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.

• Klíčová slova
• EU, Influenza, antiviral treatment, clinic, epidemiology, fatal outcome, hospital, influenza virus, risk factors, surveillance,
• MeSH
• antivirové látky terapeutické užití   MeSH
• chřipka lidská * farmakoterapie   epidemiologie   MeSH
• guanidiny terapeutické užití   MeSH
• inhibitory enzymů terapeutické užití   MeSH
• lidé MeSH
• mortalita v nemocnicích MeSH
• neuraminidasa MeSH
• oseltamivir * terapeutické užití   MeSH
• senioři MeSH
• výsledek terapie MeSH
• zanamivir terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antivirové látky MeSH
• guanidiny MeSH
• inhibitory enzymů MeSH
• neuraminidasa MeSH
• oseltamivir * MeSH
• zanamivir MeSH

BACKGROUND: Morbidity, severity, and mortality associated with annual influenza epidemics are of public health concern. We analyzed surveillance data on hospitalized laboratory-confirmed influenza cases admitted to intensive care units to identify common determinants for fatal outcome and inform and target public health prevention strategies, including risk communication. METHODS: We performed a descriptive analysis and used Poisson regression models with robust variance to estimate the association of age, sex, virus (sub)type, and underlying medical condition with fatal outcome using European Union data from 2009 to 2017. RESULTS: Of 13 368 cases included in the basic dataset, 2806 (21%) were fatal. Age ≥40 years and infection with influenza A virus were associated with fatal outcome. Of 5886 cases with known underlying medical conditions and virus A subtype included in a more detailed analysis, 1349 (23%) were fatal. Influenza virus A(H1N1)pdm09 or A(H3N2) infection, age ≥60 years, cancer, human immunodeficiency virus infection and/or other immune deficiency, and heart, kidney, and liver disease were associated with fatal outcome; the risk of death was lower for patients with chronic lung disease and for pregnant women. CONCLUSIONS: This study re-emphasises the importance of preventing influenza in the elderly and tailoring strategies to risk groups with underlying medical conditions.

• Klíčová slova
• EU, age, influenza virus, intensive care units, underlying medical conditions,
• Publikační typ
• časopisecké články MeSH

Severe influenza infection has no effective treatment available. One of the key barriers to developing host-directed therapy is a lack of reliable prognostic factors needed to guide such therapy. Here, we use a network analysis approach to identify host factors associated with severe influenza and fatal outcome. In influenza patients with moderate-to-severe diseases, we uncover a complex landscape of immunological pathways, with the main changes occurring in pathways related to circulating neutrophils. Patients with severe disease display excessive neutrophil extracellular traps formation, neutrophil-inflammation and delayed apoptosis, all of which have been associated with fatal outcome in animal models. Excessive neutrophil activation correlates with worsening oxygenation impairment and predicted fatal outcome (AUROC 0.817-0.898). These findings provide new evidence that neutrophil-dominated host response is associated with poor outcomes. Measuring neutrophil-related changes may improve risk stratification and patient selection, a critical first step in developing host-directed immune therapy.

• MeSH
• aktivace neutrofilů imunologie   MeSH
• buněčný cyklus imunologie   MeSH
• chřipka lidská imunologie   mortalita   patologie   MeSH
• exprese genu genetika   MeSH
• extracelulární pasti imunologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• neutrofily imunologie   MeSH
• plíce imunologie   MeSH
• prospektivní studie MeSH
• respirační insuficience mortalita   patologie   virologie   MeSH
• umělé dýchání MeSH
• virus chřipky A, podtyp H1N1 imunologie   izolace a purifikace   MeSH
• virus chřipky A, podtyp H3N2 imunologie   izolace a purifikace   MeSH
• virus chřipky B imunologie   izolace a purifikace   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Seasonal influenza is a prevalent and serious annual illness resulting in widespread morbidity and economic disruption throughout the population; the elderly and immunocompromised are particularly vulnerable to serious sequelae and mortality. The changing demographics worldwide to an aging society have important implications for public health policy and pharmaceutical innovations. For instance, primary prevention via immunization is effective in reducing the burden of influenza illness among the elderly. However, the elderly may be insufficiently protected by vaccination due to the immunosenescence which accompanies aging. In addition, vaccine hesitancy among the younger populations increases the likelihood of circulating infectious diseases, and thus concomitant exposure. While it is clear that the development of more immunogenic vaccines is an imperative and worthy endeavor, clinical trials continue to demonstrate that the current influenza vaccine formulation remains highly effective in reducing morbidity and mortality when well matched to circulating strains.

• Klíčová slova
• burden of flu, efficacy, elderly, immunization strategies, influenza vaccination,
• MeSH
• chřipka lidská imunologie   prevence a kontrola   MeSH
• lidé MeSH
• senioři MeSH
• stárnutí imunologie   MeSH
• vakcinace metody   MeSH
• vakcíny proti chřipce imunologie   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• vakcíny proti chřipce MeSH

The Global Influenza Hospital Surveillance Network (GIHSN) has established a prospective, active surveillance, hospital-based epidemiological study to collect epidemiological and virological data for the Northern and Southern Hemispheres over several consecutive seasons. It focuses exclusively on severe cases of influenza requiring hospitalization. A standard protocol is shared between sites allowing comparison and pooling of results. During the 2014-2015 influenza season, the GIHSN included seven coordinating sites from six countries (St. Petersburg and Moscow, Russian Federation; Prague, Czech Republic; Istanbul, Turkey; Beijing, China; Valencia, Spain; and Rio de Janeiro, Brazil). Here, we present the detailed epidemiological and influenza vaccine effectiveness findings for the Northern Hemisphere 2014-2015 influenza season.

• Klíčová slova
• Epidemiological study, Hospitalization, Influenza, Surveillance, Vaccine, Virus,
• MeSH
• chřipka lidská epidemiologie   prevence a kontrola   MeSH
• dítě MeSH
• dospělí MeSH
• hospitalizace * MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• prospektivní studie MeSH
• roční období MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• surveillance populace * MeSH
• vakcíny proti chřipce imunologie   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Brazílie epidemiologie   MeSH
• Česká republika epidemiologie   MeSH
• Čína epidemiologie   MeSH
• Rusko epidemiologie   MeSH
• Španělsko epidemiologie   MeSH
• Turecko epidemiologie   MeSH
• Názvy látek
• vakcíny proti chřipce MeSH