Daniel Owusu1,2, Melissa A Rolfes2, Carmen S Arriola2, Pam Daily Kirley3, Nisha B Alden4, James Meek5, Evan J Anderson6,7,8, Maya L Monroe9, Sue Kim10, Ruth Lynfield11, Kathy Angeles12, Nancy Spina13, Christina B Felsen14, Laurie Billing15, Ann Thomas16, H Keipp Talbot17, William Schaffner17, Ryan Chatelain18, Carrie Reed2, Shikha Garg2. 1. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 2. Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 3. California Emerging Infections Program, Oakland, California, USA. 4. Colorado Department of Public Health and Environment, Denver, Colorado, USA. 5. Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, Connecticut, USA. 6. Department of Medicine and Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA. 7. Georgia Emerging Infections Program, Georgia Department of Health, Atlanta, Georgia, USA. 8. Atlanta Veterans Affairs Medical Center, Atlanta, Georgia, USA. 9. Maryland Department of Health, Baltimore, Maryland, USA. 10. Michigan Department of Health and Human Services, Lansing, Michigan, USA. 11. Minnesota Department of Health, St Paul, Minnesota, USA. 12. New Mexico Department of Health, Santa Fe, New Mexico, USA. 13. New York State Department of Health, Albany, New York, USA. 14. University of Rochester School of Medicine and Dentistry, Rochester, New York, USA. 15. Ohio Department of Health, Columbus, Ohio, USA. 16. Oregon Public Health Authority, Portland, Oregon, USA. 17. Vanderbilt University School of Medicine, Nashville, Tennessee, USA. 18. Salt Lake County Health Department, Salt Lake City, Utah, USA.
Abstract
Background: Diabetes mellitus (DM) is common among older adults hospitalized with influenza, yet data are limited on the impact of DM on risk of severe influenza-associated outcomes. Methods: We included adults aged ≥65 years hospitalized with influenza during 2012-2013 through 2016-2017 from the Influenza Hospitalization Surveillance Network (FluSurv-NET), a population-based surveillance system for laboratory-confirmed influenza-associated hospitalizations conducted in defined counties within 13 states. We calculated population denominators using the Centers for Medicare and Medicaid Services county-specific DM prevalence estimates and National Center for Health Statistics population data. We present pooled rates and rate ratios (RRs) of intensive care unit (ICU) admission, pneumonia diagnosis, mechanical ventilation, and in-hospital death for persons with and without DM. We estimated RRs and 95% confidence intervals (CIs) using meta-analysis with site as a random effect in order to control for site differences in the estimates. Results: Of 31 934 hospitalized adults included in the analysis, 34% had DM. Compared to those without DM, adults with DM had higher rates of influenza-associated hospitalization (RR, 1.57 [95% CI, 1.43-1.72]), ICU admission (RR, 1.84 [95% CI, 1.67-2.04]), pneumonia (RR, 1.57 [95% CI, 1.42-1.73]), mechanical ventilation (RR, 1.95 [95% CI, 1.74-2.20]), and in-hospital death (RR, 1.48 [95% CI, 1.23-1.80]). Conclusions: Older adults with DM have higher rates of severe influenza-associated outcomes compared to those without DM. These findings reinforce the importance of preventing influenza virus infections through annual vaccination, and early treatment of influenza illness with antivirals in older adults with DM. Published by Oxford University Press on behalf of Infectious Diseases Society of America 2022.
Background: Diabetes mellitus (DM) is common among older adults hospitalized with influenza, yet data are limited on the impact of DM on risk of severe influenza-associated outcomes. Methods: We included adults aged ≥65 years hospitalized with influenza during 2012-2013 through 2016-2017 from the Influenza Hospitalization Surveillance Network (FluSurv-NET), a population-based surveillance system for laboratory-confirmed influenza-associated hospitalizations conducted in defined counties within 13 states. We calculated population denominators using the Centers for Medicare and Medicaid Services county-specific DM prevalence estimates and National Center for Health Statistics population data. We present pooled rates and rate ratios (RRs) of intensive care unit (ICU) admission, pneumonia diagnosis, mechanical ventilation, and in-hospital death for persons with and without DM. We estimated RRs and 95% confidence intervals (CIs) using meta-analysis with site as a random effect in order to control for site differences in the estimates. Results: Of 31 934 hospitalized adults included in the analysis, 34% had DM. Compared to those without DM, adults with DM had higher rates of influenza-associated hospitalization (RR, 1.57 [95% CI, 1.43-1.72]), ICU admission (RR, 1.84 [95% CI, 1.67-2.04]), pneumonia (RR, 1.57 [95% CI, 1.42-1.73]), mechanical ventilation (RR, 1.95 [95% CI, 1.74-2.20]), and in-hospital death (RR, 1.48 [95% CI, 1.23-1.80]). Conclusions: Older adults with DM have higher rates of severe influenza-associated outcomes compared to those without DM. These findings reinforce the importance of preventing influenza virus infections through annual vaccination, and early treatment of influenza illness with antivirals in older adults with DM. Published by Oxford University Press on behalf of Infectious Diseases Society of America 2022.
Entities:
Keywords:
diabetes mellitus; influenza; influenza hospitalization; severe influenza outcomes
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