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On the other hand&#44; it was considered that certain patient groups might need a higher dose &#40;300<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">6&#44;8&#44;9</span></a> due to a possible decrease in intestinal absorption of the drug and&#47;or an increase in distribution volume when mechanical ventilation proved necessary and&#47;or in obese individuals&#46; The duration of the antiviral treatment in patients with mild or moderate disease was limited to 5 days &#40;the viral elimination time&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0375"><span class="elsevierStyleSup">7&#8211;9</span></a> while in critical patients&#44; where the viral elimination period could be significantly prolonged&#44;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">6&#44;8&#44;9</span></a> a longer treatment course of 10 days was advised&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The degree of global adherence to the clinical guidelines is highly variable but generally low&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10&#8211;12</span></a> The antiviral treatment guides during the pandemic period 2009 and in the post-pandemic period 2010&#8211;2011 were applied according to the criteria of each Spanish Autonomous Community&#44; each health center&#44; and each individual prescriber&#46; We therefore postulate that there is a considerable difference between the treatment recommendations of the health authorities and the way in which they are actually implemented in clinical practice&#46; Despite the many publications on influenza A&#40;H1N1&#41;pdm09&#44; the degree of adherence to the antiviral treatment guides during the influenza A pandemic is not known&#46; We therefore aimed to evaluate the degree of adherence to the antiviral treatment recommendations in critical patients with influenza A infection in two periods&#44; pandemic and post-pandemic&#44; and to explore the association among adherence&#44; risk factors and mortality&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Materials and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">A secondary analysis of a prospective&#44; multicenter observational study was carried out&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Study population</span><p id="par0025" class="elsevierStylePara elsevierViewall">The study population consisted of two adult cohorts with confirmed influenza A&#40;H1N1&#41;pdm09 infection and admitted to 148 Spanish Intensive Care Units &#40;ICUs&#41;&#46; Other influenza viruses &#40;H3N2 or B&#41; were not included&#44; since the circulation of virus A &#40;H1N1&#41;pdm09 was predominant during the study periods&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Inclusion and exclusion criteria</span><p id="par0030" class="elsevierStylePara elsevierViewall">We included all patients with clinical data compatible with influenza and who presented fever &#40;&#62;38<span class="elsevierStyleHsp" style=""></span>&#176;C&#41;&#44; consistent respiratory symptoms characterized by cough&#44; sore throat&#44; flu-type disease or muscle pain&#44; acute respiratory failure&#44; and with microbiological confirmation of influenza A&#40;H1N1&#41;pdm09 infection&#46; Patients under 15 years of age were excluded&#44; as were those individuals with clinical manifestations compatible with flu syndrome but without microbiological confirmation of influenza A&#40;H1N1&#41;pdm09 infection&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Two periods were analyzed&#58; &#40;1&#41; one patient cohort admitted between epidemiological weeks 23&#8211;52 of the year 2009&#44; corresponding to the pandemic&#59; and &#40;2&#41; another patient cohort during the post-pandemic period&#44; which registered the cases diagnosed between epidemiological weeks 50&#8211;52 of the 2010 and weeks 1&#8211;9 of 2011&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Data collection</span><p id="par0040" class="elsevierStylePara elsevierViewall">The data were obtained from a voluntary registry created by the Spanish Society of Intensive and Critical Care Medicine and Coronary Units &#40;<span class="elsevierStyleItalic">Sociedad Espa&#241;ola de Medicina Intensiva&#44; Cr&#237;tica y Unidades Coronarias</span>&#44; SEMICYUC&#41;&#46; The study was approved by the Institutional Review Board of the hospital coordinating the project &#40;<span class="elsevierStyleItalic">IRB NEUMAGRIP&#47;11809</span>&#41;&#46; The identity of the patients was kept anonymous&#44; and the obtainment of informed consent was not considered necessary&#44; due to the observational nature of the study and the sanitary urgency involved&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The data were reported by the supervising physician in each participating center using a voluntary registry form&#46; The confirmation of influenza A&#40;H1N1&#41;pdm09 infection was made by real-time PCR using nasopharyngeal smears or tracheal secretion samples in each institution or on a centralized basis in a reference &#40;core&#41; laboratory&#46; The criteria for admission to the ICU and the decisions referred to treatment for all the