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Supplementary Material for: Influenza A-Associated In-Hospital Mortality in Very Older People: Does Inflammation Also Play a Role?

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posted on 30.09.2021, 12:07 by Arrieta E., Lalueza A., Ayuso-García B., Trujillo H., Folgueira D., Paredes D., Verdejo M.Á., Camacho J., Caso J.M., Heredia C., Cueto-Felgueroso C., Pleguezuelo D., Serrano A., Lumbreras C.
Background: The aim of the study was to analyze the clinical manifestations and outcome of the oldest old (people aged ≥85 years) who were admitted to the hospital with a confirmed influenza A virus infection in comparison with younger patients and to assess the role of inflammation in the outcome of influenza infection in this population. Methods: This is an observational prospective study including all adult patients with influenza A virus infection hospitalized in a tertiary teaching hospital in Madrid, in 2 consecutive influenza seasons (2016–17 and 2017–18). Results: Five hundred nine hospitalized patients with influenza A infection were included, of whom 117 (23%) were older than 85 years (median age: 89.3 ± 3.2). We compared the clinical characteristics and outcome with those of the rest of the population (median age: 72.8 ± 15.7). Overall, mortality was higher in older patients (10% vs. 4%; p = 0.03) with no differences in clinical presentation. Patients older than 85 years who ultimately died (12 out of 117) showed increased systemic inflammation expressed by higher levels of C-reactive protein (CRP) and ferritin compared to survivors who were discharged (odds ratio [OR] of CRP >20 mg/dL: 5.16, 95% confidence interval [CI]: 1.29–20.57, and OR of ferritin >500 mg: 4.3, 95% CI: 1.04–17.35). Conclusions: Patients aged 85 and older with influenza A virus infection presented a higher in-hospital mortality than younger subjects. CRP and ferritin levels were higher in the oldest old who died, suggesting that inflammation could play a key role in the outcome of this subset of patients.

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