• The Journal of infection · Mar 2011

    Effect of immunomodulatory therapies in patients with pandemic influenza A (H1N1) 2009 complicated by pneumonia.

    • Diego Viasus, José Ramón Paño-Pardo, Elisa Cordero, Antoni Campins, Francisco López-Medrano, Aroa Villoslada, Maria C Fariñas, Asunción Moreno, Jesús Rodríguez-Baño, José Antonio Oteo, Joaquín Martínez-Montauti, Julián Torre-Cisneros, Ferrán Segura, Jordi Carratalà, and Novel Influenza A (H1N1) Study Group, Spanish Network for Research in Infectious Diseases.
    • Department of Infectious Diseases, Hospital Universitari de Bellvitge, University of Barcelona, Feixa Llarga s/n, Barcelona, Spain.
    • J. Infect. 2011 Mar 1;62(3):193-9.

    ObjectiveTo determine the effect of immunomodulatory therapies on the development of severe disease in hospitalized adults with laboratory-confirmed pandemic influenza A (H1N1) 2009 complicated by pneumonia.MethodsObservational, prospective cohort study at thirteen tertiary hospitals in Spain. The use of corticosteroids, macrolides and statins was recorded. The outcome of interest was severe disease, defined as the composite of intensive care unit admission or death after the first day of hospitalization.ResultsOf the 197 patients with pandemic influenza A (H1N1) 2009 complicated by pneumonia, 68 (34.5%) received some anti-inflammatory therapy since hospital admission (corticosteroids in 37, macrolides in 31 and statins in 12). Severe disease occurred in 29 (14.7%) patients. After adjustment for confounding factors, immunomodulatory therapies as a group were not associated with a lower risk for developing severe disease (odds ratio [OR] 0.64; 95% confidence interval [CI] 0.22-1.86). In a further a priori analysis, corticosteroids, macrolides and statins were included in a multivariate model. None of these therapies was found to be associated with a lower risk for developing severe disease.ConclusionsImmunomodulatory therapies use since hospital admission did not prevent the development of severe disease in adults with pandemic influenza A (H1N1) 2009 complicated by pneumonia.Copyright © 2011 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

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