{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:50:22Z","timestamp":1791910222047,"version":"4.3.4"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer Inc","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute symptoms of influenza are understood; however, less is known about potential postacute sequelae. We conducted a retrospective matched cohort study to identify conditions with elevated risk following influenza.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data from the Merative MarketScan Research Databases (2001\u20132019), including 3.3 million patients with a diagnosis of influenza. Cases were matched 1:1 to patients based on similar age, sex, care setting, and enrollment period with no influenza diagnosis. We examined the frequency of diagnosis codes in the year before and after the index influenza event, applying K-means clustering to identify diagnoses with post-influenza visit patterns similar to cough, a known sequela of influenza. Conditions were reviewed and aggregated into clinical categories. We compared trends in diagnoses between influenza cases and controls using a difference-in-differences approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 67 diagnostic categories with significantly increased incidence post-influenza infection. Both commonly known sequelae, such as pneumonia and otitis media as well as less expected findings, such as acute kidney failure and oral candidiasis were identified. The duration of elevated risk varied by condition, ranging from a week (eg, rhabdomyolysis) to 5 weeks (eg, hemoptysis) or 8 weeks (eg, chronic bronchitis).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We found that influenza is associated with conditions not typically considered. Also, some symptoms last longer than commonly appreciated, suggesting that some patients may suffer from a prolonged illness due to the influenza infection. Our findings have important implications for not only demonstrating the full burden of influenza but also informing future studies to prevent or treat influenza.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag629","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T11:39:18Z","timestamp":1791027558000},"source":"Crossref","is-referenced-by-count":0,"title":["Estimating the Range and Duration of Post-influenza Symptoms, Conditions, and Diseases"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6828-8966","authenticated-orcid":false,"given":"Aaron C","family":"Miller","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Iowa , Iowa City, Iowa ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1599-1809","authenticated-orcid":false,"given":"D Erik","family":"Boonstra","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Iowa , Iowa City, Iowa ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph E","family":"Cavanaugh","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Iowa , Iowa City, Iowa ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6814-9720","authenticated-orcid":false,"given":"Roger D","family":"Struble","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Iowa , Iowa City, Iowa ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantina","family":"Boikos","sequence":"additional","affiliation":[{"name":"Department of Medical Affairs, Pfizer Inc. , Kirkland, QC ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2660-8871","authenticated-orcid":false,"given":"Tianyan","family":"Hu","sequence":"additional","affiliation":[{"name":"Pfizer Inc. , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy L","family":"Wiemken","sequence":"additional","affiliation":[{"name":"Department of Medical Affairs, Pfizer Inc. , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1316-5395","authenticated-orcid":false,"given":"Verna L","family":"Welch","sequence":"additional","affiliation":[{"name":"Department of Medical Affairs, Pfizer Inc. , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0630-5898","authenticated-orcid":false,"given":"Philip M","family":"Polgreen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Iowa , Iowa City, Iowa ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"2026101312122432800_ofag629-B1","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1097\/EDE.0000000000000340","article-title":"Review article: the fraction of influenza virus infections that are asymptomatic: a systematic review and meta-analysis","volume":"26","author":"Leung","year":"2015","journal-title":"Epidemiology"},{"key":"2026101312122432800_ofag629-B2","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1186\/s13054-019-2539-x","article-title":"Influenza virus-related critical illness: pathophysiology and epidemiology","volume":"23","author":"Kalil","year":"2019","journal-title":"Crit Care"},{"key":"2026101312122432800_ofag629-B3","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/S1473-3099(05)70270-X","article-title":"Understanding the symptoms of the common cold and influenza","volume":"5","author":"Eccles","year":"2005","journal-title":"Lancet Infect Dis"},{"key":"2026101312122432800_ofag629-B4","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1016\/S0140-6736(17)30129-0","article-title":"Influenza","volume":"390","author":"Paules","year":"2017","journal-title":"Lancet"},{"key":"2026101312122432800_ofag629-B5","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1111\/j.1469-0691.2010.03117.x","article-title":"Dynamics of clinical symptoms in patients with pandemic influenza A (H1N1)","volume":"16","author":"Lee","year":"2010","journal-title":"Clin Microbiol Infect"},{"key":"2026101312122432800_ofag629-B6","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1111\/1348-0421.12965","article-title":"Secondary streptococcal infection following influenza","volume":"66","author":"Okahashi","year":"2022","journal-title":"Microbiol