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Impact of Neuraminidase Inhibitors on Influenza A(H1n1)Pdm09-Related Pneumonia: An Individual Participant Data Meta-Analysis Publisher Pubmed



Muthuri SG1 ; Venkatesan S1 ; Myles PR1 ; Leonardibee J1 ; Lim WS2 ; Al Mamun A3 ; Anovadiya AP4 ; Araujo WN5 ; Azzizbaumgartner E6 ; Baez C7 ; Bantar C8 ; Barhoush MM9 ; Bassetti M10 ; Beovic B11 Show All Authors
Authors
  1. Muthuri SG1
  2. Venkatesan S1
  3. Myles PR1
  4. Leonardibee J1
  5. Lim WS2
  6. Al Mamun A3
  7. Anovadiya AP4
  8. Araujo WN5
  9. Azzizbaumgartner E6
  10. Baez C7
  11. Bantar C8
  12. Barhoush MM9
  13. Bassetti M10
  14. Beovic B11
  15. Bingisser R12
  16. Bonmarin I13
  17. Borjaaburto VH14
  18. Cao B15
  19. Carratala J16
  20. Cuezzo MR17
  21. Denholm JT18
  22. Dominguez SR19
  23. Duarte PAD20
  24. Dubnovraz G21
  25. Echavarria M22
  26. Fanella S23
  27. Fraser J24
  28. Gao Z25
  29. Gerardin P26, 27, 28, 29
  30. Giannella M30
  31. Gubbels S31
  32. Herberg J32
  33. Higuera Iglesias AL33
  34. Hoeger PH34
  35. Hoffmann M35
  36. Hu X36
  37. Islam QT37
  38. Jimenez MF38
  39. Kandeel A39
  40. Keijzers G40
  41. Khalili H41
  42. Khandaker G42
  43. Knight M43
  44. Kusznierz G44
  45. Kuzman I45
  46. Kwan AMC46
  47. Lahlou Amine I47
  48. Langenegger E48
  49. Lankarani KB49
  50. Leo YS50
  51. Linko R51
  52. Liu P52
  53. Madanat F53
  54. Manabe T54
  55. Mayomontero E55
  56. Mcgeer A56
  57. Memish ZA57, 58
  58. Metan G59
  59. Mikic D60
  60. Mohn KGI61, 62
  61. Moradi A63, 64
  62. Nymadawa P65
  63. Ozbay B66
  64. Ozkan M67
  65. Parekh D68
  66. Paul M69
  67. Poeppl W70
  68. Polack FP71, 72
  69. Rath BA73
  70. Rodriguez AH74
  71. Siqueira MM75
  72. Skretmagierlo J76
  73. Talarek E77
  74. Tang JW78, 79, 80
  75. Torres A81
  76. Torun SH82
  77. Tran D83
  78. Uyeki TM84
  79. Van Zwol A85
  80. Vaudry W86
  81. Velyvyte D87
  82. Vidmar T88
  83. Zarogoulidis P89
  84. Nguyenvantam JS1
Show Affiliations
Authors Affiliations
  1. 1. Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
  2. 2. Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
  3. 3. International Centre for Diarrhoeal Diseases, Research Bangladesh (ICDDRB), Dhaka, Bangladesh
  4. 4. Department of Pharmacology, Government Medical College and Sir Takhtsinhji General Hospital, Bhavnagar, India
  5. 5. University of Brasilia, Brasilia, Brazil
  6. 6. Centers for Disease Control and Prevention, Atlanta, GA, United States
  7. 7. Ministerio de Salud de la Provincia de Buenos Aires, Buenos Aires, Argentina
  8. 8. Department of Infection Control, Hospital San Martin de Parana, Entre Rios, Argentina
  9. 9. Department of Medicine, King Saud Medical City, Riyadh, Saudi Arabia
  10. 10. Santa Maria Misericordia Hospital, Udine, Italy
  11. 11. Department of Infectious Diseases, University Medical Centre, Ljubljana, Slovenia
  12. 12. Department of Emergency Medicine, University Hospital Basel, Basel, Switzerland
  13. 13. Institut de Veille Sanitaire, Saint-Maurice, France
  14. 14. Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
  15. 15. Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
  16. 16. Department of Infectious Diseases, Hospital Universitari de Bellvitge, Bellvitge Institute for Biomedical Research, L'Hospitalet de Llobregat, Red Espanola de Investigacion en Patologia Infecciosa, Univ. of Barcelona, Barcelona, Spain
  17. 17. Ministerio de Salud de Tucuman, Tucuman, Argentina
  18. 18. Victorian Infectious Diseases Service and Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, Parkville, VIC, Australia
  19. 19. Department of Pediatric Infectious Diseases, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, United States
