Prevalence of common flu symptoms varies by patient age
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Key takeaways:
- Older adults were more likely to present with shortness of breath.
- Children and younger adults were more likely to present with fever and cough.
Global data indicate that some common influenza symptoms increase with age as others decrease, researchers found.
“The Global Influenza Hospital Surveillance Network (GIHSN) is an international collaboration which offers a unique opportunity to examine influenza presentations and outcomes across settings and age groups,” Melissa K. Andrew, MD, associate professor of medicine at Dalhousie University, told Healio.
“Here we were particularly interested in studying the impacts of age and underlying comorbidities. It is also a great example of how we can advance knowledge by working together as a global community with a shared purpose,” she said.
To assess the impact of age and comorbidities on influenza severity and symptoms, Andrew and colleagues used a multivariate logistic regression model to analyze the extent to which numerous risk factors can predict severe outcomes in patients with influenza. According to the study, the researchers used data from between November 2018 and October 2019 gathered from 19 sites in 18 countries that were part of the GIHSN.
Of 16,022 patients enrolled in the GIHSN, 21.9% had laboratory-confirmed influenza. The most commonly reported symptoms were fever and cough, although these symptoms decreased with age (P < .001).
Specifically, the study showed that 98.9% of patients aged 5 to 17 years reported fever and 95% reported cough, falling to 80.7% with fever and 85.5% with cough in those aged 80 years and older (P for temporal trend = .027).
Shortness of breath — which was uncommon among patients aged 50 years and younger — increased with age (P < .001), with most adults reportedly having this symptom — 58.1% of patients aged 50 to 64 years, 61.7% of those aged 65 to 79 years, and 75.3% of those aged 80 years and older (P for temporal trend = .027).
The study also showed that patient comorbidities varied by age group. The most common comorbidities about adults were cardiovascular diseases (22%), diabetes (10.7%), chronic obstructive pulmonary disease (9.9%) and obesity (6.1%), whereas most children — specifically those aged 5 years and younger — had no underlying conditions.
Additional data collected from the study demonstrated that clinical adverse outcomes were generally worse for children aged 5 years and younger and in older adults; that hospital lengths of hospital stay increased with age; and rates of mechanical ventilation and ICU admission were relatively high in children aged 5 years and younger and peaked in adults aged 50 to 64 years, whereas mechanical ventilation was highest in those aged 65 to 79 years.
“These age differences in presenting symptoms have important implications for influenza surveillance and management — during the local influenza season, clinicians should keep influenza in mind even when symptoms are not classical for ‘influenza-like illness,’” Andrew concluded.
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