720. Respiratory and Non-Respiratory Complications among Patients Hospitalized with Influenza, FluSurv-NET, 2016–17
Session: Poster Abstract Session: Respiratory Infections: Viral
Thursday, October 4, 2018
Room: S Poster Hall
  • Complications_ID Week Poster.pdf (387.2 kB)
  • Background: Influenza is most commonly associated with respiratory complications; however, non-respiratory complications occur frequently among patients hospitalized with influenza. We used data from the Influenza Hospitalization Surveillance Network (FluSurv-NET) to describe complications recorded on discharge summaries of patients hospitalized with influenza.

    Methods: We included children (0-17 years) and adults (≥ 18 years), who resided within a FluSurv-NET catchment area and were hospitalized with laboratory-confirmed influenza during 2016-17. We abstracted data on underlying conditions and discharge diagnoses from medical charts. We calculated the frequency of respiratory and non-respiratory complications in all age groups and used univariate and multivariable logistic regression to examine factors associated with select complications among adults.

    Results: Among 17,489 patients, the most common respiratory complications were pneumonia (26%) and acute respiratory failure (23%) and the most common non-respiratory complications were sepsis (16%) and acute renal failure (ARF) (12%). Complications varied by age group (Figure). Pneumonia was the most common respiratory complication in all age groups except 0-4 years; among children aged 0-4 years bronchiolitis was most common (104/712; 15%). Among 97 children aged 0-4 years with bronchiolitis who underwent testing for respiratory syncytial virus (RSV), 37% had RSV.  The most common non-respiratory complication was seizures in children aged 0-17 years (17% had a history of prior seizures) and sepsis in adults. Among adults (n=16057), factors most strongly associated with ARF included chronic renal disease (adjusted odds ratio (AOR) 2.5; 95% confidence interval (95%CI) 2.2-2.8), male sex (AOR 1.5 95%CI 1.4-1.7) and age ≥65 years (AOR 1.4 95%CI 1.2-1.7); the factor most strongly associated with sepsis was chronic neuromuscular disease (AOR 1.5 95%CI 1.3-1.8).

    Conclusion:  Influenza hospitalizations are associated with a broad spectrum of complications including pneumonia, respiratory failure, sepsis, ARF and seizures. During the influenza season, astute clinicians should keep influenza in the differential diagnosis for patients with a wide range of presentations.


    Shikha Garg, MD, MPH1, Charisse Nitura Cummings, MPH2, Alissa O'Halloran, MSPH2, Pam Daily Kirley, MPH3, Rachel Herlihy, MD MPH4, Kimberly Yousey-Hindes, MPH, CPH5, Maya Monroe, MPH6, Seth Eckel, MPH7, Melissa McMahon, MPH8, Kathy Angeles, MPH9, Alison Muse, MPH10, Nancy M. Bennett, MD11, Laurie Billing, MPH12, Ann Thomas, MD, MPH13, H. Keipp Talbot, MD, MPH14, Andrea George, MPH15, Evan J. Anderson, MD16 and Carrie Reed, DSc, MPH2, (1)Centers for Disease Control and Prevention, Atlanta, GA, (2)Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, (3)California Emerging Infections Program, Oakland, CA, (4)Colorado Department of Public Health and Environment, Denver, CO, (5)Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT, (6)Maryland Department of Health and Mental Hygiene, Baltimore, MD, (7)Communicable Disease Division, Michigan Department of Health and Human Services, Lansing, MI, (8)Minnesota Department of Health, St. Paul, MN, (9)New Mexico Emerging Infections Program, University of New Mexico, Albuquerque, NM, (10)New York State Department of Health, Albany, NY, (11)Emerging Infections Program, New York, NY, (12)Ohio Department of Health, Columbus, OH, (13)Oregon Public Health Division, Portland, OR, (14)Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN, (15)Salt Lake County Health Department, Salt Lake City, UT, (16)Emerging Infections Program, Atlanta Veterans Affairs Medical Center, Atlanta, GA


    S. Garg, None

    C. Nitura Cummings, None

    A. O'Halloran, None

    P. D. Kirley, None

    R. Herlihy, None

    K. Yousey-Hindes, None

    M. Monroe, None

    S. Eckel, None

    M. McMahon, None

    K. Angeles, None

    A. Muse, None

    N. M. Bennett, None

    L. Billing, None

    A. Thomas, None

    H. K. Talbot, Sanofi Pasteur: Investigator , Research grant . Gilead: Investigator , Research grant . MedImmune: Investigator , Research grant . Vaxinnate: Safety Board , none . Seqirus: Safety Board , none .

    A. George, None

    E. J. Anderson, NovaVax: Grant Investigator , Research grant . Pfizer: Grant Investigator , Research grant . AbbVie: Consultant , Consulting fee . MedImmune: Investigator , Research support . PaxVax: Investigator , Research support . Micron: Investigator , Research support .

    C. Reed, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.