{Reference Type}: Journal Article
{Title}: The Impact of Thrombocytopenia and Lymphopenia on Mortality in Patients Infected with Influenza Virus: A Retrospective Cohort Study.
{Author}: Sherban A;Hussen R;Gafter-Gvili A;Atamna A;Bishara J;Raanani P;Ben Tikva Kagan K;Avni T;
{Journal}: Acta Haematol
{Volume}: 146
{Issue}: 6
{Year}: 2023 Aug 9
{Factor}: 3.068
{DOI}: 10.1159/000533466
{Abstract}: <B>BACKGROUND: </B>Influenza virus causes significant global annual morbidity and mortality. Thrombocytopenia is recognized as a poor prognostic factor in sepsis and is associated with mortality, while lymphopenia has been established as a poor prognostic factor in other viral infections. We aimed to assess the incidence of thrombocytopenia and lymphopenia in seasonal influenza and their effect on clinical outcomes.<BR><B>METHODS: </B>This single-center, retrospective, cohort study included consecutive adult patients, hospitalized in Rabin Medical Center between October 2017 and April 2018, with laboratory-confirmed influenza. Patients were grouped according to blood counts on admission: (1) thrombocytopenia (&lt;150 K/mL), (2) lymphopenia (&lt;0.5 K/mL), and (3) both thrombocytopenia and lymphopenia. Patients without thrombocytopenia and lymphopenia were designated as controls. The primary outcome was 30-day all-cause mortality. Risk factors were identified by univariable and multivariable analyses, using logistic regression and reported as odds ratios (ORs) and 95% confidence intervals (CIs).<BR><B>RESULTS: </B>A total of 625 patients were included, 112 (18%) had thrombocytopenia, 98 (15.6%) had lymphopenia, and 107 (17%) had both. The crude 30-day all-cause mortality was 7.6% (48/625). Mortality rates were 7.1% (8/112) for the thrombocytopenia group, 11.2% (11/98) for the lymphopenia group, and 14.9% (16/107) for patients with both versus 4.2% (13/308) in the control (p = 0.000 for all). In a multivariable regression model, significant thrombocytopenia (&lt;100 K/μL) [OR 5.07 (95% CI 1.5-16.2)], age [OR 1.07 (95% CI 1.02-1.11)], time to oseltamivir [OR 1.006 (95% CI 1.002-1.11)], and significant respiratory support [OR 8.85 (3.4-22.6)] were associated with 30-day all-cause mortality.<BR><B>CONCLUSIONS: </B>Patients hospitalized with seasonal influenza and thrombocytopenia &lt;100 K/mL on admission, have an increased 30-day all-cause mortality.