Early oseltamivir treatment improves survival in critically ill patients with influenza pneumonia

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  • dc.contributor.author Moreno, Gerard
  • dc.contributor.author Rodríguez, Alejandro
  • dc.contributor.author Sole-Violán, Jordi
  • dc.contributor.author Martín Loeches, Ignacio
  • dc.contributor.author Díaz, Emili
  • dc.contributor.author Bodí, María
  • dc.contributor.author Reyes, Luis F.
  • dc.contributor.author Gómez, Josep
  • dc.contributor.author Guardiola, Juan
  • dc.contributor.author Trefler, Sandra
  • dc.contributor.author Vidaur, Loreto
  • dc.contributor.author Papiol, Elisabet
  • dc.contributor.author Socias, Lorenzo
  • dc.contributor.author García Vidal, Carolina
  • dc.contributor.author Correig, Eudald
  • dc.contributor.author Marín Corral, Judith
  • dc.contributor.author Restrepo, Marcos I.
  • dc.contributor.author Nguyen-Van-Tam, Jonathan S.
  • dc.contributor.author Torres, Antoni
  • dc.date.accessioned 2021-04-30T07:33:40Z
  • dc.date.available 2021-04-30T07:33:40Z
  • dc.date.issued 2021
  • dc.description.abstract Background: The relationship between early oseltamivir treatment (within 48 h of symptom onset) and mortality in patients admitted to intensive care units (ICUs) with severe influenza is disputed. This study aimed to investigate the association between early oseltamivir treatment and ICU mortality in critically ill patients with influenza pneumonia. Methods: This was an observational study of patients with influenza pneumonia admitted to 184 ICUs in Spain during 2009-2018. The primary outcome was to evaluate the association between early oseltamivir treatment and ICU mortality compared with later treatment. Secondary outcomes were to compare the duration of mechanical ventilation and ICU length of stay between the early and later oseltamivir treatment groups. To reduce biases related to observational studies, propensity score matching and a competing risk analysis were performed. Results: During the study period, 2124 patients met the inclusion criteria. All patients had influenza pneumonia and received oseltamivir before ICU admission. Of these, 529 (24.9%) received early oseltamivir treatment. In the multivariate analysis, early treatment was associated with reduced ICU mortality (OR 0.69, 95% CI 0.51-0.95). After propensity score matching, early oseltamivir treatment was associated with improved survival rates in the Cox regression (hazard ratio 0.77, 95% CI 0.61-0.99) and competing risk (subdistribution hazard ratio 0.67, 95% CI 0.53-0.85) analyses. The ICU length of stay and duration of mechanical ventilation were shorter in patients receiving early treatment. Conclusions: Early oseltamivir treatment is associated with improved survival rates in critically ill patients with influenza pneumonia, and may decrease ICU length of stay and mechanical ventilation duration.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Moreno G, Rodríguez A, Sole-Violán J, Martín-Loeches I, Díaz E, Bodí M, Reyes LF, Gómez J, Guardiola J, Trefler S, Vidaur L, Papiol E, Socias L, García-Vidal C, Correig E, Marín-Corral J, Restrepo MI, Nguyen-Van-Tam JS, Torres A. Early oseltamivir treatment improves survival in critically ill patients with influenza pneumonia. ERJ Open Res. 2021;7(1):00888-2020. DOI: 10.1183/23120541.00888-2020
  • dc.identifier.doi http://dx.doi.org/10.1183/23120541.00888-2020
  • dc.identifier.issn 2312-0541
  • dc.identifier.uri http://hdl.handle.net/10230/47263
  • dc.language.iso eng
  • dc.publisher European Respiratory Society
  • dc.relation.ispartof European Respiratory Journal. 2021;7(1):00888-2020
  • dc.rights Copyright © ERS 2021. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/
  • dc.title Early oseltamivir treatment improves survival in critically ill patients with influenza pneumonia
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion