RT Journal Article
SR Electronic
T1 Differences between asthmatics and nonasthmatics hospitalised with influenza A infection
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 824
OP 831
DO 10.1183/09031936.00015512
VO 41
IS 4
A1 Puja Myles
A1 Jonathan S. Nguyen-Van-Tam
A1 Malcolm G. Semple
A1 Stephen J. Brett
A1 Barbara Bannister
A1 Robert C. Read
A1 Bruce L. Taylor
A1 Jim McMenamin
A1 Joanne E. Enstone
A1 Karl G. Nicholson
A1 Peter J. Openshaw
A1 Wei Shen Lim
YR 2013
UL http://erj.ersjournals.com/content/41/4/824.abstract
AB Asthmatics hospitalised because of influenza A infection are less likely to require intensive care or die compared with nonasthmatics. The reasons for this are unknown.We performed a retrospective analysis of data on 1520 patients admitted to 75 UK hospitals with confirmed influenza A/H1N1 2009 infection. A multivariable model was used to investigate reasons for the association between asthma and severe outcomes (intensive care unit support or death).Asthmatics were less likely than nonasthmatics to have severe outcome (11.2% versus 19.8%, unadjusted OR 0.51, 95% CI 0.36–0.72) despite a greater proportion requiring oxygen on admission (36.4% versus 26%, unadjusted OR 1.63) and similar rates of pneumonia (17.1% versus 16.6%, unadjusted OR 1.04). The results of multivariable logistic regression suggest the association of asthma with outcome (adjusted OR 0.62, 95% CI 0.36–1.05; p=0.075) are explained by pre-admission inhaled corticosteroid use (adjusted OR 0.34, 95% CI 0.18–0.66) and earlier admission (≤4 days from symptom onset) (adjusted OR 0.60, 95% CI 0.38–0.94). In asthmatics, systemic corticosteroids were associated with a decreased likelihood of severe outcomes (adjusted OR 0.36, 95% CI 0.18–0.72).Corticosteroid use and earlier hospital admission explained the association of asthma with less severe outcomes in hospitalised patients.