patients&#8211;including the need for intubation and the type of antibiotic or antiviral treatment provided&#8211;were established by the supervising physician&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Septic shock and organ failure &#40;SOFA score&#41; were established following the criteria of the American College of Chest Physicians and the Society of Critical Care Medicine&#46;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">13&#44;14</span></a> Primary viral pneumonia was defined by the presence of acute breathing difficulty and alveolar opacity in two or more lobes&#44; with negative respiratory and blood cultures during the acute phase of influenza virus infection&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">12</span></a> Community-acquired respiratory coinfection was defined as a bacterial or fungal infection diagnosed within the first two days of hospital stay&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">14</span></a> Those infections occurring after the first 48<span class="elsevierStyleHsp" style=""></span>h of stay were taken to be nosocomial processes&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Hematological disease was defined as that manifesting in patients with acute lymphoblastic leukemia&#44; acute myeloblastic leukemia&#44; chronic lymphocytic leukemia&#44; chronic myeloid leukemia&#44; Hodgkin lymphoma&#44; non-Hodgkin lymphoma&#44; myeloma&#44; or graft- vs -host disease&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">12</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Obese individuals were taken to be those with a body mass index &#40;BMI&#41; of &#62;30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">15</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Those patients previously vaccinated against influenza A&#40;H1N1&#41;pdm09 with the monovalent vaccine or the polyvalent vaccine for seasonal influenza 2010&#8211;2011 were defined as &#8220;vaccinated&#8221;&#46; Acute renal failure and its grades were diagnosed according to the Acute Kidney Injury &#40;AKI&#41; criteria&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">16</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">As regards antiviral therapy&#44; &#8220;early&#8221; treatment was taken to be therapy started within 48<span class="elsevierStyleHsp" style=""></span>h or less after the onset of symptoms&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">3</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Patients with &#8220;severity criteria&#8221; were defined as those presenting a combination of pneumonia&#44; obesity &#40;BMI<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41; and&#47;or invasive mechanical ventilation following the recommendations on antiviral treatment of the SEMICYUC&#46; According to these recommendations&#44; this group of patients could benefit from the administration of oseltamivir at high doses &#40;150<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h&#41; and with treatment durations of over 10 days&#44; on the grounds of the existence of an increased distribution volume&#46; For the rest of the patients&#44; i&#46;e&#46;&#44; &#8220;without severity criteria&#8221;&#44; standard doses and durations were recommended &#40;75<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h during less than 10 days&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">3</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">The variable &#8220;adherence&#8221; to the recommendations of antiviral treatment was established from the combination of the variables &#8220;severity criteria&#8221; and the duration and dosage of the antiviral treatment prescribed for each patient&#46; In this way we established four degrees of adherence&#44; as shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; We also studied adherence as a dichotomic variable where &#8220;total adherence&#8221; &#40;TA&#41; corresponded to patients who had received the treatment as recommended in terms of both dose and duration&#44; while the rest of the patients were considered to show &#8220;non-adherence&#8221; &#40;NA&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Statistical analysis</span><p id="par0085" class="elsevierStylePara elsevierViewall">Categorical variables were reported as values &#40;percentages&#41;&#44; and continuous variables as the mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation &#40;SD&#41; or median with the corresponding 25&#8211;75 interquartile ranges&#46; With regard to the demographic and clinical characteristics of the patients&#44; the differences between groups were evaluated using the chi-squared test or the Fisher exact test for categorical variables&#44; and the Student <span class="elsevierStyleItalic">t</span>-test or Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span>-test for continuous variables&#44; as appropriate&#46; The impact of the different variables upon mortality was analyzed using Cox regression analysis&#46;<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">17&#44;18</span></a> In order to avoid false associations&#44; the choice of variables entered in the analysis was decided by statistical criterion for