Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09‐related pneumonia: an individual participant data meta‐analysis

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P, Araújo, Wildo N, Azziz‐Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M, Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja‐Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T, Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov‐Raz, Gal, Echavarria,, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L, Hoeger, Peter H, Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T, Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili,, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee‐Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo‐Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P, Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt‐Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan S., Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P, Araújo, Wildo N, Azziz‐Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M, Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja‐Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T, Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov‐Raz, Gal, Echavarria,, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L, Hoeger, Peter H, Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T, Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili,, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee‐Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo‐Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P, Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt‐Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan S.

Abstract

BACKGROUND: The impact of neuraminidase inhibitors (NAIs) on influenza‐related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. METHODS: A worldwide meta‐analysis of individual participant data from 20 634 hospitalised patients with laboratory‐confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) ‘pandemic influenza’. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. RESULTS: Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64–1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44–1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71–1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55–0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54–0·85; P = 0·001)]. CONCLUSIONS: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.

Full Text
View/download PDF

19. Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikić, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan, Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikić, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan

Abstract

Neuraminidase inhibitors were widely used during the 2009/10 influenza A H1N1 pandemic, but evidence for their effectiveness in reducing mortality is uncertain. We did a meta-analysis of individual participant data to investigate the association between use of neuraminidase inhibitors and mortality in patients admitted to hospital with pandemic influenza A H1N1pdm09 virus infection. We assembled data for patients (all ages) admitted to hospital worldwide with laboratory confirmed or clinically diagnosed pandemic influenza A H1N1pdm09 virus infection. We identified potential data contributors from an earlier systematic review of reported studies addressing the same research question. In our systematic review, eligible studies were done between March 1, 2009 (Mexico), or April 1, 2009 (rest of the world), until the WHO declaration of the end of the pandemic (Aug 10, 2010); however, we continued to receive data up to March 14, 2011, from ongoing studies. We did a meta-analysis of individual participant data to assess the association between neuraminidase inhibitor treatment and mortality (primary outcome), adjusting for both treatment propensity and potential confounders, using generalised linear mixed modelling. We assessed the association with time to treatment using time-dependent Cox regression shared frailty modelling. We included data for 29?234 patients from 78 studies of patients admitted to hospital between Jan 2, 2009, and March 14, 2011. Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk (adjusted odds ratio [OR] 0·81; 95% CI 0·70?0·93; p=0·0024). Compared with later treatment, early treatment (within 2 days of symptom onset) was associated with a reduction in mortality risk (adjusted OR 0·48; 95% CI 0·41?0·56; p<0·0001). Early treatment versus no treatment was also associated with a reduction in mortality (adjusted OR 0·50; 95% CI 0·37?0·67; p<0·0001). These associat

Full Text
View/download PDF

20. Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09‐related pneumonia: an individual participant data meta‐analysis

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P, Araújo, Wildo N, Azziz‐Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M, Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja‐Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T, Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov‐Raz, Gal, Echavarria,, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L, Hoeger, Peter H, Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T, Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili,, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee‐Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo‐Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P, Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt‐Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan S., Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P, Araújo, Wildo N, Azziz‐Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M, Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja‐Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T, Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov‐Raz, Gal, Echavarria,, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L, Hoeger, Peter H, Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T, Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili,, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee‐Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo‐Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P, Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt‐Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan S.

Abstract

BACKGROUND: The impact of neuraminidase inhibitors (NAIs) on influenza‐related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. METHODS: A worldwide meta‐analysis of individual participant data from 20 634 hospitalised patients with laboratory‐confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) ‘pandemic influenza’. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. RESULTS: Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64–1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44–1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71–1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55–0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54–0·85; P = 0·001)]. CONCLUSIONS: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.

