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Gender differences and influenza-associated mortality in hospitalized influenza A patients during the 2018/19 season

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Abstract

Background

In this study we analyzed gender differences in the clinical presentation of patients with molecular confirmed influenza A. Additionally, we tried to identify predictors of influenza-associated mortality.

Materials/methods

In this prospective observational multi-center-study we included all influenza-positive patients ≥ 18 years who were hospitalized and treated on flu-isolation-wards in three hospitals in Vienna during the 2018/19 influenza season. Diagnoses were made via Cobas® Liat® POCT.

Results

490 Patients (48.8% female) tested positive for influenza A. Female patients were older (median age 76 years vs. 70 years, p < 0.001). Male patients had a higher rate of chronic liver disease in history (8.8% vs. 2.9%, p = 0.006), myositis (11.7% vs. 3.1%, p < 0.001) and ICU admissions (9.6% vs. 4.6%, p = 0.03). The in-hospital mortality rate was 4.3% and increased to 9.5% during the 90-day follow-up period. Female patients > 75 years had a significantly higher in-hospital mortality rate than ≤ 75-year-old females (9.2% vs. 1.7%, p = 0.019). This effect was not observed in male patients (5.4% vs. 1.9%, p = ns). Age > 75 years (OR 5.49, 95% CI 1.10–27.43), acute heart failure (OR 3.56, 95% CI 1.03–12.05) and ICU admission (OR 6.1, 95% CI 0.98–37.91) were predictors for in-hospital mortality for female patients, while any malignancy (OR 9.4, 95% CI 1.90–46.54) and ICU admission (OR 7.05, 95% CI 1.44–34.55) were predictors in male patients.

Conclusions

Gender is associated with differences in clinical presentation and complications of influenza A virus infection. Women with acute heart failure or aged > 75 years have an increased risk of influenza associated in-hospital mortality, while ICU admission and any malignancy are predictors for male patients. Mortality rates in patients > 75 years are 5–10 times higher compared to their non-hospitalized influenza-negative Austrian counterparts.

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Funding

This study was not funded.

Author information

Authors and Affiliations

  1. Department for Infectious Diseases, Kaiser-Franz-Josef-Hospital (KFJ), Kundratstraße 3, 1100, Vienna, Austria

    Mario Karolyi, E. Pawelka, T. Seitz, M. Traugott, A. Zoufaly & C. Wenisch

  2. Medical University of Vienna (MUW), Vienna, Austria

    H. Kelani

  3. Medical Department II and Karl-Landsteiner Institute for Lung Research and Pulmonological Oncology, Wilheminen-Hospital (WSP), Vienna, Austria

    G. C. Funk & S. Publig

  4. Medical Department II, Center for Diagnosis and Treatment of Rheumatic Diseases, Hospital Hietzing, Vienna, Austria

    B. Lindner & C. Porpaczy

  5. Department for Anesthesia and Surgical Intensive Care, Kaiser-Franz-Josef-Hospital (KFJ), Vienna, Austria

    M. Unterweger

Authors
  1. Mario Karolyi
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  2. E. Pawelka
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  3. H. Kelani
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  4. G. C. Funk
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  5. B. Lindner
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  6. C. Porpaczy
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  7. S. Publig
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  8. T. Seitz
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  9. M. Traugott
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  10. M. Unterweger
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  11. A. Zoufaly
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  12. C. Wenisch
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Correspondence to Mario Karolyi.

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Karolyi, M., Pawelka, E., Kelani, H. et al. Gender differences and influenza-associated mortality in hospitalized influenza A patients during the 2018/19 season. Infection 49, 103–110 (2021). https://doi.org/10.1007/s15010-020-01537-x

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  • DOI: https://doi.org/10.1007/s15010-020-01537-x

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