those variables showing significance in the univariate analysis &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;1&#41;&#44; or based on the criterion of potential clinical relevance&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">In order to assess the possibility of a differential impact of the explanatory variables upon the results of each period&#44; the interactions between the explanatory variables and periods were used in the models&#46; The results are presented as hazard ratios &#40;HRs&#41;&#44; with 95&#37; confidence intervals &#40;95&#37;CI&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Lastly&#44; a post hoc analysis was made&#44; excluding those patients who died before the adherence objectives could be reached&#46; In this way we specifically analyzed adherence to the recommendations only in those patients who had completed treatment&#44; on a per protocol &#40;PP&#41; basis&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Statistical significance was considered for <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46; The SPSS version 16&#46;0 statistical package for MS Windows &#40;SPSS&#44; Chicago&#44; IL&#44; USA&#41; was used throughout&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Results</span><p id="par0105" class="elsevierStylePara elsevierViewall">The present analysis included a total of 1058 patients admitted to ICUs with confirmed influenza A&#40;H1N1&#41;pdm09 infection&#58; 661 patients &#40;62&#46;5&#37;&#41; were individuals infected during the pandemic of 2009&#44; and 397 &#40;37&#46;5&#37;&#41; were patients corresponding to the period 2010&#8211;2011 &#40;post-pandemic&#41;&#46; The variables related to antiviral treatment evaluated for each period are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; The patients of the post-pandemic period were comparatively in more serious condition and had greater organ dysfunction and a higher frequency of shock&#44; renal failure&#44; and need for mechanical ventilation and dialysis&#46; They also showed greater delays in diagnosis and admission to both hospital and the ICU&#46; Regarding treatment&#44; the post-pandemic period was characterized by a greater delay in the start of antiviral medication &#40;one day&#41; and a lesser indication of early empirical therapy&#44; as well as a generally lesser use of high doses&#44; and shorter durations of antiviral treatment&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">Global <span class="elsevierStyleItalic">total adherence</span> in the study was 41&#46;6&#37; and was greater during the pandemic period &#40;43&#46;9&#37;&#41; vs the period 2010&#8211;2011 &#40;38&#37;&#41;&#44; though the difference failed to reach statistical significance &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;07&#41;&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">On analyzing the degree of adherence according to the two patient categories established in the protocol &#40;presence or absence of severity criteria&#41;&#44; the percentage of patients with &#8220;severity criteria&#8221; requiring high doses was seen to be greater during the post-pandemic period &#40;68&#46;5&#37;&#41; than during the pandemic period &#40;62&#46;8&#37;&#41;&#44; though statistical significance was not reached &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;06&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows the different degrees of adherence according to the presence or absence of severity criteria in both study periods&#46; &#8220;Total adherence&#8221; was 54&#46;7&#37; for 2009 and decreased significantly to 36&#46;4&#37; during 2010&#8211;2011&#46; On the other hand&#44; non-adherence and partial adherence in time &#40;duration&#41; were more frequent in the post-pandemic period&#46; In contrast to the situation in patients with severity criteria&#44; those without such criteria showed a greater degree of &#8220;total adherence&#8221; during the post-pandemic period&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">The mortality rate was significantly higher &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; in the patients of the post-pandemic period 2010&#8211;2011 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>119&#59; 30&#37;&#41; than in those of the pandemic period &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>144&#59; 21&#46;8&#37;&#41;&#8211;this being associated to increased patient severity as scored by the APACHE II &#40;16&#46;2 &#91;7&#46;7&#93; vs 13&#46;9 &#91;7&#46;2&#93;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and increased organ dysfunction &#40;SOFA score upon admission 6&#46;2 &#91;4&#46;0&#93; vs 5&#46;7 &#91;3&#46;6&#93;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#41; for that period&#46; <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> shows the variables associated to mortality in both study periods&#46; On including the variables showing statistical significance in the multivariate analysis&#44; we found the APACHE II score&#44; hematological disease and adherence to treatment to be the variables independently associated to mortality &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#41;&#46; On