Last two influenza season: Evaluation of solid organ transplant recipients
Tugba Yanik Yalcin1, Cigdem Erol1, Nuran Sari1, Hande Arslan1, Emre Karakaya2, Mehmet A. Haberal2.
1Infectious Diseases, Baskent University, Ankara, Turkey; 2Transplantation, Baskent University, Ankara, Turkey
Introduction and Purpose: Flu can cause serious complications and death especially in young children, elderly, pregnant women, patients with chronic diseases and immunosuppressive patients.
In this study, solid organ transplantation recipients which were positive for influenza in laboratory in Baskent University Ankara Hospital in 2018-2019 and 2019-2020 influenza seasons were examined.
Method: Patients who were admitted to our hospital with the diagnosis of influenza-like illness last two influenza seasons (September 2018- March 2019 and September 2019- February 2020) and who had positive influenza rapid antigen test (SofiaTM) or influenza PCR (VIASURE) test were included in the study. Demographic characteristics, laboratory and radiological findings, hospitalization and need for intensive care were recorded in IBM SPSS 25 program and their statistical analyzes were performed.
Results: A total of 2060 tests were studied in the winter season of 2018-2019 and winter season2019-2020 in adults (≥18).Flu rapid antigen or PCR tests positivity was found in 521 tests (25.2%).
Thirty-nine attacks were recorded in 38 patients with solid organ transplants. Twenty-four (63.1%) of these patients were male. Twenty-three (58.9%) of these attacks were due to Influenza A, ten (25.6%) of them were Influenza B. During this period three patients (7.6%) had combined influenza A and influenza B infections. Four patients (10.2%) had combined influenza B and RSV infections, while three patients (7.6%) had only RSV infections.
The patients applied to the emergency department in 20 (51.3%) attacks and outpatient clinic in 11 (28.2%) attacks. Eight (20.5%) attacks developed in the inpatient.
Only two patients (5.1%) were known to have been vaccinated. Twenty-five patients (64.1%) underwent chest X-ray. Thoracic CT was performed in 19 (48.7%) patients. All patients were given oseltamivir treatment, 26 (66.7%) patients received antibiotic treatment. Twenty-five patients (64.1%) were hospitalized due to influenza. Five of these patients (12.8%) needed intensive care support, two of them needed mechanical ventilator. Influenza was mortal in two patient (5.2%).
Laboratory values of the patients were leucosyte 9898 ± 7829 (min 2380-max 35600), CRP 60.6 ± 72.5 (min 1- max 348).
Discussion and Conclusion: Timely diagnosis and early treatment with antivirals reduce the duration of symptoms and reduces the risk of complications and hospitalizations. In addition, awareness of vaccination, which is the most important prevention method of influenza in solid organ transplant recipients, should be increased at the patient and physician awareness.
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