BACKGROUND clinical guidelines recommend initiation of antiviral therapy as soon as possible for patients hospitalized with confirmed or suspected influenza. METHODS A multicenter US observational sentinel surveillance network prospectively enrolled adults (aged ≥18 years) hospitalized with laboratory-confirmed influenza at 24 hospitals during October 1, 2022-July 21, 2023. A multivariable proportional odds model was used to compare peak pulmonary disease severity (no oxygen support, standard supplemental oxygen, high-flow oxygen/non-invasive ventilation, invasive mechanical ventilation, or death) after the day of hospital admission among patients starting oseltamivir treatment on the day of admission (early) versus those who did not (late or not treated), adjusting for baseline (admission day) severity, age, sex, site, and vaccination status. Multivariable logistic regression models were used to evaluate the odds of intensive care unit (ICU) admission, acute kidney replacement therapy or vasopressor use, and in-hospital death. RESULTS A total of 840 influenza-positive patients were analyzed, including 415 (49%) who started oseltamivir treatment on the day of admission, and 425 (51%) who did not. Compared with late or not treated patients, those treated early had lower peak pulmonary disease severity (proportional aOR: 0.60, 95% CI: 0.49-0.72), and lower odds of intensive care unit admission (aOR: 0.24, 95% CI: 0.13-0.47), acute kidney replacement therapy or vasopressor use (aOR: 0.40, 95% CI: 0.22-0.67), and in-hospital death (aOR: 0.36, 95% CI: 0.18-0.72). CONCLUSION Among adults hospitalized with influenza, treatment with oseltamivir on day of hospital admission was associated reduced risk of disease progression, including pulmonary and extrapulmonary organ failure and death.

中文翻译：

---

早期奥司他韦治疗对因甲型流感住院的成人的益处：一项观察性研究。


背景 临床指南建议，对于确诊或疑似流感住院的患者，应尽快开始抗病毒治疗。方法 一个多中心美国观察哨点监测网络前瞻性招募了 2022 年 10 月 1 日至 2023 年 7 月 21 日期间在 24 家医院因实验室确诊流感住院的成人 （≥18 岁）。使用多变量比例比值模型比较入院当天（早期）开始奥司他韦治疗的患者入院当天（早期）与未开始（晚期或未治疗）的患者入院后肺部疾病峰值严重程度（无氧支持、标准补充氧气、高流量氧气/无创通气、有创机械通气或死亡），调整基线（入院日）严重程度， 年龄、性别、部位和疫苗接种状态。多变量 logistic 回归模型用于评估重症监护病房 （ICU） 收治、急性肾脏替代治疗或血管加压药使用以及院内死亡的几率。结果 共分析 840 例流感阳性患者，其中 415 例 （49%） 在入院当天开始奥司他韦治疗，425 例 （51%） 未开始。与晚期或未治疗的患者相比，早期接受治疗的患者肺部疾病严重程度峰值较低（比例 aOR： 0.60,95% CI：0.49-0.72），重症监护病房收治几率较低 （aOR： 0.24,95% CI： 0.13-0.47），急性肾脏替代治疗或血管加压药使用 （aOR： 0.40,95% CI： 0.22-0.67） 和院内死亡 （aOR： 0.36,95% CI： 0.18-0.72）。 结论 在因流感住院的成人中，入院当天接受奥司他韦治疗与降低疾病进展风险相关，包括肺和肺外器官衰竭和死亡。