Immunol"},{"key":"2026101312122432800_ofag629-B7","doi-asserted-by":"crossref","first-page":"338","DOI":"10.3389\/fcimb.2017.00338","article-title":"Mechanisms of severe mortality-associated bacterial co-infections following influenza virus infection","volume":"7","author":"Jia","year":"2017","journal-title":"Front Cell Infect Microbiol"},{"key":"2026101312122432800_ofag629-B8","doi-asserted-by":"crossref","first-page":"1857","DOI":"10.1093\/infdis\/jir618","article-title":"Influenza virus induces bacterial and nonbacterial otitis media","volume":"204","author":"Short","year":"2011","journal-title":"J Infect Dis"},{"key":"2026101312122432800_ofag629-B9","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1128\/IAI.01278-12","article-title":"Influenza-induced inflammation drives pneumococcal otitis media","volume":"81","author":"Short","year":"2013","journal-title":"Infect Immun"},{"key":"2026101312122432800_ofag629-B10","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1086\/528685","article-title":"Viral upper respiratory tract infection and otitis media complication in young children","volume":"46","author":"Chonmaitree","year":"2008","journal-title":"Clin Infect Dis"},{"key":"2026101312122432800_ofag629-B11","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1056\/NEJM198206103062301","article-title":"A longitudinal study of respiratory viruses and bacteria in the etiology of acute otitis media with effusion","volume":"306","author":"Henderson","year":"1982","journal-title":"N Engl J Med"},{"key":"2026101312122432800_ofag629-B12","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1093\/cid\/ciab702","article-title":"Excess invasive meningococcal disease associated with seasonal influenza, South Africa, 2003\u20132018","volume":"74","author":"Meiring","year":"2022","journal-title":"Clin Infect Dis"},{"key":"2026101312122432800_ofag629-B13","doi-asserted-by":"crossref","first-page":"1257.e1","DOI":"10.1016\/j.cmi.2020.01.004","article-title":"Influenza increases invasive meningococcal disease risk in temperate countries","volume":"26","author":"Salomon","year":"2020","journal-title":"Clin Microbiol Infect"},{"key":"2026101312122432800_ofag629-B14","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1093\/cid\/ciy073","article-title":"A smartphone-driven thermometer application for real-time population- and individual-level influenza surveillance","volume":"67","author":"Miller","year":"2018","journal-title":"Clin Infect Dis"},{"key":"2026101312122432800_ofag629-B15","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1007\/s11883-021-00973-w","article-title":"Moving the needle on atherosclerotic cardiovascular disease and heart failure with influenza vaccination","volume":"23","author":"Behrouzi","year":"2021","journal-title":"Curr Atheroscler Rep"},{"key":"2026101312122432800_ofag629-B16","doi-asserted-by":"crossref","first-page":"101337","DOI":"10.1016\/j.arr.2021.101337","article-title":"Effects of influenza vaccination on clinical outcomes of chronic obstructive pulmonary disease: a systematic review and meta-analysis","volume":"68","author":"Bao","year":"2021","journal-title":"Ageing Res Rev"},{"key":"2026101312122432800_ofag629-B17","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1186\/s12890-017-0420-8","article-title":"Seasonal influenza vaccination in patients with COPD: a systematic literature review","volume":"17","author":"Bekkat-Berkani","year":"2017","journal-title":"BMC Pulm Med"},{"key":"2026101312122432800_ofag629-B18","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1111\/resp.12165","article-title":"Association of hospitalizations for asthma with seasonal and pandemic influenza","volume":"19","author":"Gerke","year":"2014","journal-title":"Respirology (Carlton, VIC)"},{"key":"2026101312122432800_ofag629-B19","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1017\/S0950268812002890","article-title":"Acute myocardial infarctions, strokes and influenza: seasonal and pandemic effects","volume":"141","author":"Foster","year":"2013","journal-title":"Epidemiol Infect"},{"key":"2026101312122432800_ofag629-B20","doi-asserted-by":"crossref","first-page":"e201323","DOI":"10.1001\/jamanetworkopen.2020.1323","article-title":"Respiratory and nonrespiratory diagnoses associated with influenza in hospitalized adults","volume":"3","author":"Chow","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2026101312122432800_ofag629-B21","doi-asserted-by":"crossref","first-page":"3243","DOI":"10.1001\/archinte.160.21.3243","article-title":"Clinical signs and symptoms predicting influenza infection","volume":"160","author":"Monto","year":"2000","journal-title":"Arch Intern Med"},{"key":"2026101312122432800_ofag629-B22","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1001\/jama.293.8.987","article-title":"Does this patient have influenza?","volume":"293","author":"Call","year":"2005","journal-title":"JAMA"},{"key":"2026101312122432800_ofag629-B23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3122\/jabfm.17.1.1","article-title":"A systematic review of the history and physical examination to diagnose influenza","volume":"17","author":"Ebell","year":"2004","journal-title":"J Am Board Fam Pract"},{"key":"2026101312122432800_ofag629-B24","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1111\/irv.12470","article-title":"The hidden burden of influenza: a review of the extra-pulmonary complications of influenza infection","volume":"11","author":"Sellers","year":"2017","journal-title":"Influenza Other Respir Viruses"},{"key":"2026101312122432800_ofag629-B25","doi-asserted-by":"crossref","first-page":"A6","DOI":"10.1016\/j.vaccine.2020.09.048","article-title":"The disease burden of influenza beyond respiratory illness","volume":"39 Suppl 