Effect of immunomodulatory therapies in patients with pandemic influenza A (H1N1) 2009 complicated by pneumonia.

Published

Journal Article

OBJECTIVE: To determine the effect of immunomodulatory therapies on the development of severe disease in hospitalized adults with laboratory-confirmed pandemic influenza A (H1N1) 2009 complicated by pneumonia. METHODS: Observational, prospective cohort study at thirteen tertiary hospitals in Spain. The use of corticosteroids, macrolides and statins was recorded. The outcome of interest was severe disease, defined as the composite of intensive care unit admission or death after the first day of hospitalization. RESULTS: Of the 197 patients with pandemic influenza A (H1N1) 2009 complicated by pneumonia, 68 (34.5%) received some anti-inflammatory therapy since hospital admission (corticosteroids in 37, macrolides in 31 and statins in 12). Severe disease occurred in 29 (14.7%) patients. After adjustment for confounding factors, immunomodulatory therapies as a group were not associated with a lower risk for developing severe disease (odds ratio [OR] 0.64; 95% confidence interval [CI] 0.22-1.86). In a further a priori analysis, corticosteroids, macrolides and statins were included in a multivariate model. None of these therapies was found to be associated with a lower risk for developing severe disease. CONCLUSIONS: Immunomodulatory therapies use since hospital admission did not prevent the development of severe disease in adults with pandemic influenza A (H1N1) 2009 complicated by pneumonia.

Full Text

Cited Authors

  • Viasus, D; Paño-Pardo, JR; Cordero, E; Campins, A; López-Medrano, F; Villoslada, A; Fariñas, MC; Moreno, A; Rodríguez-Baño, J; Oteo, JA; Martínez-Montauti, J; Torre-Cisneros, J; Segura, F; Carratalà, J; Novel Influenza A (H1N1) Study Group, Spanish Network for Research in Infectious Diseases,

Published Date

  • March 2011

Published In

Volume / Issue

  • 62 / 3

Start / End Page

  • 193 - 199

PubMed ID

  • 21295604

Pubmed Central ID

  • 21295604

Electronic International Standard Serial Number (EISSN)

  • 1532-2742

International Standard Serial Number (ISSN)

  • 0163-4453

Digital Object Identifier (DOI)

  • 10.1016/j.jinf.2011.01.014

Language

  • eng