Objective:

To evaluate the association of antiviral treatment with hospitalization, ICU admission, and mortality in nonhospitalized patients with laboratory-confirmed influenza.

Approach:

Key Findings:

• Hospitalization rates were 1.54% in antiviral-treated patients vs 1.70% in untreated (RR, 0.91).
• Emergency department visits were 3.54% vs 4.41% (RR, 0.80).
• ICU admission rates were 0.09% vs 0.10% (RR, 0.84).
• Mortality rates were 0.02% vs 0.04% (RR, 0.60).
• Absolute risk reductions were 1.56 per 1,000 patients for hospitalization and 0.15 per 1,000 for mortality.
• Oseltamivir showed fewer events across secondary outcomes, while baloxavir had a significant reduction in primary outcomes (RR, 0.28).

Interpretation:

Antiviral treatment is associated with reduced risks of hospitalization, ICU admission, and mortality in patients with influenza; however, results should be interpreted cautiously due to study limitations.

Limitations:

• Potential unmeasured confounding despite propensity score matching.
• Incomplete documentation of symptoms and vaccination status.
• Possible immortal time bias.
• Inability to establish causality.
• Differences in antiviral administration routes may have influenced outcomes.

Conclusion:

Antiviral treatment is negatively associated with hospitalization, ICU admission, and mortality in influenza patients, but findings require careful interpretation due to inherent study limitations.

Sources:

• BMC Medicine
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