Full Text
View/download PDF

21. Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikić, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan, Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikić, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan

Abstract

Neuraminidase inhibitors were widely used during the 2009/10 influenza A H1N1 pandemic, but evidence for their effectiveness in reducing mortality is uncertain. We did a meta-analysis of individual participant data to investigate the association between use of neuraminidase inhibitors and mortality in patients admitted to hospital with pandemic influenza A H1N1pdm09 virus infection. We assembled data for patients (all ages) admitted to hospital worldwide with laboratory confirmed or clinically diagnosed pandemic influenza A H1N1pdm09 virus infection. We identified potential data contributors from an earlier systematic review of reported studies addressing the same research question. In our systematic review, eligible studies were done between March 1, 2009 (Mexico), or April 1, 2009 (rest of the world), until the WHO declaration of the end of the pandemic (Aug 10, 2010); however, we continued to receive data up to March 14, 2011, from ongoing studies. We did a meta-analysis of individual participant data to assess the association between neuraminidase inhibitor treatment and mortality (primary outcome), adjusting for both treatment propensity and potential confounders, using generalised linear mixed modelling. We assessed the association with time to treatment using time-dependent Cox regression shared frailty modelling. We included data for 29?234 patients from 78 studies of patients admitted to hospital between Jan 2, 2009, and March 14, 2011. Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk (adjusted odds ratio [OR] 0·81; 95% CI 0·70?0·93; p=0·0024). Compared with later treatment, early treatment (within 2 days of symptom onset) was associated with a reduction in mortality risk (adjusted OR 0·48; 95% CI 0·41?0·56; p<0·0001). Early treatment versus no treatment was also associated with a reduction in mortality (adjusted OR 0·50; 95% CI 0·37?0·67; p<0·0001). These associat

Full Text
View/download PDF

22. Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09‐related pneumonia: an individual participant data meta‐analysis

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P, Araújo, Wildo N, Azziz‐Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M, Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja‐Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T, Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov‐Raz, Gal, Echavarria,, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L, Hoeger, Peter H, Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T, Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili,, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee‐Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo‐Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P, Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt‐Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan S., Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Lim, Wei Shen, Al Mamun, Abdullah, Anovadiya, Ashish P, Araújo, Wildo N, Azziz‐Baumgartner, Eduardo, Báez, Clarisa, Bantar, Carlos, Barhoush, Mazen M, Bassetti, Matteo, Beovic, Bojana, Bingisser, Roland, Bonmarin, Isabelle, Borja‐Aburto, Victor H., Cao, Bin, Carratala, Jordi, Cuezzo, María R., Denholm, Justin T, Dominguez, Samuel R., Duarte, Pericles A. D., Dubnov‐Raz, Gal, Echavarria,, Marcela, Fanella, Sergio, Fraser, James, Gao, Zhancheng, Gérardin, Patrick, Giannella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Higuera Iglesias, Anjarath L, Hoeger, Peter H, Hoffmann, Matthias, Hu, Xiaoyun, Islam, Quazi T, Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili,, Hossein, Khandaker, Gulam, Knight, Marian, Kusznierz, Gabriela, Kuzman, Ilija, Kwan, Arthur M. C., Lahlou Amine, Idriss, Langenegger, Eduard, Lankarani, Kamran B., Leo, Yee‐Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Manabe, Toshie, Mayo‐Montero, Elga, McGeer, Allison, Memish, Ziad A., Metan, Gokhan, Mikić, Dragan, Mohn, Kristin G. I., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Ozbay, Bulent, Ozkan, Mehpare, Parekh, Dhruv, Paul, Mical, Poeppl, Wolfgang, Polack, Fernando P, Rath, Barbara A., Rodríguez, Alejandro H., Siqueira, Marilda M., Skręt‐Magierło, Joanna, Talarek, Ewa, Tang, Julian W., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., van Zwol, Annelies, Vaudry, Wendy, Velyvyte, Daiva, Vidmar, Tjasa, Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan S.

Abstract

BACKGROUND: The impact of neuraminidase inhibitors (NAIs) on influenza‐related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. METHODS: A worldwide meta‐analysis of individual participant data from 20 634 hospitalised patients with laboratory‐confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) ‘pandemic influenza’. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. RESULTS: Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64–1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44–1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71–1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55–0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54–0·85; P = 0·001)]. CONCLUSIONS: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support.

