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Impact of early neuraminidase inhibitor treatment on clinical outcomes in patients with influenza B-related pneumonia: a multicenter cohort study

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Abstract

The aim of this study is to evaluate the impact of early (within 2 days after disease onset) neuraminidase inhibitor (NAI) administration on clinical outcomes in patients with laboratory-confirmed influenza B-related pneumonia (FluB-p). This was a multicenter study conducted from 1 January 2013 to 1 May 2019. Data of immunocompetent adult and adolescent FluB-p patients hospitalized at five different teaching hospitals in China were retrospectively collected, including demographic and clinical features as well as clinical and treatment outcomes. Univariate and multivariate logistic regression analyses were performed to assess the effects of early NAI administration on clinical outcomes in FluB-p patients. In total, 386 hospitalized patients with community-onset FluB-p were included in this study, of whom 39.6% (153/386) were treated with NAI early. After adjusting for the weighted propensity scores of treatment, systemic corticosteroid, and antibiotic uses, the results of multivariate logistic regression model indicated that early NAI treatment was associated with the decreased risks of invasive ventilation [odd ratio (OR) 0.325, 95% confidence interval (CI) 0.123–0.858; p = 0.023), admittance to intensive care unit (OR 0.425, 95% CI 0.204–0.882; p = 0.022), and 30-day mortality (OR 0.416, 95% CI 0.184–0.944, p = 0.036)] in FluB-p patients. In addition, the multivariate logistic regression analysis revealed that early NAI treatment (OR 0.306, 95% CI 0.063–0.618; p = 0.010) was an independent predictor for 30-day mortality in patients with FluB-p. Early NAI treatment was associated with better clinical outcomes in FluB-p patients, which supports the recommendations of its use in severe influenza illness.

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Authors and Affiliations

  1. Department of Infectious Disease, Beijing Jishuitan Hospital, 4th Medical College of Peking University, Beijing, China

    Liang Chen

  2. Department of Pulmonary and Critical Care Medicine, Qingdao Municipal Hospital, Qingdao City, Shandong Province, China

    Xiudi Han

  3. Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

    YanLi Li

  4. Department of Pulmonary and Critical Care Medicine, Beijing Huimin Hospital, Beijing, China

    Chunxiao Zhang

  5. Department of Pulmonary and Critical Care Medicine, The Second People’s Hospital of Yunnan Province, Kunming City, Yunnan Province, China

    Xiqian Xing

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  1. Liang Chen
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  3. YanLi Li
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Correspondence to Liang Chen.

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The study design was approved by the Ethics Committee of Chao-Yang Hospital (No.2015–86).

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Chen, L., Han, X., Li, Y. et al. Impact of early neuraminidase inhibitor treatment on clinical outcomes in patients with influenza B-related pneumonia: a multicenter cohort study. Eur J Clin Microbiol Infect Dis 39, 1231–1238 (2020). https://doi.org/10.1007/s10096-020-03835-6

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