  20. 20. Universidade Estadual do Oeste do Parana, UNIOESTE, Cascavel, PR, Brazil
  21. 21. The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel
  22. 22. Clinical Virology Laboratory, CEMIC University Hospital, Buenos Aires, Argentina
  23. 23. Section of Pediatric Infectious Diseases, University of Manitoba, Winnipeg, Canada
  24. 24. Paediatric Intensive Care Unit, Bristol Children's Hospital, Bristol, United Kingdom
  25. 25. Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China
  26. 26. NICU/PICU, PFME, CHU Saint Pierre, La Reunion, France
  27. 27. CIC 1410 (CHU/Inserm/University of La Reunion/URML-OI), CHU Saint Pierre, La Reunion, France
  28. 28. UMR PIMIT (CHU/Inserm/University of La Reunion/IRD/CNRS), CYROI, Saint Denis - Reunion Island, France
  29. 29. NICU/PICU CHU of La Reunion, Groupe Hospitalier Sud Reunion, La Reunion, France
  30. 30. Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Maranon, Madrid, Spain
  31. 31. Department of Infectious Disease Epidemiology, Sector for National Health Documentation and Research, Statens Serum Institut, Copenhagen, Denmark
  32. 32. Section of Paediatrics, Division of Infectious Disease, Imperial College, London, United Kingdom
  33. 33. Epidemiology Research Unit, Instituto Nacional de Enfermedades Respiratorias, Ismael Cosio Villegas, Mexico City, Mexico
  34. 34. Cath. Children's Hospital Wilhelmstift, Hamburg, Germany
  35. 35. Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
  36. 36. Peking Union Medical College Hospital, Beijing, China
  37. 37. Dhaka Medical College Hospital, Dhaka, Bangladesh
  38. 38. Departamento de Ginecologia e Obstetricia - UFCSPA, Preceptora da Residencia Medica do Hospital Femina, Porto Alegre, Brazil
  39. 39. Ministry of Health in Egypt, Cairo, Egypt
  40. 40. Gold Coast Hospital, Gold Coast, QLD, Australia
  41. 41. Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
  42. 42. National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, University of Sydney, Sydney, Australia
  43. 43. National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
  44. 44. National Institute of Respiratory Diseases 'Emilio Coni' ANLIS C. Malbran, Santa Fe, Argentina
  45. 45. School of Medicine, University Hospital for Infectious Diseases, University of Zagreb, Zagreb, Croatia
  46. 46. Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
  47. 47. Faculty of Medicine and Pharmacy, Mohammed V Military Teaching Hospital, Biosafety Level 3 and Research Laboratory, University Mohammed V-Souissi, Rabat, Morocco
  48. 48. Department of Obstetrics and Gynaecology, Stellenbosch University and Tygerberg, Stellenbosch, South Africa
  49. 49. Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  50. 50. Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore
  51. 51. Helsinki University Hospital, Helsinki, Finland
  52. 52. Department of Infectious Diseases, The First Affiliated Hospital, China Medical University, Shenyang, China
  53. 53. Department of Pediatrics, King Hussein Cancer Center, Amman, Jordan
  54. 54. Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
  55. 55. Instituto de Medicina Preventiva de la Defensa, Capitan Medico Ramon y Cajal (IMPDEF), Ministerio de Defensa, Madrid, Spain
  56. 56. Toronto Invasive Bacterial Diseases Network, University of Toronto, Toronto, ON, Canada
  57. 57. Ministry of Health, Riyadh, Saudi Arabia
  58. 58. College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
  59. 59. Department of Infectious Diseases and Clinical Microbiology, Erciyes University Faculty of Medicine, Kayseri, Turkey
  60. 60. Military Medical Academy, Clinic for Infectious and Tropical Diseases, Belgrade, Serbia
