{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:11:37Z","timestamp":1784693497978,"version":"3.55.0"},"reference-count":34,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Background: Influenza can cause severe complications, especially in patients with specific risk factors or comorbidities associated with poor outcomes. Some patients are at increased risk of a complicated disease course, including secondary infections, ICU admission, and the need for mechanical ventilation. The first post\u2013COVID-19 seasonal influenza season placed a substantial burden on Dutch ICUs. This study investigates the disease course and outcomes of ICU patients with influenza. Methods: A retrospective influenza registry study was conducted across 34 Dutch ICUs, including patients aged 18 and older admitted to the ICU with a positive influenza RT-PCR test, between 1 November 2023 and 17 March 2024. Data on demographic information, medical history, clinical symptoms, laboratory and imaging results, parameters of mechanical ventilation, additional treatments, length of hospital stay, and mortality was retrieved from the electronic patient record. Results: A total of 498 patients were included in the study. The median age was 64 (IQR: 55\u201372) years and 58.8% of the patients were men. The most common comorbidities were cardiovascular disease (34.1%), chronic obstructive pulmonary disease (COPD) (31.5%), and diabetes (22.3%). Bacterial co-infections were present in 37.6% of the patients. Invasive mechanical ventilation (IMV) was necessary in 46.0% of patients, 38.0% of those requiring IMV were treated in prone position. A substantial mortality rate was observed, with an ICU mortality rate of 21.9% and an additional hospital mortality rate of 5.2%. Conclusion: This study described the characteristics and course of disease of all patients with laboratory-confirmed influenza infection admitted to one of the 34 participating Dutch ICUs between November 2023 and March 2024. The major findings of this study are the substantial mortality rate, a high proportion of patients with bacterial co-infections, and a significant percentage of patients requiring IMV and prone position ventilation. Finally, patients without comorbidities that were admitted to the ICU with an influenza virus infection showed severe disease parameters but had a lower mortality than patients with comorbidities.<\/jats:p>","DOI":"10.3390\/v17111467","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T13:47:58Z","timestamp":1762177678000},"page":"1467","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical Characteristics and Outcomes of ICU Patients During the First Post-COVID-19 2023\u20132024 Influenza Season in The Netherlands"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8135-9669","authenticated-orcid":false,"given":"Sjoerd","family":"van der Bie","sequence":"first","affiliation":[{"name":"Department of Intensive Care Medicine, Spaarne Gasthuis, 2035 RC Haarlem Hoofddorp, The Netherlands"},{"name":"Department of Intensive Care Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes P. C.","family":"van den Akker","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6048-5778","authenticated-orcid":false,"given":"Ramon C.","family":"Fluit","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Spaarne Gasthuis, 2035 RC Haarlem Hoofddorp, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9153-8196","authenticated-orcid":false,"given":"Steven F. L.","family":"van Lelyveld","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Spaarne Gasthuis, 2035 RC Haarlem, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten E.","family":"Nuver","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Meander Medisch Centrum, 3813 TZ Amersfoort, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Stads","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Ikazia, 3083 AN Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Spronk","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Gelre Hospital, 7334 DZ Apeldoorn, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7495-1659","authenticated-orcid":false,"given":"Carina","family":"Bethlehem","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Medisch Centrum Leeuwarden, 8934 AD Leeuwarden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romy","family":"Takken","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Maasstad Ziekenhuis, 3079 DZ Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0635-2843","authenticated-orcid":false,"given":"Corstiaan A.","family":"den Uil","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Maasstad Ziekenhuis, 3079 DZ Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jantine","family":"Van Holten","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Maasstad Ziekenhuis, 3079 DZ Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rutger","family":"Van Raalte","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Tergooi Medisch Centrum, 1212 VG Hilversum, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jurre","family":"Kuipers","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Elisabeth-TweeSteden Ziekenhuis, 5042 AD Tilburg, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4475-2207","authenticated-orcid":false,"given":"Marc","family":"Schluep","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Bravis Ziekenhuis, 4624 VT Bergen op Zoom, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matty","family":"Koopmans","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Onze Lieve Vrouwe Gasthuis, 1091 