the other hand&#44; early antiviral treatment was only found to be associated to survival in the pandemic period&#44; while human immunodeficiency virus &#40;HIV&#41; infection was associated to survival in the seasonal outbreak &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#41;&#46; The adjusted survival analysis showed adherence to the established antiviral treatment protocols to result in improved survival referred to both the global population &#40;HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;57&#59; 95&#37;CI&#58; 0&#46;431&#8211;0&#46;77&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and the two periods considered separately &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">The post hoc analysis identified only 23 patients &#40;2&#46;2&#37;&#41; who died before completing the treatment prescribed by the supervising physician&#59; these subjects were therefore excluded&#46; The final population for this analysis consisted of 1035 individuals&#46; Twelve of the deceased patients &#40;1&#46;2&#37;&#41; corresponded to the pandemic period and 11 &#40;1&#46;0&#37;&#41; to the post-pandemic period&#46; Global adherence was similar &#40;42&#46;6&#37;&#41; to that recorded for the total population&#44; without statistically significant differences between the periods&#46; In this population&#44; adherence to the recommendations &#40;HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;62&#59; 95&#37;CI&#58; 0&#46;43&#8211;0&#46;96&#41; and early antiviral treatment &#40;HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;64&#59; 95&#37;CI&#58; 0&#46;43&#8211;0&#46;95&#41; were the only variables independently associated to lesser mortality in the multivariate analysis&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Discussion</span><p id="par0130" class="elsevierStylePara elsevierViewall">The main finding of the present study was the low global adherence to the treatment recommendations referred to influenza A during the period 2009&#8211;2011&#44; and which proved more evident for the post-pandemic period&#46; Adherence to the treatment recommendations was low even among those patients considered to be at high risk&#46; In this particular subgroup of patients&#44; the management protocol was only followed in one out of every two individuals during the pandemic period&#44; and this situation was even worse in the post-pandemic period&#44; when only four out of every 10 patients adhered to the mentioned recommendations&#46; Another observation of great interest was that adherence to the treatment recommendations was associated to a 50&#37; decrease in mortality on considering the global population&#44; on distinguishing between the two periods&#44; and on excluding the early mortality cases&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Our findings are consistent with those obtained by other studies on treatment compliance in other populations&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11&#44;12</span></a> Seale et al&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">19</span></a> published the degree of adherence to the antiviral drug treatment protocol developed by the Health Protection Agency &#40;HPA&#41; of the United Kingdom for the pediatric population in ICUs&#46; The recommendations of the HPA were to start antiviral treatment early &#40;within the first 48<span class="elsevierStyleHsp" style=""></span>h after symptoms onset&#41; in this particular subgroup of patients&#46; The authors evaluated a total of 36 children&#44; of which nine had been treated before publication of the guide and the rest after its implementation&#46; The prescription rate for oseltamivir upon admission to the ICU increased significantly from 11&#37; &#40;1&#47;9&#41; to 50&#37; &#40;9&#47;18&#41; &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#41;&#46; As can be seen&#44; despite this improvement in compliance&#44; in the end only one out of every two children were treated in line with the recommendations&#46; On the other hand&#44; Fietje et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a> on analyzing oseltamivir prescription practice in The Netherlands during the pandemic&#44; recorded an increase of 100&#37; with respect to 2008&#46; The aim of the study was to determine whether the dispensation of oseltamivir complied with the prescription recommendations of the national guides for the pandemic&#46; In addition&#44; an analysis was made of the use of this drug by the patients&#44; based on a questionnaire&#46; A total of 630 patients were contacted&#44; and 361 &#40;57&#46;3&#37;&#41; completed the questionnaire&#46; Thirty-seven percent of the subjects &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>111&#41; received oseltamivir in the absence of any criterion justifying such prescription&#46; Regarding patient adherence&#44; the results reflected strong compliance&#44; since 97&#46;4&#37; of the patients started the prescribed treatment and 90&#46;8&#37; adhered to the established duration of therapy&#46; On the other hand&#44; Hersh et al&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">21</span></a> evaluated the degree of adherence to the guidelines of