COPD: influenza vaccine cuts influenza-related hospitalization

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Takeaway

  • Seasonal influenza vaccination significantly reduces influenza-related hospitalizations by 38% in patients with COPD.

Why this matters

  • Ensure that patients with COPD receive age-appropriate quadrivalent or recombinant influenza vaccines per updated CDC guidelines.
  • Consider antivirals in hospitalized patients to reduce influenza-related complications.

Key results

  • 4755 hospitalized patients with COPD; 38.5% (1833) with PCR-confirmed influenza.
  • 41% (612/1490) of influenza patients had not been vaccinated during season when hospitalization occurred, 69.3% received antivirals while hospitalized.
  • 9.7% (177/1833) influenza-positive patients required mechanical ventilation, 11.1% (204/1833) died, 18.1% (332/1833) admitted to intensive care.
  • Risk factors for mechanical ventilation: diabetes (OR, 1.7; 95% CI, 1.1-2.6), current smoking (OR, 3.2; 95% CI, 1.5-7.2).
  • Risk factors for mortality (hospitalized patients): age >75 years (OR, 3.7; 95% CI, 0.4-30.3), home oxygen use (OR, 2.9; 95% CI, 1.6-5.1), admission from long-term care (OR, 2.6; 95% CI, 1.5-4.5).

Study design

  • Post hoc analysis of prospective cohort study data to determine influenza vaccine effectiveness for preventing influenza-related hospitalization in patients with COPD.
  • Funding: Canadian Institutes for Health Research, others.

Limitations

  • Noninfluenza virus rates unconfirmed.
  • COPD cases confirmed by medical records.
  • Selection bias.
  • Unaccounted bacterial co-infections, frailty selection bias, all-cause mortality.