AC Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7361-7277","authenticated-orcid":false,"given":"Louise","family":"Urlings-Strop","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Reinier de Graaf Groep, 2625 AD Delft, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther K.","family":"Haspels-Hogervorst","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Martini Hospital, 9728 NT Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina E.","family":"Disseldorp","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Martini Hospital, 9728 NT Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2257-8527","authenticated-orcid":false,"given":"Jan","family":"Elderman","sequence":"additional","affiliation":[{"name":"Intensive Care Department, IJsselland Ziekenhuis, 2906 ZC Capelle aan den IJssel, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Sneijder","sequence":"additional","affiliation":[{"name":"Intensive Care Department, Admiraal de Ruyter Ziekenhuis, 4462 RA Goes, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasper","family":"de Roos","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Amphia Hospital, 4818 CK Breda, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7624-1535","authenticated-orcid":false,"given":"Merijn","family":"Kant","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Amphia Hospital, 4818 CK Breda, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9958-2842","authenticated-orcid":false,"given":"Robbert G.","family":"Bentvelsen","sequence":"additional","affiliation":[{"name":"Microvida Laboratory for Microbiology, Amphia Hospital, 4818 CK Breda, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Neijzen","sequence":"additional","affiliation":[{"name":"Medische Faculteit, Amsterdam UMC, Locatie Vrije Universiteit Medisch Centrum, 1081 BT Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorien","family":"Kiers","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Franciscus Gasthuis & Vlietland, 3045 PM Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaas","family":"de Groot","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Maxima Medisch Centrum, 5631 BM Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"de Bie","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Catharina Ziekenhuis, 5623 EJ Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"de Jager","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Jeroen Bosch Ziekenhuis, 5223 GZ \u2018s-Hertogenbosch, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7016-7920","authenticated-orcid":false,"given":"Michiel","family":"Blans","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Rijnstate, 6815 AD Arnhem, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myrthe","family":"de Haas","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Rijnstate, 6815 AD Arnhem, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariska","family":"Lont","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Dijklander Ziekenhuis, 1624 NP Hoorn, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Koster","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Zaans Medisch Centrum, 1502 DV Zaandam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelique C. M.","family":"Jansen","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Alrijne Ziekenhuis, 2334 CK Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petronella E.","family":"Deetman","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Albert Schweitzer Ziekenhuis, 3318 AT Dordrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fieke","family":"Mus","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, HagaZiekenhuis, 2545 AA Den Haag, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"Nowitzky","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, HagaZiekenhuis, 2545 AA Den Haag, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Brands","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Groene Hart Ziekenhuis, 2803 HH Gouda, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazra","family":"Moeniralam","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, St Antonius Ziekenhuis, 3435 CM Nieuwegein, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Schaftenaar","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, St Antonius Ziekenhuis, 3435 CM Nieuwegein, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn","family":"van Tellingen","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Frisius MC, 8934 AD Leeuwarden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3916-8760","authenticated-orcid":false,"given":"Jasper","family":"Haringman","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Isala, 8025 AB Zwolle, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Thieme Groen","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Flevoziekenhuis, 1315 RA Almere, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3120-6891","authenticated-orcid":false,"given":"Lenneke E. M.","family":"Haas","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Diakonessenhuis, 3582 KE Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wouter","family":"de Ruijter","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Noordwest Ziekenhuisgroep, 1815 JD Alkmaar, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob","family":"Wilting","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Elisabeth-TweeSteden Ziekenhuis, 5042 AD Tilburg, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hetty","family":"Kranen","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Universitair Medisch Centrum Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8969-1509","authenticated-orcid":false,"given":"Charlotte