ArticleOpen forum infectious diseases2020
Influenza With and Without Fever: Clinical Predictors and Impact on Outcomes in Patients Requiring Hospitalization.
Article in Open forum infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 14 citations in OpenAlex.
- Observational
- Avian-origin influenza A viruses tolerate elevated pyrexic temperatures in mammals.Science (New York, N.Y.) · 2025Article
- Article
- Association between Acute and Chronic Inflammatory States: A Case-Control Study.Homeopathy : the journal of the Faculty of Homeopathy · 2024Article
- Postpandemic Sentinel Surveillance of Respiratory Diseases in the Context of the World Health Organization Mosaic Framework: Protocol for a Development and Evaluation Study Involving the English Primary Care Network 2023-2024.JMIR public health and surveillance · 2024Article
- Hospitalisation, morbidity and outcomes associated with respiratory syncytial virus compared with influenza in adults of all ages.Influenza and other respiratory viruses · 2022Article
- Screening for COVID-19 in Older Adults: Pulse Oximeter vs. Temperature.Frontiers in medicine · 2021Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Infectious Diseases Society of America influenza guidelines no longer require fever as part of their influenza case definition in patients requiring hospitalization. However, the impact of fever or lack of fever on clinical decision-making and patient outcomes has not been studied.
methodsWe conducted a retrospective review of adult patients admitted to our tertiary health service between April 2016 and June 2019 with laboratory-confirmed influenza, with and without fever (≥37.8ºC). Patient demographics, presenting features, and outcomes were analyzed using Pearson's chi-square test, the Wilcoxon rank-sum test, and logistic regression.
resultsOf 578 influenza inpatients, 219 (37.9%) had no fever at presentation. Fever was less likely in individuals with a nonrespiratory syndrome (adjusted odds ratio [aOR], 0.44; 95% CI, 0.26-0.77), symptoms for ≥3 days (aOR, 0.53; 95% CI, 0.36-0.78), influenza B infection (aOR, 0.45; 95% CI, 0.29-0.70), chronic lung disease (aOR, 0.55; 95% CI, 0.37-0.81), age ≥65 (aOR, 0.36; 95% CI, 0.23-0.54), and female sex (aOR, 0.69; 95% CI, 0.48-0.99). Patients without fever had lower rates of testing for influenza in the emergency department (64.8% vs 77.2%;
conclusionsAbsence of fever in influenza is associated with delayed diagnosis, longer length of stay, and higher mortality.
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