69647669a67c2c5676126d044428805f 321085.pdf 6bbbaee67fd3ddad20854ed1cf23126b165b4756 321085.pdf 21ea19e0ef9047df6596630a46b42c9b2ce4248b923587e9088784b8d76323be 321085.pdf Title: Acute Influenza Virus-Associated Encephalitis and Other Neurological Complications in Severe Hospitalized Laboratory-Confirmed Influenza Cases—Catalonia 2010–2020 Subject: Neurological complications associated with influenza (NCIs) are rare events in adults. Influenza-associated encephalopathy is one of the most severe and frequently reported NCIs. The aim of this study is to describe the frequency and characteristics of NCIs in adults during 10 post-2009 pandemic influenza seasons. Data were obtained from the registry of influenza cases admitted to hospitals of the PIDIRAC network for the surveillance of severe hospitalized laboratory-confirmed influenza (SHLCI) cases in Catalonia from October 2010 to March 2020. The variables analyzed were NCI, age, antiviral treatment, vaccination status, and outcome at discharge. During the study period, 9 (1.5‰) of 5931 SHLCI cases presented NCI. Five (55.6%) had influenza A and four (44.4%) had influenza B. Median age was 62 (17–67) years. One case had been vaccinated, all had received antiviral treatment, and five required ICU admission. The mean length of stay was 25.6 days (SD 25.8). Encephalitis was the most frequent complication, occurring in six cases (66.7%). Of these, three cases (50%) were caused by influenza A (two AH1N1pdm09 strains and one AH3N2). The high frequency of influenza-associated encephalitis caused by both type A and B influenza viruses suggests that both should be considered as potential etiologic factors for encephalopathy and other neurological diseases in adults. This recommendation would allow for the prompt antiviral treatment and prevention of severe outcomes. Keywords: influenza; encephalitis; neurological complication Author: Pilar Ciruela, Nuria Soldevila, Nuria Torner, Luca Basile, Maria del Mar Mosquera, M. Angeles Marcos, Anna Martínez, Mireia Jané, Cristina Rius, Angela Domínguez and the Working Group for the Catalan Influenza and Severe Acute Respiratory Infection Sentinel Surveillance Network (PIDIRAC) Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Mon Mar 3 09:49:17 2025 CET ModDate: Mon Mar 3 10:22:34 2025 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 7 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 811070 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- XMBXGH+URWPalladioL-Roma Type 1 Custom yes yes yes 10 0 LQRBMH+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 OXWQRM+URWPalladioL-Ital Type 1 Custom yes yes yes 21 0 EKHPAG+IBMPlexMono TrueType WinAnsi yes yes no 60 0 EKHNLF+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 63 0 EKHNLG+PalatinoLinotype CID TrueType Identity-H yes yes yes 66 0 EKHNLH+PalatinoLinotype TrueType WinAnsi yes yes no 72 0 EKHNLJ+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 75 0 EKHOAJ+PalatinoLinotype TrueType MacRoman yes yes no 78 0 EKHNLF+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 92 0 EKHNLH+PalatinoLinotype TrueType WinAnsi yes yes no 95 0 EKHNLJ+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 98 0 EKHOAJ+PalatinoLinotype TrueType MacRoman yes yes no 101 0 MEHHCT+VnURWPalladioL Type 1 Custom yes yes yes 111 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-11-11 04:22:54 CET RepresentationInformation: 321085.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-11-10 14:53:40 CET Size: 811070 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 196 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Item: Title: Results Destination: section.3 Item: Title: Discussion Destination: section.4 Item: Title: References Destination: section.5 Info: Title: Acute Influenza Virus-Associated Encephalitis and Other Neurological Complications in Severe Hospitalized Laboratory-Confirmed Influenza Cases Catalonia 2010 2020 Author: Pilar Ciruela, Nuria Soldevila, Nuria Torner, Luca Basile, Maria del Mar Mosquera, M. Angeles Marcos, Anna Martínez, Mireia Jané, Cristina Rius, Angela Domínguez and the Working Group for the Catalan Influenza and Severe Acute Respiratory Infection Sentinel Surveillance Network (PIDIRAC) Subject: Neurological complications associated with influenza (NCIs) are rare events in adults. Influenza-associated encephalopathy is one of the most severe and frequently reported NCIs. The aim of this study is to describe the frequency and characteristics of NCIs in adults during 10 post-2009 pandemic influenza seasons. Data were obtained from the registry of influenza cases admitted to hospitals of the PIDIRAC network for the surveillance of severe hospitalized laboratory-confirmed influenza (SHLCI) cases in Catalonia from October 2010 to March 2020. The variables analyzed were NCI, age, antiviral treatment, vaccination status, and outcome at discharge. During the study period, 9 (1.5‰) of 5931 SHLCI cases presented NCI. Five (55.6%) had influenza A and four (44.4%) had influenza B. Median age was 62 (17 67) years. One case had been vaccinated, all had received antiviral treatment, and five required ICU admission. The mean length of stay was 25.6 days (SD 25.8). Encephalitis was the most frequent complication, occurring in six cases (66.7%). Of these, three cases (50%) were caused by influenza A (two AH1N1pdm09 strains and one AH3N2). The high frequency of influenza-associated encephalitis caused by both type A and B influenza viruses suggests that both should be considered as potential etiologic factors for encephalopathy and other neurological diseases in adults. This recommendation would allow for the prompt antiviral treatment and prevention of severe outcomes. 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