Drug use and severe outcomes among adults hospitalized with influenza, 2016-2019

• Type of Material: Article
• Authors: Christina E Parisi, University of Florida; Kimberly Yousey-Hindes, Yale University; Rachel Holstein, Centers for Disease Control and Prevention, Atlanta; Alissa O'Halloran, Centers for Disease Control and Prevention, Atlanta; Pam Dailey Kirley, California Emerging Infections Program; Nisha B Alden, Colorado Department of Public Health and Environment; Evan Anderson, Emory University; Sue Kim, Michigan Department of Health and Human Services; Melissa McMahon, Minnesota Department of Health; Sarah A Khanlian, New Mexico Department of Health; Nancy Spina, New York State Department of Health; Maria A Gaitan, University of Rochester; Eli Shiltz, Ohio Department of Health; Ann Thomas, Oregon Health Authority; William Schaffner, Vanderbilt University; Keipp Talbot, Vanderbilt University; Melanie T Crossland, Salt Lake County Health Department; Robert L Cook, University of Florida; Shikha Garg, Centers for Disease Control and Prevention, Atlanta; James Meek, Yale University; James Hadler, Yale University
• Language: English
• Date: 2022-10-27
• Publisher: WILEY
• Publication Version: Final Published Version
• Copyright Statement: © 2022 The Authors. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1111/irv.13052
• Title of Journal or Parent Work: INFLUENZA AND OTHER RESPIRATORY VIRUSES
• Volume: 17
• Issue: 1
• Start Page: e13052
• End Page: e13052
• Grant/Funding Information: This work was supported by the Centers for Disease Control and Prevention (CDC) through an Emerging Infections Program cooperative agreement (Grant CK17‐1701) and a Council of State and Territorial Epidemiologists cooperative agreement (Grant NU38OT000297‐02‐00). C.E.P. is funded by the National Institute on Alcohol Abuse and Alcoholism (Grant T32AA025877).
• Keywords: COVID-19; UNITED-STATES; Public Health Surveillance; PULMONARY COMPLICATIONS; Science & Technology; Life Sciences & Biomedicine; Virology; epidemiology; drug abuse; influenza; substance use; Infectious Diseases; OVERDOSE DEATHS; USE DISORDERS
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Public Health

Abstract

Background: Influenza is a persistent public health problem associated with severe morbidity and mortality. Drug use is related to myriad health complications, but the relationship between drug use and severe influenza outcomes is not well understood. The study objective was to evaluate the relationship between drug use and severe influenza-associated outcomes. Methods: Data were collected by the Influenza Hospitalization Surveillance Network (FluSurv-NET) from the 2016–2017 through 2018–2019 influenza seasons. Among persons hospitalized with influenza, descriptive statistics and logistic regression models were used to analyze differences in demographic characteristics, risk and behavioral factors, and severe outcomes (intensive care unit [ICU] admission, mechanical ventilation, or death) between people who use drugs (PWUD), defined as having documented drug use within the past year, and non-PWUD. Results: Among 48,430 eligible hospitalized influenza cases, 2019 were PWUD and 46,411 were non-PWUD. PWUD were younger than non-PWUD and more likely to be male, non-Hispanic Black or Hispanic/Latino, smoke tobacco, abuse alcohol, and have chronic conditions including asthma, chronic liver disease, chronic lung disease, or immunosuppressive conditions. PWUD had greater odds of ICU admission and mechanical ventilation, but not death compared with non-PWUD; however, these findings were not statistically significant after adjustment. Opioid use specifically was associated with increased risk of ICU admission and mechanical ventilation. Conclusion: These results support targeted initiatives to prevent influenza in this population, including influenza vaccination, which remains one of the most important tools to prevent influenza infection and associated severe outcomes.