H. S. B.","family":"van den Berg","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Universitair Medisch Centrum Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6808-7702","authenticated-orcid":false,"given":"Diederik","family":"Gommers","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evert-jan","family":"Wils","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Franciscus Gasthuis & Vlietland, 3045 PM Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Endeman","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands"},{"name":"Department of Intensive Care, Onze Lieve Vrouwe Gasthuis, 1091 AC Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3165-8193","authenticated-orcid":false,"given":"Marco","family":"Goeijenbier","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Spaarne Gasthuis, 2035 RC Haarlem Hoofddorp, The Netherlands"},{"name":"Department of Intensive Care Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1186\/s40001-023-01482-z","article-title":"Characteristics and outcomes of patients hospitalized for infection with influenza, SARS-CoV-2 or respiratory syncytial virus in the season 2022\/2023 in a large German primary care centre","volume":"28","author":"Quarg","year":"2023","journal-title":"Eur. J. Med. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1080\/17476348.2023.2272704","article-title":"Extracorporeal membrane oxygenation for COVID-19 and influenza associated acute respiratory distress syndrome: A systematic review","volume":"17","author":"Wang","year":"2023","journal-title":"Expert. Rev. Respir. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1093\/infdis\/jiae064","article-title":"The burden of HMPV and influenza associated hospitalizations in adults in New Zealand, 2012\u20132015","volume":"230","author":"Aminisani","year":"2024","journal-title":"J. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.ijid.2023.04.003","article-title":"Determinants of poor clinical outcome in patients with influenza pneumonia: A systematic review and meta-analysis","volume":"131","author":"Presa","year":"2023","journal-title":"Int. J. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1111\/irv.12925","article-title":"The burden of seasonal influenza in Italy: A systematic review of influenza-related complications, hospitalizations, and mortality","volume":"16","author":"Giacchetta","year":"2022","journal-title":"Influenza Other Respir. Viruses"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1111\/irv.12969","article-title":"Global patterns of seasonal influenza activity, duration of activity and virus (sub)type circulation from 2010 to 2020","volume":"16","author":"Zanobini","year":"2022","journal-title":"Influenza Other Respir. Viruses"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Matera, L., Manti, S., Petrarca, L., Pierangeli, A., Conti, M.G., Mancino, E., Leonardi, S., Midulla, F., and Nenna, R. (2023). An overview on viral interference during SARS-CoV-2 pandemic. Front. Pediatr., 11.","DOI":"10.3389\/fped.2023.1308105"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2300724","DOI":"10.2807\/1560-7917.ES.2024.29.4.2300724","article-title":"Increased incidence of Mycoplasma pneumoniae infections and hospital admissions in the Netherlands, November to December 2023","volume":"29","author":"Bolluyt","year":"2024","journal-title":"Euro Surveill."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Zhao, P., Zhang, Y., Wang, J., Li, Y., Wang, Y., Gao, Y., Zhao, M., Zhao, M., Tan, H., and Tie, Y. (2024). Epidemiology of respiratory pathogens in patients with acute respiratory infections during the COVID-19 pandemic and after easing of COVID-19 restrictions. Microbiol. Spectr., 12.","DOI":"10.1128\/spectrum.01161-24"},{"key":"ref_10","first-page":"449","article-title":"Severe influenza: Overview in critically ill patients","volume":"25","author":"Sarda","year":"2019","journal-title":"Curr. Opin. Crit. Care"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.jcrc.2018.11.013","article-title":"Influenza virus and factors that are associated with ICU admission, pulmonary co-infections and ICU mortality","volume":"50","author":"Beumer","year":"2019","journal-title":"J. Crit. Care"},{"key":"ref_12","first-page":"8172","article-title":"COVID-19 and seasonal influenza infection outcomes in the ICU: A retrospective comparison study","volume":"26","author":"Tocut","year":"2022","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"51","DOI":"10.18773\/austprescr.2019.013","article-title":"Influenza: Overview on prevention and therapy","volume":"42","author":"Robson","year":"2019","journal-title":"Aust. Prescr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1186\/s13054-019-2425-6","article-title":"Influenza and associated co-infections in critically ill immunosuppressed patients","volume":"23","author":"Lemiale","year":"2019","journal-title":"Crit. Care"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.jiac.2018.10.014","article-title":"Community-acquired bacterial co-infection predicts severity and mortality in influenza-associated pneumonia admitted patients","volume":"25","author":"Teng","year":"2019","journal-title":"J. Infect. Chemother."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"154164","DOI":"10.1016\/j.jcrc.2022.154164","article-title":"The impacts of bacterial co-infections and secondary bacterial infections on patients with severe influenza pneumonitis admitted to the intensive care units","volume":"72","author":"Lee","year":"2022","journal-title":"J. Crit. Care"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1007\/s00134-021-06431-0","article-title":"Posaconazole for prevention of invasive pulmonary aspergillosis in critically ill influenza patients (POSA-FLU): A randomised, open-label, proof-of-concept trial","volume":"47","author":"Vanderbeke","year":"2021","journal-title":"Intensive Care Med."