TY - JOUR T1 - Effect of neuraminidase inhibitor (oseltamivir) treatment on outcome of hospitalised influenza patients, surveillance data from 11 EU countries, 2010 to 2020. JF - Euro Surveill Y1 - 2023 A1 - Adlhoch, Cornelia A1 - Concepción Delgado-Sanz A1 - AnnaSara Carnahan A1 - Larrauri, Amparo A1 - Odette Popovici A1 - Nathalie Bossuyt A1 - Isabelle Thomas A1 - Jan Kynčl A1 - Pavel Slezak A1 - Mia Brytting A1 - Raquel Guiomar A1 - Monika Redlberger-Fritz A1 - Jackie Maistre Melillo A1 - Tanya Melillo A1 - Arianne B van Gageldonk-Lafeber A1 - Sierk D Marbus A1 - O'Donnell, Joan A1 - Domegan, Lisa A1 - Joana Gomes Dias A1 - Sonja J Olsen KW - Aged KW - Antiviral Agents KW - Enzyme Inhibitors KW - Guanidines KW - Hospital Mortality KW - Humans KW - Influenza, Human KW - Neuraminidase KW - Oseltamivir KW - Treatment Outcome KW - Zanamivir AB -

BackgroundTimely treatment with neuraminidase inhibitors (NAI) can reduce severe outcomes in influenza patients.AimWe assessed the impact of antiviral treatment on in-hospital deaths of laboratory-confirmed influenza patients in 11 European Union countries from 2010/11 to 2019/20.MethodsCase-based surveillance data from hospitalised patients with known age, sex, outcome, ward, vaccination status, timing of antiviral treatment, and hospitalisation were obtained. A mixed effect logistic regression model using country as random intercept was applied to estimate the adjusted odds ratio (aOR) for in-hospital death in patients treated with NAIs vs not treated.ResultsOf 19,937 patients, 31% received NAIs within 48 hours of hospital admission. Older age (60-79 years aOR 3.0, 95% CI: 2.4-3.8; 80 years 8.3 (6.6-10.5)) and intensive care unit admission (3.8, 95% CI: 3.4-4.2) increased risk of dying, while early hospital admission after symptom onset decreased risk (aOR 0.91, 95% CI: 0.90-0.93). NAI treatment initiation within 48 hours and up to 7 days reduced risk of dying (0-48 hours aOR 0.51, 95% CI: 0.45-0.59; 3-4 days 0.59 (0.51-0.67); 5-7 days 0.64 (0.56-0.74)), in particular in patients 40 years and older (e.g. treatment within 48 hours: 40-59 years aOR 0.43, 95% CI: 0.28-0.66; 60-79 years 0.50 (0.39-0.63); ≥80 years 0.51 (0.42-0.63)).ConclusionNAI treatment given within 48 hours and possibly up to 7 days after symptom onset reduced risk of in-hospital death. NAI treatment should be considered in older patients to prevent severe outcomes.

VL - 28 CP - 4 M3 - 10.2807/1560-7917.ES.2023.28.4.2200340 ER -