Early oseltamivir treatment improves survival in critically ill patients with influenza pneumonia.

Autor:	Moreno G; Critical Care Dept, Hospital Universitari de Tarragona Joan XXIII, URV/IISPV/CIBERES, Tarragona, Spain.; These authors contributed equally., Rodríguez A; Critical Care Dept, Hospital Universitari de Tarragona Joan XXIII, URV/IISPV/CIBERES, Tarragona, Spain.; These authors contributed equally., Sole-Violán J; Critical Care Dept, Hospital Universitario de Gran Canaria Dr Negrín, CIBERES, Las Palmas de Gran Canaria, Spain., Martín-Loeches I; Dept of Anaesthesia and Critical Care, St James's University Hospital, Trinity Centre for Health Sciences, Multidisciplinary Intensive Care Research Organisation (MICRO), Dublin, Ireland., Díaz E; Critical Care Dept, Hospital Parc Taulí, CIBERES, Sabadell, Spain., Bodí M; Critical Care Dept, Hospital Universitari de Tarragona Joan XXIII, URV/IISPV/CIBERES, Tarragona, Spain., Reyes LF; Microbiology Dept, Universidad de La Sabana, Bogotá, Colombia., Gómez J; Critical Care Dept, Hospital Universitari de Tarragona Joan XXIII, URV/IISPV/CIBERES, Tarragona, Spain., Guardiola J; Division of Pulmonary, Critical Care and Sleep Medicine, University of Louisville and Robley Rex VA Medical Center, Louisville, KY, USA., Trefler S; Critical Care Dept, Hospital Universitari de Tarragona Joan XXIII, URV/IISPV/CIBERES, Tarragona, Spain., Vidaur L; Critical Care Dept, Hospital Universitario Donostia, San Sebastián, Spain., Papiol E; Critical Care Dept, Hospital Vall d'Hebrón, Barcelona, Spain., Socias L; Critical Care Dept, Hospital Son Llàtzer, Palma de Mallorca, Spain., García-Vidal C; Infectious Diseases, Hospital Clínic de Barcelona, Barcelona, Spain., Correig E; Critical Care Dept, Hospital Universitari de Tarragona Joan XXIII, URV/IISPV/CIBERES, Tarragona, Spain., Marín-Corral J; Critical Care Dept, Hospital Del Mar, Research Group in Critical Disorders (GREPAC), IMIM, Barcelona, Spain., Restrepo MI; South Texas Veterans Health Care System, University of Texas Health Sciences at San Antonio, San Antonio, TX, USA., Nguyen-Van-Tam JS; Health Protection and Influenza Research Group, Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK., Torres A; Servei de Pneumologia i Al·lèrgia Respiratòria, Institut Clínic del Tórax, Hospital Clínic de Barcelona, CIBERES, Barcelona, Spain.; GETGAG Study Group Investigators are listed in the supplementary material.
Jazyk:	angličtina
Zdroj:	ERJ open research [ERJ Open Res] 2021 Mar 08; Vol. 7 (1). Date of Electronic Publication: 2021 Mar 08 (Print Publication: 2021).
DOI:	10.1183/23120541.00888-2020
Abstrakt:	Background: The relationship between early oseltamivir treatment (within 48 h of symptom onset) and mortality in patients admitted to intensive care units (ICUs) with severe influenza is disputed. This study aimed to investigate the association between early oseltamivir treatment and ICU mortality in critically ill patients with influenza pneumonia. Methods: This was an observational study of patients with influenza pneumonia admitted to 184 ICUs in Spain during 2009-2018. The primary outcome was to evaluate the association between early oseltamivir treatment and ICU mortality compared with later treatment. Secondary outcomes were to compare the duration of mechanical ventilation and ICU length of stay between the early and later oseltamivir treatment groups. To reduce biases related to observational studies, propensity score matching and a competing risk analysis were performed. Results: During the study period, 2124 patients met the inclusion criteria. All patients had influenza pneumonia and received oseltamivir before ICU admission. Of these, 529 (24.9%) received early oseltamivir treatment. In the multivariate analysis, early treatment was associated with reduced ICU mortality (OR 0.69, 95% CI 0.51-0.95). After propensity score matching, early oseltamivir treatment was associated with improved survival rates in the Cox regression (hazard ratio 0.77, 95% CI 0.61-0.99) and competing risk (subdistribution hazard ratio 0.67, 95% CI 0.53-0.85) analyses. The ICU length of stay and duration of mechanical ventilation were shorter in patients receiving early treatment. Conclusions: Early oseltamivir treatment is associated with improved survival rates in critically ill patients with influenza pneumonia, and may decrease ICU length of stay and mechanical ventilation duration. Competing Interests: Conflict of interest: G. Moreno has nothing to disclose. Conflict of interest: A. Rodríguez has nothing to disclose. Conflict of interest: J. Sole-Violán has nothing to disclose. Conflict of interest: I. Martín-Loeches has nothing to disclose. Conflict of interest: E. Díaz has nothing to disclose. Conflict of interest: M. Bodí has nothing to disclose. Conflict of interest: L.F. Reyes has nothing to disclose. Conflict of interest: J. Gómez has nothing to disclose. Conflict of interest: J. Guardiola has nothing to disclose. Conflict of interest: S. Trefler has nothing to disclose. Conflict of interest: L. Vidaur has nothing to disclose. Conflict of interest: E. Papiol has nothing to disclose. Conflict of interest: L. Socias has nothing to disclose. Conflict of interest: C. García-Vidal reports grants and other support from Gilead Science and Merck Sharp & Dohme, and other support from Novartis, Pfizer, Janssen and Lilly, outside the submitted work. Conflict of interest: E. Correig has nothing to disclose. Conflict of interest: J. Marín-Corral has nothing to disclose. Conflict of interest: M.I. Restrepo has nothing to disclose. Conflict of interest: J.S. Nguyen-Van-Tam reports grants from F. Hoffmann-La Roche, outside the submitted work. He was seconded to the Dept of Health and Social Care (DHSC) England in 2017; the views in this article are those of the authors and not necessarily those of the DHSC. Conflict of interest: A. Torres has nothing to disclose. (Copyright ©ERS 2021.)
Databáze:	MEDLINE
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