},{"key":"ref_18","unstructured":"RIVM (2025, January 18). Terugblik Surveillance van Luchtweginfecties 2023\/2024\u2014Influenza, Available online: https:\/\/www.rivm.nl\/griep-griepprik\/feiten-en-cijfers."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e458","DOI":"10.1002\/edm2.458","article-title":"The association between obesity with treatment duration, ICU length of stay and the risk of death in critically ill patients with COVID-19","volume":"6","author":"Gholamalizadeh","year":"2023","journal-title":"Endocrinol. Diabetes Metab."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"996","DOI":"10.47102\/annals-acadmedsg.2020299","article-title":"Obesity in COVID-19: A Systematic Review and Meta-Analysis","volume":"49","author":"Ho","year":"2020","journal-title":"Ann. Acad. Med. Singap."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e13168","DOI":"10.1111\/irv.13168","article-title":"Severe forms of influenza infections admitted in intensive care units: Analysis of mortality factors","volume":"17","author":"Verdier","year":"2023","journal-title":"Influenza Other Respir. Viruses"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Chen, Z., Zhan, Q., Huang, L., and Wang, C. (2023). Coinfection and superinfection in ICU critically ill patients with severe COVID-19 pneumonia and influenza pneumonia: Are the pictures different?. Front. Public. Health, 11.","DOI":"10.3389\/fpubh.2023.1195048"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"105600","DOI":"10.1016\/j.jcv.2023.105600","article-title":"Comparing COVID-19 and influenza: Epidemiology, clinical characteristics, outcomes and mortality in the ICU","volume":"169","author":"Pangot","year":"2023","journal-title":"J. Clin. Virol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/S2213-2600(18)30274-1","article-title":"Invasive aspergillosis in patients admitted to the intensive care unit with severe influenza: A retrospective cohort study","volume":"6","author":"Schauwvlieghe","year":"2018","journal-title":"Lancet Respir. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1186\/s13054-019-2395-8","article-title":"The effect of corticosteroids on mortality of patients with influenza pneumonia: A systematic review and meta-analysis","volume":"23","author":"Ni","year":"2019","journal-title":"Crit. Care"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1007\/s00134-019-05594-1","article-title":"Obesity in the critically ill: A narrative review","volume":"45","author":"Schetz","year":"2019","journal-title":"Intensive Care Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.orcp.2021.03.010","article-title":"Impact of obesity on influenza compared to pneumonia hospitalization outcomes","volume":"15","author":"Wei","year":"2021","journal-title":"Obes. Res. Clin. Pract."},{"key":"ref_28","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":"ref_29","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.ijid.2020.11.185","article-title":"Morbidity and mortality of respiratory syncytial virus infection in hospitalized adults: Comparison with seasonal influenza","volume":"103","author":"Atamna","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.jinf.2023.05.011","article-title":"Differences in clinical characteristics and outcomes between COVID-19 and influenza in critically ill adult patients: A national database study","volume":"87","author":"Naouri","year":"2023","journal-title":"J. Infect."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Al-Dorzi, H.M., Alsafwani, Z.A., Alsalahi, E., Aljulayfi, A.S., Alshaer, R., Alanazi, S., Aldossari, M.A., Alsahoo, D.A., and Khan, R. (2024). Patients with influenza admitted to a tertiary-care hospital in Riyadh between 2018 and 2022: Characteristics, outcomes and factors associated with ICU admission and mortality. BMC Pulm. Med., 24.","DOI":"10.1186\/s12890-024-03281-6"},{"key":"ref_32","first-page":"269","article-title":"Outcomes among critically ill adults with influenza infection","volume":"6","author":"Aziza","year":"2021","journal-title":"J. Assoc. Med. Microbiol. Infect. Dis. Can."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Volkov, L., Delpuech, M., Conrad, M., Courte, G., Cravoisy, A., Nace, L., Baumann, C., and Gibot, S. (2022). Clinical outcomes and characteristics of critically ill patients with influenza- and COVID-19-induced ARDS: A retrospective, matched cohort study. Front. Med., 9.","DOI":"10.3389\/fmed.2022.1027984"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Smiechowicz, J., Barteczko-Grajek, B., Adamik, B., Bojko, J., Gozdzik, W., and Lipinska-Gediga, M. (2021). Influenza in patients with respiratory failure admitted to intensive care units in Poland and the use of extracorporeal respiratory support: A survey-based multicenter study. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-021-06672-w"}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/17\/11\/1467\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T08:54:33Z","timestamp":1763542473000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/17\/11\/1467"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,1]]},"references-count":34,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["v17111467"],"URL":"https:\/\/doi.org\/10.3390\/v17111467","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,1]]}}}