Journal article
Benefit of early oseltamivir therapy for adults hospitalized with influenza A: an observational study
Clinical infectious diseases, Vol.81(1), pp.190-197
08/01/2025
DOI: 10.1093/cid/ciae584
PMCID: PMC13016773
PMID: 39607747
Abstract
Background
Clinical guidelines recommend initiation of antiviral therapy as soon as possible for patients hospitalized with confirmed or suspected influenza.
Methods
A multicenter US observational sentinel surveillance network prospectively enrolled adults (aged ≥18 years) hospitalized with laboratory-confirmed influenza at 24 hospitals during October 1, 2022-July 21, 2023. A multivariable proportional odds model was used to compare peak pulmonary disease severity (no oxygen support, standard supplemental oxygen, high-flow oxygen/non-invasive ventilation, invasive mechanical ventilation, or death) after the day of hospital admission among patients starting oseltamivir treatment on the day of admission (early) versus those who did not (late or not treated), adjusting for baseline (admission day) severity, age, sex, site, and vaccination status. Multivariable logistic regression models were used to evaluate the odds of intensive care unit (ICU) admission, acute kidney replacement therapy or vasopressor use, and in-hospital death.
Results
A total of 840 influenza-positive patients were analyzed, including 415 (49%) who started oseltamivir treatment on the day of admission, and 425 (51%) who did not. Compared with late or not treated patients, those treated early had lower peak pulmonary disease severity (proportional aOR: 0.60, 95% CI: 0.49-0.72), and lower odds of intensive care unit admission (aOR: 0.24, 95% CI: 0.13-0.47), acute kidney replacement therapy or vasopressor use (aOR: 0.40, 95% CI: 0.22-0.67), and in-hospital death (aOR: 0.36, 95% CI: 0.18-0.72).
Conclusion
Among adults hospitalized with influenza, treatment with oseltamivir on day of hospital admission was associated reduced risk of disease progression, including pulmonary and extrapulmonary organ failure and death.
Details
- Title: Subtitle
- Benefit of early oseltamivir therapy for adults hospitalized with influenza A: an observational study
- Creators
- Nathaniel M Lewis - National Center for Immunization and Respiratory DiseasesElizabeth J Harker - National Center for Immunization and Respiratory DiseasesLauren B Grant - National Center for Immunization and Respiratory DiseasesYuwei Zhu - Vanderbilt University Medical CenterCarlos G Grijalva - Vanderbilt University Medical CenterJames D Chappell - Vanderbilt University Medical CenterJillian P Rhoads - Vanderbilt University Medical CenterAdrienne Baughman - Vanderbilt University Medical CenterJonathan D Casey - Vanderbilt University Medical CenterPaul W Blair - Vanderbilt University Medical CenterIan D Jones - Vanderbilt University Medical CenterCassandra A Johnson - Vanderbilt University Medical CenterAdam S Lauring - University of MichiganManju Gaglani - Baylor College of MedicineShekhar Ghamande - Baylor College of MedicineCristie Columbus - Baylor College of MedicineJay S Steingrub - Baystate Medical CenterNathan I Shapiro - Beth Israel Deaconess Medical CenterAbhijit Duggal - Cleveland ClinicLaurence W Busse - Emory UniversityJamie Felzer - Emory UniversityMatthew E Prekker - Hennepin County Medical CenterIthan D Peltan - Intermountain Medical CenterSamuel M Brown - University of UtahDavid N Hager - Johns Hopkins UniversityMichelle N Gong - Albert Einstein College of MedicineAmira Mohamed - Albert Einstein College of MedicineMatthew C Exline - The Ohio State UniversityAkram Khan - Oregon Health & Science UniversityCatherine L Hough - Oregon Health & Science UniversityJennifer G Wilson - Stanford UniversityJarrod Mosier - University of ArizonaNida Qadir - Ronald Reagan UCLA Medical CenterSteven Y Chang - Ronald Reagan UCLA Medical CenterAdit A Ginde - University of Colorado DenverAmanda Martinez - University of Colorado DenverNicholas M Mohr - University of IowaChristopher Mallow - University of MiamiEstelle S Harris - University of UtahNicholas J Johnson - University of WashingtonVasisht Srinivasan - University of WashingtonKevin W Gibbs - Wake Forest UniversityJennie H Kwon - Washington University in St. LouisIvana A Vaughn - Henry Ford Health SystemMayur Ramesh - Henry Ford Health SystemBasmah Safdar - Yale UniversityAnirudh Goyal - Yale UniversityLauren E DeLamielleure - Yale UniversityJennifer DeCuir - Global ViralDiya Surie - Global ViralFatimah S Dawood - Global ViralMark W Tenforde - National Center for Immunization and Respiratory DiseasesTimothy M Uyeki - National Center for Immunization and Respiratory DiseasesShikha Garg - National Center for Immunization and Respiratory DiseasesSascha Ellington - National Center for Immunization and Respiratory DiseasesWesley H Self - Vanderbilt University Medical CenterInvestigating Respiratory Viruses in the Acutely Ill (IVY) Network
- Resource Type
- Journal article
- Publication Details
- Clinical infectious diseases, Vol.81(1), pp.190-197
- DOI
- 10.1093/cid/ciae584
- PMID
- 39607747
- PMCID
- PMC13016773
- NLM abbreviation
- Clin Infect Dis
- ISSN
- 1537-6591
- eISSN
- 1537-6591
- Publisher
- OXFORD UNIV PRESS INC; CARY
- Grant note
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases: 75D30122C12914, 75D30122C14944
The current study was funded by contracts awarded to Dr Wesley Self from the Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, contract numbers 75D30122C12914 and 75D30122C14944.
- Language
- English
- Electronic publication date
- 11/28/2024
- Date published
- 08/01/2025
- Academic Unit
- Epidemiology; Emergency Medicine; Anesthesia; Injury Prevention Research Center
- Record Identifier
- 9984752554802771
Metrics
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