%0 Generic
%A Moreno, G.
%A Rodríguez, A.
%A Sole Violán, J.
%A Martín Loeches, I.
%A Díaz, E.
%A Bodí, M.
%A Reyes, L.F.
%A Gómez, J.
%A Guardiola, J.
%A Trefler, S.
%A Vidaur, L.
%A Papiol, E.
%A Socias, L.
%A García Vidal, C.
%A Correig , E.
%A Marín Corral, J.
%A Restrepo, M.I
%A Nguyen-Van-Tam, J.S.
%A Torres, A.
%8 2021
%@ 23120541
%U http://hdl.handle.net/10818/53966
%X Background: The relationship between early oseltamivir treatment (within 48 h of symptom onset) and
mortality in patients admitted to intensive care units (ICUs) with severe influenza is disputed. This study
aimed to investigate the association between early oseltamivir treatment and ICU mortality in critically ill
patients with influenza pneumonia.
Methods: This was an observational study of patients with influenza pneumonia admitted to 184 ICUs in
Spain during 2009–2018. The primary outcome was to evaluate the association between early oseltamivir
treatment and ICU mortality compared with later treatment. Secondary outcomes were to compare the
duration of mechanical ventilation and ICU length of stay between the early and later oseltamivir
treatment groups. To reduce biases related to observational studies, propensity score matching and a
competing risk analysis were performed.
Results: During the study period, 2124 patients met the inclusion criteria. All patients had influenza
pneumonia and received oseltamivir before ICU admission. Of these, 529 (24.9%) received early
oseltamivir treatment. In the multivariate analysis, early treatment was associated with reduced ICU
mortality (OR 0.69, 95% CI 0.51–0.95). After propensity score matching, early oseltamivir treatment was
associated with improved survival rates in the Cox regression (hazard ratio 0.77, 95% CI 0.61–0.99) and
competing risk (subdistribution hazard ratio 0.67, 95% CI 0.53–0.85) analyses. The ICU length of stay and
duration of mechanical ventilation were shorter in patients receiving early treatment.
Conclusions: Early oseltamivir treatment is associated with improved survival rates in critically ill patients
with influenza pneumonia, and may decrease ICU length of stay and mechanical ventilation duration.
%I ERJ Open Research
%T Early oseltamivir treatment improves survival in critically ill patients with influenza pneumonia
%R 10.1183/23120541.00888-2020
%~ Intellectum