Full Text
View/download PDF

23. Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data

Author

Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikić, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, Nguyen-Van-Tam, Jonathan, Muthuri, Stella G., Venkatesan, Sudhir, Myles, Puja R., Leonardi-Bee, Jo, Al Khuwaitir, Tarig S., Al Mamun, Abdullah, Anovadiya, Ashish P., Azziz-Baumgartner, Eduardo, Báez, Clarisa, Bassetti, Matteo, Beovic, Bojana, Bertisch, Barbara, Bonmarin, Isabelle, Booy, Robert, Borja-Aburto, Victor H., Burgmann, Heinz, Cao, Bin, Carratala, Jordi, Denholm, Justin T., Dominguez, Samuel R., Duarte, Pericles A.D., Dubnov-Raz, Gal, Echavarria, Marcela, Fanella, Sergio, Gao, Zhancheng, Gérardin, Patrick, Gianella, Maddalena, Gubbels, Sophie, Herberg, Jethro, Iglesias, Anjarath L. Higuera, Hoger, Peter H., Hu, Xiaoyun, Islam, Quazi T., Jiménez, Mirela F., Kandeel, Amr, Keijzers, Gerben, Khalili, Hossein, Knight, Marian, Kudo, Koichiro, Kusznierz, Gabriela, Kuzman, Iljia, Kwan, Arthur M.C., Amine, Idriss Lahlou, Langenegger, Eduard, Lankarani, Kamran B, Leo, Yee-Sin, Linko, Rita, Liu, Pei, Madanat, Faris, Mayo-Montero, Elga, McGeer, Allison, Memish, Ziad, Metan, Gokhan, Mickiene, Aukse, Mikić, Dragan, Mohn, Kristin G., Moradi, Ahmadreza, Nymadawa, Pagbajabyn, Oliva, Maria E., Oskan, Mehpare, Parekh, Dhruv, Paul, Mical, Polack, Fernando P., Rath, Barbara A., Rodríguez, Alejandro H., Sarrouf, Elena B., Seale, Anna C., Sertogullarindan, Bunyamin, Siqueira, Marilda M., Skręt-Magierło, Joanna, Stephan, Frank, Talarek, Ewa, Tang, Julian W., To, Kelvin K., Torres, Antoni, Törün, Selda H., Tran, Dat, Uyeki, Timothy M., Van Zwol, Annelies, Vaudry, Wendy, Vidmar, Tjasa, Yokota, Renata T.C., Zarogoulidis, Paul, and Nguyen-Van-Tam, Jonathan

Abstract

Neuraminidase inhibitors were widely used during the 2009/10 influenza A H1N1 pandemic, but evidence for their effectiveness in reducing mortality is uncertain. We did a meta-analysis of individual participant data to investigate the association between use of neuraminidase inhibitors and mortality in patients admitted to hospital with pandemic influenza A H1N1pdm09 virus infection. We assembled data for patients (all ages) admitted to hospital worldwide with laboratory confirmed or clinically diagnosed pandemic influenza A H1N1pdm09 virus infection. We identified potential data contributors from an earlier systematic review of reported studies addressing the same research question. In our systematic review, eligible studies were done between March 1, 2009 (Mexico), or April 1, 2009 (rest of the world), until the WHO declaration of the end of the pandemic (Aug 10, 2010); however, we continued to receive data up to March 14, 2011, from ongoing studies. We did a meta-analysis of individual participant data to assess the association between neuraminidase inhibitor treatment and mortality (primary outcome), adjusting for both treatment propensity and potential confounders, using generalised linear mixed modelling. We assessed the association with time to treatment using time-dependent Cox regression shared frailty modelling. We included data for 29?234 patients from 78 studies of patients admitted to hospital between Jan 2, 2009, and March 14, 2011. Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk (adjusted odds ratio [OR] 0·81; 95% CI 0·70?0·93; p=0·0024). Compared with later treatment, early treatment (within 2 days of symptom onset) was associated with a reduction in mortality risk (adjusted OR 0·48; 95% CI 0·41?0·56; p<0·0001). Early treatment versus no treatment was also associated with a reduction in mortality (adjusted OR 0·50; 95% CI 0·37?0·67; p<0·0001). These associat

Full Text
View/download PDF

24. Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09-related pneumonia: an individual participant data meta-analysis.

