The Prevalence and Outcomes of Influenza Virus Infection in Heart Failure Patients in Brazil: Influenza Infection in Heart Failure

Henrique Godoy^1*, Juliana Soares¹, Paula Zanellatto Neves², N.C.J. Bellei³, Dirceu R. Almeida¹

¹Division of Cardiology, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil.
²Hospital Epidemiology Committee, Federal University of Sao Paulo, Sao Paulo, Brazil.
³Clinical Virology Laboratory, Division of Infectious Diseases, Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil.

DOI: 10.4236/aid.2015.53011                

Abstract

Background: Respiratory tract infections were associated with acute exacerbations of heart failure (HF). However, the role of the influenza virus, a major agent of such infections, in this population remained unclear. Method: During the influenza virus seasons of 2013 and 2014 we prospectively assessed influenza respiratory illnesses in a cohort of adults primarily hospitalized for management of acute decompensated HF and a cohort of HF outpatients. Qualitative RT-PCR for influenza A (A/H1, A/H12009pdm, A/H3) and B virus testing was performed on nasopharyngeal swab samples. Result: A total of 121 patients were included, 58.3% males (n = 70), mean age 57.7 years old (±14.0), mean left ejection fraction 35.3 (±9.8). Of these, 50.4% were inpatients (n = 61). The prevalence of symptoms of respiratory infections was 28.0% (n = 34) and 4.9% (n = 6) of all samples were positive for influenza virus. Only influenza A was detected and all cases were among inpatients. Influenza-positive patients had a greater need for antimicrobials (83.3%, n = 5; 16.3%, n= 9; p = 0.001) and for mechanical ventilation (50.0%, n = 3; 3.6%, n = 2; p < 0.001) than Influenza-negative patients. The prevalence of influenza virus was not related to mortality (OR 4.58; p = 0.16). Conclusion: Although not common, the influenza virus infection resulted in worst outcomes, with a greater need for antimicrobials and mechanical ventilation. Immunization and antiviral treatment in high risk patients may positively impact their outcomes.

Keywords

Influenza Virus, Heart Failure, Epidemiology

Conflicts of Interest

The authors declare no conflicts of interest.

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