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Severe flu management: a point of view


Annual flu seasons are typically characterized by changes in types and subtypes of influenza, with variations in terms of severity. Despite remarkable improvements in the prevention and management of patients with suspected or laboratory-confirmed diagnosis of influenza, annual seasonal influenza continues to be associated with a high morbidity and mortality. Admission to the intensive care unit is required for patients with severe forms of seasonal influenza infection, with primary pneumonia being present in most of the cases. This review summarizes the most recent knowledge on the diagnosis and treatment strategies in critically ill patients with influenza, focused on diagnostic testing methods, antiviral therapy, use of corticosteroids, antibacterial and antifungal therapy, and supportive measures. The review focuses on diagnostic testing methods, antiviral therapy, use of corticosteroids, antibacterial and antifungal therapy, supportive measures and relevant existing evidence, in order to provide the non-expert clinician a useful overview. An enhanced understanding of current diagnostic and treatment aspects of influenza infection can contribute to improve outcomes and reduce mortality among ICU patients with influenza.

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Correspondence to Antoni Torres.

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Conflict of interest

AT is member of the advisory Board of Jansen for pimovidir. NL has previously received honoraria for consultancy work, speaking in educational programs, and/or travel support from: Shionogi Inc., Janssen Inc., Sanofi Pasteur Ltd., F. Hoffmann-La Roche Ltd., Genentech Inc., CIDARA Therapeutics Inc., all outside the submitted work. IL has no conflict of interest to declare. WS has no conflict of interest to declare.

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Torres, A., Loeches, I., Sligl, W. et al. Severe flu management: a point of view. Intensive Care Med (2020).

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  • Influenza
  • ICU
  • Antivirals
  • Corticosteroids
  • Mortality
  • Pneumonia