the United States Centers for Disease Control and Prevention &#40;CDC&#41; regarding the prescription of antiviral drugs during the influenza A&#40;H1N1&#41; pandemic of 2009 in the United States&#46; In contrast to the abovementioned study&#44; the frequency of prescription was found to be no different during the influenza A&#40;H1N1&#41;pdm09 period &#40;58&#37;&#41; with respect to earlier years &#40;59&#37;&#41;&#46; During the pandemic&#44; antivirals were prescribed for only 47&#37; of the patients under two years of age and for 68&#37; of the patients over 65 years of age&#46; These results indicate infrautilization of antiviral treatment in these risk groups with possible complications that can be prevented&#44; and suggest opportunities for improving implementation of the public health guides in clinical practice&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Our results suggest that adherence to the treatment protocols is a variable independently associated to mortality&#46; A decrease of close to 50&#37; was observed both in general and on considering the different periods&#8211;in concordance with the existing literatures&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">22&#44;23</span></a> Failure to comply with the treatment guides in severe community-acquired pneumonia is related to increased morbidity-mortality&#44; as well as to increased hospital stay and healthcare costs&#46;<a class="elsevierStyleCrossRefs" href="#bib0300"><span class="elsevierStyleSup">24&#8211;26</span></a> However&#44; few studies have evaluated the impact of adherence to the antiviral treatment recommendations upon mortality in critical patients in ICUs during the pandemic of 2009 and in the post-pandemic period 2010&#8211;2011&#46; These recommendations were based on the cumulative body of experience gained with seasonal influenza &#40;1970&#8211;2008&#41;&#44; where early treatment with neuraminidase inhibitors reduced the severity and duration of the disorder&#44; as well as the risk of complications&#46;<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">27&#44;28</span></a> However&#44; in comparison with seasonal influenza &#40;non-pandemic H1N1 or H3N2&#41;&#44; influenza A&#40;H1N1&#41;pdm09 behaves differently&#8211;not only because it affects younger individuals&#44; but also because of its capacity to produce rapid and severe lung damage&#44; with the development of acute respiratory distress syndrome and death secondary to refractory respiratory failure&#46; In this special context&#44; it is difficult to extrapolate the impact of antiviral treatment from studies in which the included patients show only mild or moderate disease caused by some other type of virus A&#46; Controversy therefore exists regarding the impact of antiviral treatment upon infection caused by influenza A&#40;H1N1&#41;pdm09&#44; since there are no randomized and controlled studies in critical patients that have firmly demonstrated its usefulness&#46; A review<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">29</span></a> of 11 published studies showed &#40;albeit with important methodological limitations&#41; that the complications of influenza A&#40;H1N1&#41;pdm09 are reduced by the use of antivirals in patients at both low and high risk&#46; On the other hand&#44; Jain et al&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">30</span></a> found the only variable independently associated to mortality to be the administration of oseltamivir within the first 48<span class="elsevierStyleHsp" style=""></span>h&#44; while Dominguez-Cherit et al&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">31</span></a> reported greater survival &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#46;4&#41; in patients who received antivirals&#46; Three retrospective studies were published in 2011&#44;<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">32&#8211;34</span></a> with results in this same line&#46; However&#44; and despite the fact that different publications of the Cochrane Library<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">27&#44;28&#44;35</span></a> reveal no benefit with oseltamivir in terms of the prevention and&#47;or treatment of seasonal influenza&#44; the studies considered in those reviews did not include critical patients&#46; On the other hand&#44; these data are in contrast to those obtained by the Spanish multicenter GETGAG study&#44;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">22</span></a> which evidenced a decrease in mortality among patients receiving early antiviral treatment&#46; In this same sense&#44; a recent international study on the effectiveness of antiviral treatment during the pandemic period&#44; including over 29&#44;000 patients&#44; documented a decrease in mortality risk among the patients that received antiviral therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">23</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">The present study has a number of limitations that must be commented&#44; though its findings are relevant and of great interest&#46; The main limitation is referred to the analysis of adherence&#44; which only considers adhesion to the treatment