{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:38:29Z","timestamp":1782488309131,"version":"3.54.5"},"reference-count":58,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,8,28]],"date-time":"2022-08-28T00:00:00Z","timestamp":1661644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Respiratory failure (RF) is the most important complication of influenza virus infection. Its definition and incidence are heterogeneous in the literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This systematic review and meta\u2010analysis aim to determine the incidence of and risk factors for RF in patients hospitalized with influenza. Electronic databases were searched for articles on RF in patients hospitalized for influenza infection up to December 2021 regardless of their geographical location. Observational and experimental studies were considered for inclusion, excluding case series. The Newcastle\u2010Ottawa and Johanna Briggs scales were used for quality assessment. A random\u2010effects meta\u2010analysis was performed, followed by subgroup analyses according to, among others, presence\/absence of pneumonia, RF definition, serotype and time period. PRISMA guidelines were followed for this review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010six studies were finally included in the meta\u2010analysis. Overall, RF incidence was 24% (range 5%\u201385%, 95% confidence interval [95CI] 19%\u201331%). Significantly higher incidences of RF were found in patients with pneumonia (42%, 95CI 28%\u201357%, <jats:italic>p<\/jats:italic>\u00a0=\u2009.006), when RF was defined as hypoxemia (58%, 95CI 31%\u201381%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.001), and during the 2009 pandemic (25%, 95CI 16%\u201336%) and postpandemic period (23%, 95CI 15%\u201334%, <jats:italic>p<\/jats:italic>\u00a0=\u2009.01). No differences were found between human influenza serotypes. Assessment of risk factors associated with the development of RF was not possible due to their inconsistent and heterogeneous reporting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Respiratory failure is frequent in hospitalized influenza patients, especially in patients with pneumonia and since the 2009 pandemic, although its definition and reporting widely vary in the literature. This complicates its characterization and comparison between cohorts and with other respiratory viruses.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.13858","type":"journal-article","created":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T09:00:03Z","timestamp":1661245203000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["In\u2010hospital incidence of and risk factors for influenza\u2010associated respiratory failure"],"prefix":"10.1111","volume":"52","author":[{"given":"Blanca","family":"Ayuso Garc\u00eda","sequence":"first","affiliation":[{"name":"Department of Internal Medicine University Hospital 12 de Octubre  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5949-8032","authenticated-orcid":false,"given":"Alvaro","family":"Marchan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University Hospital 12 de Octubre  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Est\u00edbaliz","family":"Arrieta Ortubay","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University Hospital 12 de Octubre  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Castillo Maza","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University Hospital 12 de Octubre  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Romay Lema","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit University Hospital Lucus Augusti  Lugo Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Lalueza","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University Hospital 12 de Octubre  Madrid Spain"},{"name":"Department of Medicine, School of Medicine Complutense University  Madrid Spain"},{"name":"Research Institute of Hospital 12 de Octubre (i+12)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Lumbreras","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University Hospital 12 de Octubre  Madrid Spain"},{"name":"Department of Medicine, School of Medicine Complutense University  Madrid Spain"},{"name":"Research Institute of Hospital 12 de Octubre (i+12)  Madrid Spain"},{"name":"Infectious Diseases Unit University Hospital 12 de Octubre  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,28]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"1","article-title":"Influenza","volume":"355","author":"Ghebrehewet S","year":"2016","journal-title":"BMJ"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2008.07.025"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/vim.2006.19.147"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00058-05"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro3231"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001558"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3851\/IMP3102"},{"key":"e_1_2_9_9_1","volume-title":"The Newcastle\u2013Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta\u2010analyses","author":"Wells G","year":"2014"},{"key":"e_1_2_9_10_1","unstructured":"Joanna Briggs Institute.Checklist for systematic reviews and research syntheses.2017.https:\/\/jbi.global\/critical\u2010appraisal\u2010tools(accessed June 8 2022)."},{"key":"e_1_2_9_11_1","unstructured":"DeeksJJ JPTH AltmanDG.Chapter 10: Analysing data and undertaking meta\u2010analyses. 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