Association of Chronic Medical Conditions With Severe Outcomes Among Nonpregnant Adults 18-49 Years Old Hospitalized With Influenza, FluSurv-NET, 2011-2019

Older age and chronic conditions are associated with severe influenza outcomes; however, data are only comprehensively available for adults ≥65 years old. Using data from the Influenza Hospitalization Surveillance Network (FluSurv-NET), we identified characteristics associated with severe outcomes i...

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Bibliographic Details
Published in:	Open forum infectious diseases Vol. 10; no. 12; p. ofad599
Main Authors:	Famati, Efemona A, Ujamaa, Dawud, O'Halloran, Alissa, Kirley, Pam Daily, Chai, Shua J, Armistead, Isaac, Alden, Nisha B, Yousey-Hindes, Kimberly, Openo, Kyle P, Ryan, Patricia A, Monroe, Maya L, Falkowski, Anna, Kim, Sue, Lynfield, Ruth, McMahon, Melissa, Angeles, Kathy M, Khanlian, Sarah A, Spina, Nancy L, Bennett, Nancy M, Gaitán, Maria A, Shiltz, Eli, Lung, Krista, Thomas, Ann, Talbot, H Keipp, Schaffner, William, George, Andrea, Staten, Holly, Bozio, Catherine H, Garg, Shikha
Format:	Journal Article
Language:	English
Published:	United States Oxford University Press 01-12-2023
Subjects:	Major influenza chronic conditions hospitalizations adults severe
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Summary:	Older age and chronic conditions are associated with severe influenza outcomes; however, data are only comprehensively available for adults ≥65 years old. Using data from the Influenza Hospitalization Surveillance Network (FluSurv-NET), we identified characteristics associated with severe outcomes in adults 18-49 years old hospitalized with influenza. We included FluSurv-NET data from nonpregnant adults 18-49 years old hospitalized with laboratory-confirmed influenza during the 2011-2012 through 2018-2019 seasons. We used bivariate and multivariable logistic regression to determine associations between select characteristics and severe outcomes including intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), and in-hospital death. A total of 16 140 patients aged 18-49 years and hospitalized with influenza were included in the analysis; the median age was 39 years, and 26% received current-season influenza vaccine before hospitalization. Obesity, asthma, and diabetes mellitus were the most common chronic conditions. Conditions associated with a significantly increased risk of severe outcomes included age group 30-39 or 40-49 years (IMV, age group 30-39 years: adjusted odds ratio [aOR], 1.25; IMV, age group 40-49 years: aOR, 1.36; death, age group 30-39 years: aOR, 1.28; death, age group 40-49 years: aOR, 1.69), being unvaccinated (ICU: aOR, 1.18; IMV: aOR, 1.25; death: aOR, 1.48), and having chronic conditions including extreme obesity and chronic lung, cardiovascular, metabolic, neurologic, or liver diseases (ICU: range aOR, 1.22-1.56; IMV: range aOR, 1.17-1.54; death: range aOR, 1.43-2.36). To reduce the morbidity and mortality associated with influenza among adults aged 18-49 years, health care providers should strongly encourage receipt of annual influenza vaccine and lifestyle/behavioral modifications, particularly among those with chronic medical conditions.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Potential conflicts of interest. D.U. reports that he is a contract employee of GDIT. K.Y.H. reports grants from the CDC for the Connecticut Emerging Infections Program. M.M. reports grants from the CDC for the Emerging Infections Program. P.R. reports funding support from the Emerging Infections Program Cooperative agreement. A.F. reports grants from the Michigan Department of Health and Human Services from the CSTE Federal Grand. S.K. reports grants from the Michigan Department of Health and Human Services from the CSTE Federal Grand. R.L. reports grants from the CDC Emerging Infections Cooperative Agreement to the MN Department of Health. S.K. reports salary and data collection for the manuscript supported by a grant received from the CDC Emerging Infections Program. K.A. reports salary and data collection for the manuscript supported by a grant received from the CDC Emerging Infections Program. N.B. reports an agreement to consult for the GSK. E.S. reports grant funding for the population-based Influenza Hospitalization Surveillance Project (IHSP) and COVID-Net activities, including support for personnel and equipment for data collection activities from the Council for State and Territorial Epidemiologists (CSTE). W.S. reports a grant from the CDC Emerging Infections Program. H.K.T. reports a grant from the CDC. A.G. reports a grant from the CSTE. All other authors report no potential conflicts.
ISSN:	2328-8957 2328-8957
DOI:	10.1093/ofid/ofad599