recommendations in relation to the known risk factors&#46; Although our results show a decrease in mortality risk when following the treatment recommendations for influenza A&#40;H1N1&#41;pdm09&#44; the type of analysis performed does not allow us to establish a cause-effect relationship&#44; since other uncontrolled variables &#40;confounding factors&#41; could influence the results&#46; In this regard&#44; it is possible that those patients who followed the treatment recommendations also received more adequate medical care&#44; and hence the impact upon mortality may not have been determined only by administration of the antiviral drug&#46; However&#44; the objective of the study was to evaluate adherence to the recommendations of treatment in general&#44; considering the known severity factors&#46; Furthermore&#44; after adjusting the model for risk by means of the multivariate analysis and excluding those patients with early mortality in a post hoc analysis&#44; adherence to the treatment recommendations remained as a factor independently associated to mortality&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">On the other hand&#44; the body of data included in this study is representative of prescription practice and the use of antivirals in Spanish ICUs&#44; but such data cannot be extrapolated to other ICUs or to other types of patients&#46; Lastly&#44; it must be mentioned that there may have been uncontrolled social&#44; economical or healthcare factors that could have contributed to the lack of adherence to the treatment recommendations&#44; as has been recognized in a recent editorial&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">36</span></a> However&#44; because of the characteristics of the study&#44; it was not possible to analyze these variables&#46; Consequently&#44; our findings must be interpreted with caution&#44; and within the limitations of its design&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">In conclusion&#44; the results of the present study reveal a low level of adherence to antiviral treatment in critical patients and a close association between this situation and mortality&#46; Adherence was found to be even lower in the post-pandemic period&#44; in which the recorded mortality was higher than during the pandemic period&#46; The introduction of educational and diffusion programs designed to increase adherence to the treatment recommendations should be considered before each winter season&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conflicts of interest</span><p id="par0160" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">This study was endorsed by the Spanish Society of Intensive and Critical Care Medicine and Coronary Units &#40;<span class="elsevierStyleItalic">Sociedad Espa&#241;ola de Medicina Intensiva&#44; Cr&#237;tica y Unidades Coronarias</span>&#44; SEMICYUC&#41;&#46; The SEMICYUC has not influenced the study design&#59; data collection&#44; analysis or interpretation&#59; drafting of the manuscript&#59; or the decision to submit the study for publication&#46; The content of the manuscript is the responsibility of the authors&#44; and does not necessarily reflect the official view of the SEMICYUC&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To determine the degree of antiviral treatment recommendations adherence and its impact to critical ill patients affected by influenza A&#40;H1N1&#41;pdm09 mortality&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Design</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Secondary analysis of prospective study&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Setting</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Intensive care &#40;UCI&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Patients</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Patients with influenza A&#40;H1N1&#41;pdm09 in the 2009 pandemic and 2010&#8211;11 post-pandemic periods&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Variables</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Adherence to recommendations was classified as&#58; total &#40;AT&#41;&#59; partial in doses &#40;PD&#41;&#59; partial in time &#40;PT&#41;&#44; and non-adherence &#40;NA&#41;&#46; Viral pneumonia&#44; obesity and mechanical ventilation were considered severity criteria for the administration of high antiviral dose&#46; The analysis was performed using <span class="elsevierStyleItalic">t</span>-test or &#8220;chi&#8221; square&#46; Survival analysis was performed and adjusted by Cox regression analysis&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Results</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A total of 1058 patients&#44; 661 &#40;62&#46;5&#37;&#41; included in the pandemic and 397 &#40;37&#46;5&#37;&#41; in post-pandemic period&#44; respectively&#46; Global adherence was achieved in 41&#46;6&#37; &#40;43&#46;9&#37; and 38&#46;0&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;07&#44; respectively&#41;&#46; Severity criteria were similar in both periods &#40;68&#46;5&#37; vs&#46; 62&#46;8&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;06&#41;&#46; The AT was 54&#46;7&#37; in pandemic and 36&#46;4&#37; in