Author

Muthuri SG, Venkatesan S, Myles PR, Leonardi-Bee J, Lim WS, Al Mamun A, Anovadiya AP, Araújo WN, Azziz-Baumgartner E, Báez C, Bantar C, Barhoush MM, Bassetti M, Beovic B, Bingisser R, Bonmarin I, Borja-Aburto VH, Cao B, Carratala J, Cuezzo MR, Denholm JT, Dominguez SR, Duarte PA, Dubnov-Raz G, Echavarria M, Fanella S, Fraser J, Gao Z, Gérardin P, Giannella M, Gubbels S, Herberg J, Higuera Iglesias AL, Hoeger PH, Hoffmann M, Hu X, Islam QT, Jiménez MF, Kandeel A, Keijzers G, Khalili H, Khandaker G, Knight M, Kusznierz G, Kuzman I, Kwan AM, Lahlou Amine I, Langenegger E, Lankarani KB, Leo YS, Linko R, Liu P, Madanat F, Manabe T, Mayo-Montero E, McGeer A, Memish ZA, Metan G, Mikić D, Mohn KG, Moradi A, Nymadawa P, Ozbay B, Ozkan M, Parekh D, Paul M, Poeppl W, Polack FP, Rath BA, Rodríguez AH, Siqueira MM, Skręt-Magierło J, Talarek E, Tang JW, Torres A, Törün SH, Tran D, Uyeki TM, van Zwol A, Vaudry W, Velyvyte D, Vidmar T, Zarogoulidis P, and Nguyen-Van-Tam JS

Subjects
Adolescent, Adrenal Cortex Hormones therapeutic use, Adult, Anti-Bacterial Agents therapeutic use, Child, Child, Preschool, Enzyme Inhibitors therapeutic use, Female, Humans, Influenza, Human epidemiology, Influenza, Human mortality, Influenza, Human virology, Male, Middle Aged, Odds Ratio, Pneumonia, Viral diagnostic imaging, Pneumonia, Viral epidemiology, Treatment Outcome, Young Adult, Antiviral Agents therapeutic use, Influenza A Virus, H1N1 Subtype drug effects, Influenza A Virus, H1N1 Subtype enzymology, Influenza, Human drug therapy, Neuraminidase antagonists & inhibitors, Pneumonia, Viral drug therapy, Pneumonia, Viral virology
Abstract

Background: The impact of neuraminidase inhibitors (NAIs) on influenza-related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection., Methods: A worldwide meta-analysis of individual participant data from 20 634 hospitalised patients with laboratory-confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) 'pandemic influenza'. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids., Results: Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64-1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44-1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71-1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55-0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54-0·85; P = 0·001)]., Conclusions: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support., (© 2015 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.)

Published
2016
Full Text
View/download PDF

25. Effectiveness of neuraminidase inhibitors in reducing mortality in patients admitted to hospital with influenza A H1N1pdm09 virus infection: a meta-analysis of individual participant data.

