Copyright © 2023 The Author(s); Published by Nickan Research Institute. This is an open-access article distributed under the terms of
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Immunopathol Persa. 2023;x(x):e39462 Original
Evaluation of clinical and para-clinical parameters
related to disease severity and mortality in patients
with influenza in Isfahan, Iran; a cross sectional study
Kiana Shirani
1*
ID
, Elham Honarjou
1
, Behrooz Ataei
1
, Sodabeh Rostami
2
ID
, Zary Nokhodian
2
ID
, Manijeh Shams
3
1
Department of Infectious Diseases, Isfahan University of Medical Sciences, Isfahan, Iran
2
Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
3
Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Immunopathologia Persa
http immunopathol.com
*Correspondence to
Kiana Shirani, Email:
shirani.kiana@gmail.com,
kianashirani@med.mui.ac.ir
Received 29 Nov. 2022
Accepted 26 Jan. 2023
Published online 9 Feb. 2023
Keywords: Influenza,
Epidemiology, Clinical
findings, Para-clinical findings
Introduction: Managing influenza (flu) due to its rapid transmission is a considerable challenge for the health
system. Considering the variety of clinical symptoms in influenza and recognizing its symptoms in different
conditions of patients can be effective in its management.
Objectives: In the present cross-sectional study, we evaluate the relationship between clinical and para-clinical
findings and the treatment measures observed at the time of hospitalization of influenza patients and their
conditions at the time of discharge from the hospital.
Patients and Methods: Our investigation was conducted from March 2019 to March 2021 in Alzahra hospital of
Isfahan, Iran. The research population included influenza patients admitted to the infectious ward.
Results: A total of 122 hospitalized influenza patients (n=122) were included in this research. The number of
patients with influenza A and B was 44 and 78, respectively. There was a significant relationship between the type
of influenza and the patient’s condition upon discharge (P = 0.001). Influenza vaccination (P < 0.001), diabetes
(P = 0.038), and cardiovascular disease (P = 0.004) were significantly associated with the patient’s condition at
discharge. According to our investigation, among the drugs used, oseltamivir significantly reduced mortality in
patients receiving it (P < <0.001). There was a statistically significant difference between the variables of all chest
radiology and the patient’s condition at the time of discharge (P < 0.001). Furthermore, there was a statistically
significant difference between the length of hospital stay (P = 0.001), the number of white blood cells (P = 0.001),
the number of platelets (P = 0.006), and the amount of C-reactive protein (CRP) (P < 0.001) with the patient’s
condition upon discharge.
Conclusion: Among the comorbidities studied, diabetes and cardiovascular disease were significantly associated
with mortality in patients with influenza. Vaccination significantly reduces mortality from influenza in high-risk
patients. The antiviral drug oseltamivir is recommended as a useful drug for patients with the influenza. However,
a multi-center study with larger sample size is necessary for a more conclusive result.
Abstract
Citation: Shirani K,
Honarjou E, Ataei B,
Rostami S, Nokhodian Z,
Shams M. Evaluation of
clinical and para-clinical
parameters related to
disease severity and
mortality in patients with
influenza in Isfahan,
Iran; a cross sectional
study. Immunopathol
Persa. 2023;x(x):e39462.
DOI:10.34172/
ipp.2023.39462.
Introduction
Managing influenza (flu) is a serious
challenge for the health system due to its
rapid transmission. Severe influenza species
affect 3-5 million people worldwide annually,
leading to significant mortality in pandemic
conditions (1). Some epidemiological studies
have reported more than 600 000 deaths
per year due to respiratory involvement (2).
Influenza mortality is mainly seen in high-risk
groups such as children, pregnant women, the
elderly, patients undergoing chemotherapy and
radiotherapy, and patients with comorbidities
(3). Influenza viruses (IVs) are members of
the Orthomyxoviridae family (4). There are
four main types of IV, labeled IV A, B, C, and
D. Birds are the main source of IV A, which
can be transmitted to humans. Similarly,
IV B and C first affect humans, and IV D
Key point
Lower respiratory infections due to influenza are
the main cause of mortality in low-income countries
annually. Some populations are more vulnerable to
influenza, either because they have a greater risk of
developing severe disease or they have a greater risk
of exposure, such as pregnant women, health workers,
people over the age of 65 years, children from 6-59
months, and people with chronic health conditions
such as diabetes, HIV, asthma, heart or lung disease.
first appears in pigs and cattle. Circulation
of IV A and B in humans is associated
with considerable seasonal epidemics or
pandemics; IV C is usually associated with
moderate infections in children; and IV D
does not cause any considerable disease in
humans (5,6). The most important feature
of IV is its rapid evolution that leads to its
DOI:10.34172/ipp.2023.39462