post-pandemic period&#44; respectively &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#46; The NA &#40;19&#46;7&#37; vs&#46; 11&#46;3&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; and PT &#40;20&#46;8&#37; vs&#46; 9&#46;9&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41; were more frequent in the post-pandemic period&#46; The mortality rate was higher in the post-pandemic period &#40;30&#37; vs&#46; 21&#46;8&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; APACHE <span class="elsevierStyleSmallCaps">II</span> &#40;HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;09&#41; and hematologic disease &#40;HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;2&#41; were associated with a higher mortality and adherence &#40;HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;47&#41; was a protective factor&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusions</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A low degree of adherence to the antiviral treatment was observed in both periods&#46; Adherence to antiviral treatment recommendations was associated with lower mortality rates and should be recommended in critically ill patients with suspected influenza A&#40;H1N1&#41;pdm09&#46;</p></span>"
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        "resumen" => "<span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Objetivo</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Evaluar el grado de adherencia a las recomendaciones sobre el tratamiento antiv&#237;rico y su impacto en la mortalidad de pacientes cr&#237;ticos afectados por gripe A &#40;H1N1&#41;pdm09&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Dise&#241;o</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis secundario de estudio prospectivo&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">&#193;mbito</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Medicina intensiva &#40;UCI&#41;&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Pacientes</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Pacientes con gripe A &#40;H1N1&#41;pdm09 en el periodo pand&#233;mico 2009 y pospand&#233;mico 2010&#8211;11&#46;</p></span> <span id="abst0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Variables</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">La adherencia a las recomendaciones se clasific&#243; en&#58; total &#40;AT&#41;&#44; parcial dosis &#40;PD&#41;&#44; parcial tiempo &#40;PT&#41; y no adherencia &#40;NA&#41;&#46; La neumon&#237;a v&#237;rica&#44; obesidad y ventilaci&#243;n mec&#225;nica fueron considerados criterios de gravedad para el uso de dosificaciones elevadas de antiv&#237;rico &#40;CG&#41;&#46; An&#225;lisis mediante &#171;chi&#187; cuadrado y t-test&#46; Supervivencia mediante regresi&#243;n de Cox&#46;</p></span> <span id="abst0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 1&#46;058 pacientes&#44; 661 &#40;62&#44;5&#37;&#41; en pandemia y 397 &#40;37&#44;5&#37;&#41; en pospandemia&#46; La AT global del estudio fue del 41&#44;6&#37; &#40;el 43&#44;9&#37; y el 38&#37;&#44; respectivamente&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;07&#41;&#46; Los pacientes con criterios de gravedad no fueron diferentes en ambos periodos &#40;un 68&#44;5&#37; y un 62&#44;8&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;06&#41;&#46; En estos pacientes la AT fue del 54&#44;7&#37; durante el 2009 y del 36&#44;4&#37; en pospandemia &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46; La NA &#40;19&#44;7&#37; vs&#46; 11&#44;3&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; y la PT &#40;20&#44;8&#37; vs&#46; 9&#44;9&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; fueron m&#225;s frecuentes durante la pospandemia&#46; La mortalidad fue mayor en la pospandemia &#40;30&#37; vs&#46; 21&#44;8&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; El APACHE II &#40;HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;09&#41; y la enfermedad hematol&#243;gica &#40;HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;2&#41; se asociaron a mortalidad y la adherencia &#40;HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;47&#41; fue un factor protector&#46;</p></span> <span id="abst0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conclusiones</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Se evidencia un bajo grado de adherencia al tratamiento en ambos periodos&#46; La adherencia al tratamiento antiv&#237;rico se asocia con menor mortalidad y deber&#237;a ser recomendada en pacientes cr&#237;ticos afectados por gripe A &#40;H1N1&#41;pdm09&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Please cite this article as&#58; Canadell L&#44; Mart&#237;n-Loeches I&#44; D&#237;az E&#44; Trefler S&#44; Grau S&#44; Yebenes JC&#44; et al&#46; Grado de adherencia al tratamiento antiv&#237;rico recomendado durante la pandemia y periodo pospand&#233;mico de gripe A &#40;H1N1&#41;pdm09 en 148 unidades de cuidados intensivos espa&#241;olas&#46; Med Intensiva&#46; 2015&#59;39&#58;222&#8211;233&#46;</p>"