1","author":"Macias","year":"2021","journal-title":"Vaccine"},{"key":"2026101312122432800_ofag629-B26","first-page":"630","article-title":"Clinical diagnosis of influenza virus infection: evaluation of diagnostic tools in general practice","volume":"51","author":"Van Elden","year":"2001","journal-title":"Br J Gen Pract"},{"key":"2026101312122432800_ofag629-B27","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/1471-2296-12-4","article-title":"Clinical prediction rules combining signs, symptoms and epidemiological context to distinguish influenza from influenza-like illnesses in primary care: a cross sectional study","volume":"12","author":"Michiels","year":"2011","journal-title":"BMC Fam Pract"},{"key":"2026101312122432800_ofag629-B28","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1017\/ice.2014.64","article-title":"Clinical predictors for laboratory-confirmed influenza infections: exploring case definitions for influenza-like illness","volume":"36","author":"Shah","year":"2015","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2026101312122432800_ofag629-B29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12879-015-1330-0","article-title":"Development of the flu-PRO: a patient-reported outcome (PRO) instrument to evaluate symptoms of influenza","volume":"16","author":"Powers","year":"2015","journal-title":"BMC Infect Dis"},{"key":"2026101312122432800_ofag629-B30","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1186\/s12879-018-3220-8","article-title":"Using the influenza patient-reported outcome (FLU-PRO) diary to evaluate symptoms of influenza viral infection in a healthy human challenge model","volume":"18","author":"Han","year":"2018","journal-title":"BMC Infect Dis"},{"key":"2026101312122432800_ofag629-B31","doi-asserted-by":"crossref","first-page":"e0194180","DOI":"10.1371\/journal.pone.0194180","article-title":"Performance of the inFLUenza patient-reported outcome (FLU-PRO) diary in patients with influenza-like illness (ILI)","volume":"13","author":"Powers","year":"2018","journal-title":"PLoS One"},{"key":"2026101312122432800_ofag629-B32","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1111\/crj.12409","article-title":"The duration of cough in patients with H1N1 influenza","volume":"11","author":"Lin","year":"2017","journal-title":"Clin Respir J"},{"key":"2026101312122432800_ofag629-B33","doi-asserted-by":"publisher","DOI":"10.1002\/resp.70302","article-title":"Post-acute sequelae of non-COVID-19 respiratory viral infections: a systematic review","author":"Chong","year":"2026","journal-title":"Respirology (Carlton, VIC)"},{"key":"2026101312122432800_ofag629-B34","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/j.jiac.2018.04.013","article-title":"Duration of fever and other symptoms after the inhalation of laninamivir octanoate hydrate in the 2016\/17 Japanese influenza season; comparison with the 2011\/12 to 2015\/16 seasons","volume":"24","author":"Ikematsu","year":"2018","journal-title":"J Infect Chemother"},{"key":"2026101312122432800_ofag629-B35","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1016\/S1473-3099(20)30004-9","article-title":"Early treatment with baloxavir marboxil in high-risk adolescent and adult outpatients with uncomplicated influenza (CAPSTONE-2): a randomised, placebo-controlled, phase 3 trial","volume":"20","author":"Ison","year":"2020","journal-title":"Lancet Infect Dis"},{"key":"2026101312122432800_ofag629-B36","doi-asserted-by":"crossref","first-page":"1842","DOI":"10.1001\/archinte.162.16.1842","article-title":"Influenza burden of illness: estimates from a national prospective survey of household contacts in France","volume":"162","author":"Carrat","year":"2002","journal-title":"Arch Intern Med"},{"key":"2026101312122432800_ofag629-B37","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1111\/jgs.15298","article-title":"Underdiagnosis of influenza virus infection in hospitalized older adults","volume":"66","author":"Hartman","year":"2018","journal-title":"J Am Geriatr Soc"},{"key":"2026101312122432800_ofag629-B38","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s12976-020-00129-4","article-title":"Quantifying the annual incidence and underestimation of seasonal influenza: a modelling approach","volume":"17","author":"McCarthy","year":"2020","journal-title":"Theor Biol Med Model"},{"key":"2026101312122432800_ofag629-B39","doi-asserted-by":"crossref","first-page":"101762","DOI":"10.1016\/j.eclinm.2022.101762","article-title":"The prevalence and long-term health effects of long COVID among hospitalised and non-hospitalised populations: a systematic review and meta-analysis","volume":"55","author":"O'Mahoney","year":"2023","journal-title":"EClinicalMedicine"},{"key":"2026101312122432800_ofag629-B40","doi-asserted-by":"crossref","first-page":"101959","DOI":"10.1016\/j.eclinm.2023.101959","article-title":"Corrigendum to \u201cthe prevalence and long-term health effects of long COVID among hospitalised and non-hospitalised populations: a systematic review and meta-analysis\u201d","volume":"59","author":"O'Mahoney","year":"2023","journal-title":"EClinicalMedicine"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofag629\/71627777\/ofag629.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/13\/10\/ofag629\/71627777\/ofag629.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/13\/10\/ofag629\/71627777\/ofag629.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:12:34Z","timestamp":1791907954000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofag629\/8869045"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":40,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,9,29]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofag629","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10]]},"published":{"date-parts":[[2026,9,29]]},"article-number":"ofag629"}}