Author

Muthuri SG, Venkatesan S, Myles PR, Leonardi-Bee J, Al Khuwaitir TS, Al Mamun A, Anovadiya AP, Azziz-Baumgartner E, Báez C, Bassetti M, Beovic B, Bertisch B, Bonmarin I, Booy R, Borja-Aburto VH, Burgmann H, Cao B, Carratala J, Denholm JT, Dominguez SR, Duarte PA, Dubnov-Raz G, Echavarria M, Fanella S, Gao Z, Gérardin P, Giannella M, Gubbels S, Herberg J, Iglesias AL, Hoger PH, Hu X, Islam QT, Jiménez MF, Kandeel A, Keijzers G, Khalili H, Knight M, Kudo K, Kusznierz G, Kuzman I, Kwan AM, Amine IL, Langenegger E, Lankarani KB, Leo YS, Linko R, Liu P, Madanat F, Mayo-Montero E, McGeer A, Memish Z, Metan G, Mickiene A, Mikić D, Mohn KG, Moradi A, Nymadawa P, Oliva ME, Ozkan M, Parekh D, Paul M, Polack FP, Rath BA, Rodríguez AH, Sarrouf EB, Seale AC, Sertogullarindan B, Siqueira MM, Skręt-Magierło J, Stephan F, Talarek E, Tang JW, To KK, Torres A, Törün SH, Tran D, Uyeki TM, Van Zwol A, Vaudry W, Vidmar T, Yokota RT, Zarogoulidis P, and Nguyen-Van-Tam JS

Subjects
Adolescent, Adult, Child, Female, Hospitalization, Humans, Influenza, Human mortality, Male, Middle Aged, Proportional Hazards Models, Treatment Outcome, Young Adult, Antiviral Agents therapeutic use, Enzyme Inhibitors therapeutic use, Influenza A Virus, H1N1 Subtype, Influenza, Human drug therapy, Neuraminidase antagonists & inhibitors, Oseltamivir therapeutic use, Pandemics, Zanamivir therapeutic use
Abstract

Background: Neuraminidase inhibitors were widely used during the 2009-10 influenza A H1N1 pandemic, but evidence for their effectiveness in reducing mortality is uncertain. We did a meta-analysis of individual participant data to investigate the association between use of neuraminidase inhibitors and mortality in patients admitted to hospital with pandemic influenza A H1N1pdm09 virus infection., Methods: We assembled data for patients (all ages) admitted to hospital worldwide with laboratory confirmed or clinically diagnosed pandemic influenza A H1N1pdm09 virus infection. We identified potential data contributors from an earlier systematic review of reported studies addressing the same research question. In our systematic review, eligible studies were done between March 1, 2009 (Mexico), or April 1, 2009 (rest of the world), until the WHO declaration of the end of the pandemic (Aug 10, 2010); however, we continued to receive data up to March 14, 2011, from ongoing studies. We did a meta-analysis of individual participant data to assess the association between neuraminidase inhibitor treatment and mortality (primary outcome), adjusting for both treatment propensity and potential confounders, using generalised linear mixed modelling. We assessed the association with time to treatment using time-dependent Cox regression shared frailty modelling., Findings: We included data for 29,234 patients from 78 studies of patients admitted to hospital between Jan 2, 2009, and March 14, 2011. Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk (adjusted odds ratio [OR] 0·81; 95% CI 0·70-0·93; p=0·0024). Compared with later treatment, early treatment (within 2 days of symptom onset) was associated with a reduction in mortality risk (adjusted OR 0·48; 95% CI 0·41-0·56; p<0·0001). Early treatment versus no treatment was also associated with a reduction in mortality (adjusted OR 0·50; 95% CI 0·37-0·67; p<0·0001). These associations with reduced mortality risk were less pronounced and not significant in children. There was an increase in the mortality hazard rate with each day's delay in initiation of treatment up to day 5 as compared with treatment initiated within 2 days of symptom onset (adjusted hazard ratio [HR 1·23] [95% CI 1·18-1·28]; p<0·0001 for the increasing HR with each day's delay)., Interpretation: We advocate early instigation of neuraminidase inhibitor treatment in adults admitted to hospital with suspected or proven influenza infection., Funding: F Hoffmann-La Roche., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Published
2014
Full Text
View/download PDF

26. [Pandemic influenza (H1N1) 2009 Outbreak in a Military Academy: start of community circulation in Spain].

