Looking Back on 50 Years of Literature to Understand the Potential Impact of Influenza on Extrapulmonary Medical Outcomes

Joshua Nealon, Nieves Derqui, Caroline De Courville, Tor Biering-sørensen, Benjamin J Cowling, Harish Nair, Sandra S Chaves

Research output: Contribution to journalArticlepeer-review

Abstract

We conducted a scoping review of the epidemiological literature from the past 50 years to document the contribution of influenza virus infection to extrapulmonary clinical outcomes. We identified 99 publications reporting 243 associations using many study designs, exposure and outcome definitions, and methods. Laboratory confirmation of influenza was used in only 28 (12%) estimates, mostly in case-control and self-controlled case series study designs. We identified 50 individual clinical conditions associated with influenza. The most numerous estimates were of cardiocirculatory diseases, neurological/neuromuscular diseases, and fetal/newborn disorders, with myocardial infarction the most common individual outcome. Due to heterogeneity, we could not generate summary estimates of effect size, but of 130 relative effect estimates, 105 (81%) indicated an elevated risk of extrapulmonary outcome with influenza exposure. The literature is indicative of systemic complications of influenza virus infection, the requirement for more effective influenza control, and a need for robust confirmatory studies.
Original languageEnglish
Article numberofac352
JournalOpen forum infectious diseases
Volume9
Issue number8
DOIs
Publication statusPublished - 21 Jul 2022

Keywords

  • cardiovascular
  • epidemiology
  • extrapulmonary
  • influenza
  • review

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