Thromboembolic events in patients with influenza. A scoping review.
Abstract
IIntroduction: Influenza is an acute respiratory infection that usually
causes a short-term and self-limiting illness. In high-risk populations,
this can lead to several complications with an increase in mortality.
Several studies have investigated the relationship between influenza and
acute cardio and cerebrovascular events. Reviews of the thromboembolic
complications associated with influenza are lacking. Objectives: the
study aims to conduct a scoping review to analyze the epidemiological
and clinical characteristics of patients suffering from influenza and
thromboembolic complications. Materials and methods: A computerized
search of historical published cases using PubMed and the terms
“influenza” or “flu” and “thrombosis” or “embolism” or
“thromboembolism” or “stroke” or “infarct” was conducted. Only
articles reporting detailed data on patients with thromboembolic
complications of laboratory-confirmed influenza were considered eligible
for inclusion. Results: 57 cases with laboratory documented influenza A
or B and a related intravascular thrombosis were retrieved. Their
characteristics were analyzed along with that of a patient who motivated
our search. The localizations of thrombo-embolic events were pulmonary
embolism 21/58 (36.2 %), DVT 12/58 (20.6 %), DVT and pulmonary
embolism 3/58 (5.1 %), acute ischemic stroke 11/58 (18.9 percent),
arterial thrombosis 4/58 (6.8 percent), and acute myocardial infarction
5/58. (8.6 %). Discussion: Our findings are important in clarifying
which thromboembolic complications are more frequent in adults and
children with influenza. Symptoms of pulmonary embolism and influenza
can be very similar, so a careful clinical evaluation is required for
proper patient management, possible instrumental deepening, and
appropriate pharmacological interventions, especially for patients with
respiratory failure.