Evidence map›Paper›PMID 41004324›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2026

Severity of Clinical Presentation and Outcomes in Hospitalized Adult People With Influenza by Type and Subtype, United States-2017-2020.

Seana Cleary, Nathaniel M Lewis, H Keipp Talbot, Yuwei Zhu, Emily T Martin, Arnold S Monto, Manjusha Gaglani, Kempapura Murthy, Richard K Zimmerman, Fernanda P Silveira and 4 more

Abstract read
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Seana ClearyInfluenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.ORCID 0009-0002-8507-7607
Nathaniel M LewisInfluenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.ORCID 0000-0001-7088-9640
H Keipp TalbotDivision of Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID 0000-0003-0141-1760
Yuwei ZhuDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID 0000-0001-9849-1634
Emily T MartinCenter for Respiratory Virus Research and Response, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Arnold S MontoCenter for Respiratory Virus Research and Response, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.ORCID 0000-0003-3018-435X
Manjusha GaglaniDepartment of Pediatrics, Baylor Scott & White Health, Temple, Texas, USA.ORCID 0000-0002-3952-9230
Kempapura MurthyDepartment of Pediatrics, Baylor Scott & White Health, Temple, Texas, USA.
Richard K ZimmermanDepartment of Family Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.ORCID 0000-0001-5941-6092
Fernanda P SilveiraDepartment of Medicine, Division of Infectious Diseases, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Mark W TenfordeInfluenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.ORCID 0000-0002-8702-8393
Manish M PatelDepartment of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Sascha EllingtonInfluenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.ORCID 0000-0002-5584-5006
Samantha M OlsonInfluenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.ORCID 0000-0003-0589-5766

Funding

University of Pittsburgh Clinical and Translational Science InstituteUL1TR001857 · NCATS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E · 2016 to 2025
$129.3M
CDC )Centers for Disease Control and Prevention (EPA EP-C-15-002Intramural CDC HHS CC999999NCATS NIH HHS UL1 TR001857NCIRD CDC HHS U01 IP000969NIH HHS
6 · The paper itself

Abstract

backgroundWhile influenza A(H3N2)-predominant seasons tend to have increased rates of influenza-associated hospitalizations and deaths, little is known about differences in clinical presentation and hospitalization outcomes by influenza type and subtype.

methodsData from hospitalized adults aged ≥18 years in 4 US states from 2017 to 2020 were used to evaluate the association between influenza type/subtype and severe influenza presentation and outcomes. Log binomial regression and modified Poisson regression with robust error variance were used to estimate adjusted risk ratios (aRRs) for clinical indicators within 24 hours of hospital admission and severity outcomes. Multivariable Cox proportional hazard models were used to estimate adjusted hazard ratios for length of hospital stay and intensive care unit (ICU) stay. All models were adjusted for underlying conditions, age group, influenza vaccination, and site.

resultsPeople with influenza A(H1N1) were more likely to be admitted to an ICU (aRR = 1.42) than people with A(H3N2). People with influenza A(H1N1) had higher risk of hypoxemia (SpO2 <90%) than people with A(H3N2) (aRR = 1.24) and B (aRR = 1.43). People with influenza A(H1N1) compared with A(H3N2) also had higher risk of hyponatremia (sodium < 135 mmol/L; aRR = 1.19) and compared with B had higher risk of fever (>38°C, aRR = 1.56).

conclusionsAdult people hospitalized with influenza A(H1N1) had a higher risk of multiple severity indicators. Better understanding of influenza severity related to both host and virus type is important for reducing the burden of severe influenza in adults.

Indexed as

HospitalizationInfluenza, HumanAdolescentAdultAgedAged, 80 and overFemaleHumansInfluenza A Virus, H1N1 SubtypeInfluenza A Virus, H3N2 SubtypeIntensive Care UnitsLength of StayMaleMiddle AgedSeverity of Illness IndexUnited Statesacute respiratory illnessclinical indicatorshospital outcomesinfluenzaseverity

Identifiers

PMID41004324
PMCPMC12817258

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.