lancet-header

Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com.

Oseltamivir Therapy Improves Survival in Critically Ill Patients with Severe Influenza

40 Pages Posted: 19 Jul 2019

See all articles by Gerard Moreno

Gerard Moreno

Rovira i Virgili University - Critical Care Department URV/IISPV/CIBERES

Alejandro Rodríguez

Rovira i Virgili University - Critical Care Department URV/IISPV/CIBERES

Jordi Sole-Violán

Universidad de Las Palmas Gran Canaria

Ignacio Martín-Loeches

St James’s University Hospital

Emili Díaz

Hospital Parc Taulí

María Bodí

Rovira i Virgili University - Critical Care Department URV/IISPV/CIBERES

Luis F. Reyes

Universidad de la Sabana

Josep Gómez

Rovira i Virgili University - Critical Care Department URV/IISPV/CIBERES

Juan Guardiola

University of Louisville - School of Medicine

Sandra Trefler

Rovira i Virgili University - Critical Care Department URV/IISPV/CIBERES

Loreto Vidaur

Hospital Universitario Donostia

Elisabeth Papiol

Vall d´Hebrón University Hospital

Lorenzo Socias

Hospital Universitario Son Llatzer

Carolina Garcia-Vidal

Hospital Clinic of Barcelona - Department of Infectious Diseases

Eudald Correig

Rovira i Virgili University - Critical Care Department URV/IISPV/CIBERES

Judith Marín-Corral

Autonomous University of Barcelona - Institut Hospital del Mar d’Investigacions Mèdiques (IMIM)

Marcos I. Restrepo

University of Texas Health Science Center at San Antonio

Jonathan S. Nguyen-Van-Tam

University of Nottingham - School of Medicine

Antoni Torres

University of Barcelona - Faculty of Medicine

GETGAG Working Group

Independent

More...

Multiple version iconThere are 2 versions of this paper

Abstract

Background: We aimed to determine whether treatment with oseltamivir was associated with decreased mortality among patients admitted to intensive care units (ICUs) with severe influenza and whether early therapy (within 48 hours of symptoms onset) was associated with improved survival rates.

Methods: This was a prospective observational study of patients with confirmed influenza who were admitted to 184 ICUs in Spain. The primary outcomes were to investigate the association of ICU mortality with oseltamivir therapy by comparing patients who are untreated (UT group) with those who are treated (all treated; AT group) and those in early treatment (ET) and late treatment (LT) groups. We also assessed the associations of both ET and LT with ICU mortality and compared the results.

Findings: We enrolled 4,175 patients of whom 3,537 met the inclusion criteria. Most patients were diagnosed with influenza pneumonia (84·7%). When comparing the AT (n=3,439) and UT (n=98) groups, the former had higher survival after adjusting for severity and confounding factors (Hazard ratio [HR] 0·67; p=0·03). We included 3,388 patients to compare the ET and LT groups. In the multivariable analysis, ICU mortality was lower in the ET group, having an odds ratio of 0·7 (p=0·004). When propensity score matching was applied to a matched cohort (ET, n=790; LT, n=2,522), the ET group had lower ICU mortality (HR 0·78; p=0·008) compared with the LT group, even after a competing risks analysis (sub-HR 0·79; p=0·01).

Funding Statement: SEMICYUC (Spanish Society of Critical Care) and Ricardo Barri Casanovas Foundation.

Declaration of Interests: JSN-V-T has received research funding from F. Hoffman-La Roche for separate work. He is currently seconded to the Department of Health and Social Care, England (DHSC). The views expressed in this paper are those of the authors and not necessarily those of DHSC. CG-V has received the INTENSIFICACIÓ Grant- a grant supported by the Catalan Health Agency [PERIS (Pla estratègic de recerca i innovació en salut – ‘Strategic Plan for Research and Innovation in HealthCare’)]. All other authors declare no competing interests.

Ethics Approval Statement: The study was approved by the Joan XXIII University Hospital Ethics Committee (IRB#11809). All data were anonymised, allowing the requirement for informed consent to be waived.

Keywords: Severe Influenza infection, Oseltamivir, Critically ill, Outcome

Suggested Citation

Moreno, Gerard and Rodríguez, Alejandro and Sole-Violán, Jordi and Martín-Loeches, Ignacio and Díaz, Emili and Bodí, María and Reyes, Luis F. and Gómez, Josep and Guardiola, Juan and Trefler, Sandra and Vidaur, Loreto and Papiol, Elisabeth and Socias, Lorenzo and Garcia-Vidal, Carolina and Correig, Eudald and Marín-Corral, Judith and Restrepo, Marcos I. and Nguyen-Van-Tam, Jonathan S. and Torres, Antoni and Group, GETGAG Working, Oseltamivir Therapy Improves Survival in Critically Ill Patients with Severe Influenza (July 16, 2019). Available at SSRN: https://ssrn.com/abstract=3420414 or http://dx.doi.org/10.2139/ssrn.3420414

Gerard Moreno (Contact Author)

Rovira i Virgili University - Critical Care Department URV/IISPV/CIBERES ( email )

Tarragona
Spain

Alejandro Rodríguez

Rovira i Virgili University - Critical Care Department URV/IISPV/CIBERES

Tarragona
Spain

Jordi Sole-Violán

Universidad de Las Palmas Gran Canaria

Juan de Quesada, 30 35001 Las Palmas de Gran Cana
Las Palmas de Gran Canaria
Spain

Ignacio Martín-Loeches

St James’s University Hospital

Leeds,
United Kingdom

Emili Díaz

Hospital Parc Taulí

Spain

María Bodí

Rovira i Virgili University - Critical Care Department URV/IISPV/CIBERES

Tarragona
Spain

Luis F. Reyes

Universidad de la Sabana

Campus Universitario del Puente del Común, Km. 7
Chia, Cundinamarca A.A.140122
Colombia

Josep Gómez

Rovira i Virgili University - Critical Care Department URV/IISPV/CIBERES

Tarragona
Spain

Juan Guardiola

University of Louisville - School of Medicine

550 South Jackson Street
Louisville, KY 40202
United States

Sandra Trefler

Rovira i Virgili University - Critical Care Department URV/IISPV/CIBERES

Tarragona
Spain

Loreto Vidaur

Hospital Universitario Donostia

San Sebastian
Spain

Elisabeth Papiol

Vall d´Hebrón University Hospital

Passeig de la Vall d'Hebron, 119-129
08035 Barcelona
Spain

Lorenzo Socias

Hospital Universitario Son Llatzer

Mallorca
Spain

Carolina Garcia-Vidal

Hospital Clinic of Barcelona - Department of Infectious Diseases

Barcelona
Spain

Eudald Correig

Rovira i Virgili University - Critical Care Department URV/IISPV/CIBERES

Tarragona
Spain

Judith Marín-Corral

Autonomous University of Barcelona - Institut Hospital del Mar d’Investigacions Mèdiques (IMIM)

Spain

Marcos I. Restrepo

University of Texas Health Science Center at San Antonio

315 N. San Saba
Suite 201
San Antonio, TX 78248
United States

Jonathan S. Nguyen-Van-Tam

University of Nottingham - School of Medicine

Nottingham, NG7 2UH
United Kingdom

Antoni Torres

University of Barcelona - Faculty of Medicine

Gran Via de les Corts Catalanes, 585
Barcelona, LA 08007
Spain

GETGAG Working Group

Independent

Click here to go to TheLancet.com

Paper statistics

Downloads
178
Abstract Views
1,181
PlumX Metrics