  61. 61. Section for Infectious Diseases, Medical Department, and Department of Research and Development, Haukeland University Hospital, Bergen, Norway
  62. 62. Department of Clinical Science, The Influenza Centre, University of Bergen, Bergen, Norway
  63. 63. The Division of Ocular Immunology, Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, United States
  64. 64. National Research Institute for Tuberculosis and Lung Disease, Massih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  65. 65. National Influenza Center, National Center of Communicable Diseases, Ministry of Health, Ulaanbaatar, Mongolia
  66. 66. Department of Pulmonary and Critical Care, Yuzuncu Yil University Medical Faculty, Van, Turkey
  67. 67. Clinic of Pediatric Neurology, Dr. Sami Ulus Research and Training Hospital of Women's and Children's Health and Diseases, Ankara, Turkey
  68. 68. Critical Care and Pain Perioperative, Critical Care and Trauma Trials Group, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, United Kingdom
  69. 69. Division of Infectious Diseases, Rambam Health Care Campus, Haifa, Israel
  70. 70. Medical University of Vienna, Vienna, Austria
  71. 71. Department of Pediatrics, Vanderbilt Vaccine Center, Vanderbilt University, Nashville, United States
  72. 72. Fundacion INFANT, Buenos Aires, Argentina
  73. 73. Division of Pneumonology-Immunology, Department of Pediatrics, Charite University Medical Center, Berlin, Germany
  74. 74. Critical Care Department, Hospital Joan XXIII, IISPV, URV, CIBERES, Tarragona, Spain
  75. 75. Laboratory of Respiratory Viruses, Oswaldo Cruz Institute/Fiocruz, Rio de Janeiro, Brazil
  76. 76. Uniwersytet Rzeszowski, Rzeszow, Poland
  77. 77. Department of Children's Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
  78. 78. Division of Microbiology/Molecular Diagnostic Centre, Department of Laboratory Medicine, National University Hospital, Singapore, Singapore
  79. 79. Alberta Provincial Laboratory for Public Health, University of Alberta Hospital, Edmonton, Canada
  80. 80. Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada
  81. 81. Hospital Clinic, University of Barcelona, IDIBAPS, CIBERES, Barcelona, Spain
  82. 82. Department of Pediatric Infectious Diseases, Istanbul Medical Faculty, Istanbul, Turkey
  83. 83. Division of Infectious Diseases, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Canada
  84. 84. Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
  85. 85. Department of Pediatric Intensive Care, VU University Medical Center, Amsterdam, Netherlands
  86. 86. Division of Infectious Diseases, Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada
  87. 87. Lithuanian University of Health Sciences, Kaunas, Lithuania
  88. 88. General Hospital, Slovenj Gradec, Slovenia
  89. 89. Unit of Infectious Diseases, University General Hospital of Alexandroupolis, Democritus University Thrace, Dragana, Greece

Source: Influenza and other Respiratory Viruses Published:2016


Abstract

Background: The impact of neuraminidase inhibitors (NAIs) on influenza-related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. Methods: A worldwide meta-analysis of individual participant data from 20 634 hospitalised patients with laboratory-confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) 'pandemic influenza'. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. Results: Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64-1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44-1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71-1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55-0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54-0·85; P = 0·001)]. Conclusions: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support. © 2016 John Wiley & Sons Ltd..