Author

Mayo Montero E, Ballester Orcal E, Piñeyroa Sierra AJ, Fé Marques A, Santa-Olalla Peralta P, and Sierra Moros MJ

Subjects
Adolescent, Adult, Female, Humans, Influenza, Human prevention & control, Male, Spain epidemiology, Young Adult, Influenza A Virus, H1N1 Subtype, Influenza, Human epidemiology, Military Personnel, Pandemics
Abstract

Background: On May 19, 2009, 21 cases of influenza-like illness were reported among soldiers from an Engineering Military Academy (ACING) in Hoyo de Manzanares, Spain. In the context of an influenza A (H1N1)2009 global alert, it was decided to investigate a possible pandemic influenza outbreak. To describe a possible outbreak of influenza A (H1N1)2009 in a Military Training Centre and to describe the measures adopted for transmission control of this new infection., Methods: A specific questionnaire was administered and biological samples were collected from all cases under investigation. Isolation and quarantine were recommended for cases and contacts, respectively., Results: Eighty-one cases were confirmed. Among 52 samples tested, 31 were positive for influenza virus A/California/7/2009. The average age of the cases was 22.0 years (range 18-31 years) and 84% were men. Most common reported symptoms were cough and fever. All cases were isolated and treated with oseltamivir, with full recovery. The total attack rate was 12.42%. None of the cases had history of travel to risk areas or contact with previously diagnosed cases outside the academy. Thirty-one confirmed cases related to this outbreak were identified outside the academy, 24 cases were family contacts and friends., Conclusions: This outbreak was the first evidence of community transmission of pandemic influenza H1N1 in Spain. The rapid detection of this outbreak enhanced an early implementation of measures aiming at the containment of its transmission.

Published
2010
Full Text
View/download PDF

27. [Evolution of the degrees of influenza vaccine (flu shot) coverage in Spain throughout the 1993-2001 period. Analysis by Autonomous Communities].

Author

Mayo Montero E, Hernández Barrera V, Sierra Moros MJ, Pachón del Amo I, Carrasco Garrido P, Gil de Miguel A, and Jiménez García R

Subjects
Aged, Cross-Sectional Studies, Female, Health Surveys, Humans, Logistic Models, Male, Middle Aged, Spain epidemiology, Vaccination trends, Influenza Vaccines administration & dosage, Influenza, Human prevention & control, Vaccination statistics & numerical data
Abstract

Background: Influenza (flu) is a disease involving a high morbidity which takes a high toll on healthcare costs for which there is an effective vaccine available. This study is aimed at evaluating the evolution of the different degrees of influenza vaccine (flu shot) coverage in Spain by Autonomous Communities during the 1993-2001 period., Methods: A total of 42,123 cases from the National Health Survey (NHS) for the years 1993 (n=21,051) and 2001 (n=21,072) were analysed, all of which corresponded to non-institutionalised Spanish adults over 15 years of age. Both surveys are representative at the Autonomous Community level., Results: For the total sample, a vaccine coverage of 17.94% (CI 95% 17.42-18.46) in 1993 and of 19.30% (18.77-19.83) en 2001 was estimated. In the logic regression model, adjusted by age, sex and related chronic disease, significant improvements were found in the degrees of coverage of individuals over 64 years of age (OR = 1.28 CI 95% 1.10-1.50) for Spain as a whole and for five of the seventeen Autonomous Communities between 1993 and 2001. However, no significant changes were found in the degrees of coverage for the group under age 65 with related chronic disease entailing an indication for being administered the vaccine., Conclusions: A slight yet insufficient improvement in the degrees of coverage among the high-risk groups studied were found to exist both nation-wide in Spain as a whole as well as in the majority of the Autonomous Communities between 1993 and 2001. Degrees of coverage varied greatly among Autonomous Communities. The individual under age 65 with related chronic diseases heightening the risks of suffering from flu-related complications have not improved their degrees of coverage regarding this vaccine during the period studied. The difficulty involved in improving the degrees of coverage among this type of patients might lead us to consider the alternative and potential benefit of lowering the age limit of the current influenza vaccine (flu shot) indication-related recommendations in Spain.

Published
2004
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results