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            "apendice" => "<p id="par0175" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Andalusia&#58;</span> Pedro Cobo &#40;Hospital Punta de Europa&#44; Algeciras&#41;&#59; Javier Martins &#40;Hospital Santa Ana Motril&#44; Granada&#41;&#59; Cecilia Carbayo &#40;Hospital Torrec&#225;rdenas&#44; Almer&#237;a&#41;&#59; Emilio Robles-Musso&#44; Antonio C&#225;rdenas&#44; Javier Fierro &#40;Hospital del Poniente&#44; Almer&#237;a&#41;&#59; Oca&#241;a Fern&#225;ndez &#40;Hospital Huercal&#8211;Overa&#44; Almer&#237;a&#41;&#59; Rafael Sierra &#40;Hospital Puerta del Mar&#44; C&#225;diz&#41;&#59; M&#46; Jes&#250;s Huertos &#40;Hospital Puerto Real&#44; C&#225;diz&#41;&#59; Juan Carlos Pozo&#44; R&#46; Guerrero &#40;Hospital Reina Sof&#237;a&#44; C&#243;rdoba&#41;&#59; Enrique M&#225;rquez &#40;Hospital Infanta Elena&#44; Huelva&#41;&#59; Manuel Rodr&#237;guez-Carvajal &#40;Hospital Juan Ram&#243;n Jim&#233;nez&#44; Huelva&#41;&#59; Antonio Jare&#241;o &#40;Hospital del SAS de Jerez&#44; Jerez de la Frontera&#41;&#59; Jos&#233; Pomares&#44; Jos&#233; Luis Ballesteros &#40;Hospital Universitario San Cecilio&#44; Granada&#41;&#59; Yolanda Fern&#225;ndez&#44; Francisco Lobato&#44; Jos&#233; F&#46; Prieto&#44; Jos&#233; Albofedo-S&#225;nchez &#40;Hospital Costa del Sol&#44; Marbella&#41;&#59; Pilar Mart&#237;nez &#40;Hospital Virgen de la Victoria&#44; M&#225;laga&#41;&#59; Miguel &#193;ngel D&#237;az Castellanos &#40;Hospital Santa Ana de Motril&#44; Granada&#41;&#59; Guillermo Sevilla &#40;Cl&#237;nica Sagrado Coraz&#243;n&#44; Sevilla&#41;&#59; Jos&#233; Garnacho-Montero&#44; Rafael Hinojosa&#44; Esteban Fern&#225;ndez &#40;Hospital Virgen del Roc&#237;o&#44; Sevilla&#41;&#59; Ana Loza&#44; Crist&#243;bal Le&#243;n &#40;Hospital Universitario Nuestra Se&#241;ora de Valme&#44; Sevilla&#41;&#59; &#193;ngel Arenzana &#40;Hospital Virgen de la Macarena&#44; Sevilla&#41;&#44; Dolores Oca&#241;a &#40;Hospital de la Inmaculada&#44; Sevilla&#41;&#59; In&#233;s Navarrete &#40;Hospital Virgen de las Nieves&#44; Granada&#41;&#46;</p> <p id="par0180" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Arag&#243;n&#58;</span> Manuel Luis Avellanas&#44; Arantxa Lander&#44; S&#46; Garrido Ram&#237;rez de Arellano&#44; M&#46;I&#46; Marquina Lacueva &#40;<span class="elsevierStyleItalic">Hospital San Jorge&#44; Huesca</span>&#41;&#59; Pilar Luque &#40;<span class="elsevierStyleItalic">Hospital Lozano Blesa&#44; Zaragoza</span>&#41;&#59; Ignacio Gonz&#225;lez &#40;<span class="elsevierStyleItalic">Hospital Miquel Servet&#44; Zaragoza</span>&#41;&#59; Jose M&#46; Mont&#243;n &#40;<span class="elsevierStyleItalic">Hospital Obispo Polanco&#44; Teruel</span>&#41;&#59; Jose M&#46; D&#237;az&#44; Pilar L&#243;pez-Reina&#44; Sergio S&#225;ez &#40;<span class="elsevierStyleItalic">Hospital Virgen de la Salud&#44; Teruel</span>&#41;&#46;</p> <p id="par0185" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Asturias&#58;</span> Lisardo Iglesias&#44; Carmen Pascual Gonz&#225;lez &#40;Hospital Universitario Central de Asturias &#8211; HUCA&#44; Oviedo&#41;&#59; Quiroga &#40;Hospital de Cabue&#241;es&#44; Gij&#243;n&#41;&#59; &#193;gueda Garc&#237;a-Rodr&#237;guez &#40;Hospital Valle del Nal&#243;n&#44; Langreo&#41;&#46;</p> <p id="par0190" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Balearic Islands&#58;</span> Lorenzo Socias&#44; Pedro Ib&#225;nez&#44; Marc&#237;o Borges-Sa&#44; A&#46; Socias&#44; del Castillo A &#40;<span class="elsevierStyleItalic">Hospital Son LLatzer&#44; Palma de Mallorca</span>&#41;&#59; Ricard Jord&#224; Marcos &#40;<span class="elsevierStyleItalic">Cl&#237;nica Rotger&#44; Palma de Mallorca</span>&#41;<span class="elsevierStyleItalic">&#59;</span> Jos&#233; M&#46; Bonell &#40;<span class="elsevierStyleItalic">USP&#46; Cl&#237;nica Palmaplanas&#44; Palma de Mallorca</span>&#41;&#59; Ignacio Amestar&#225;n &#40;<span class="elsevierStyleItalic">Hospital Son Dureta&#44; Palma de Mallorca</span>&#41;&#46;</p> <p id="par0195" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Canary Islands&#58;</span> Sergio Ruiz-Santana&#44; Juan Jos&#233; D&#237;az &#40;<span class="elsevierStyleItalic">Hospital Dr Negr&#237;n&#44; Las Palmas de Gran Canaria</span>&#41;&#59; Montserrat Sis&#243;n &#40;<span class="elsevierStyleItalic">Hospital Doctor Jos&#233; Molina&#44; Lanzarote</span>&#41;&#59; David Hern&#225;ndez&#44; Ana Trujillo&#44; Luis Regalado &#40;<span class="elsevierStyleItalic">Hospital General la Palma&#44; La Palma</span>&#41;&#59; Leonardo Lorente &#40;<span class="elsevierStyleItalic">Hospital Universitario de Canarias&#44; Tenerife</span>&#41;&#59; Mar Mart&#237;n &#40;<span class="elsevierStyleItalic">Hospital de la Candelaria&#44; Tenerife</span>&#41;&#44; Sergio Mart&#237;nez&#44; J&#46;J&#46; C&#225;ceres &#40;<span class="elsevierStyleItalic">Hospital Insular de Gran Canaria</span>&#41;&#46;</p> <p id="par0200" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Cantabria&#58;</span> Borja Suberviola&#44; P&#46; Ugarte &#40;Hospital Universitario Marqu&#233;s de Valdecilla&#44; Santander&#41;&#46;</p> <p id="par0205" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Castilla La Mancha&#58;</span> Fernando Garc&#237;a-L&#243;pez &#40;Hospital General&#44; Albacete&#41;&#59; &#193;ngel &#193;lvaro Alonso&#44; Antonio Pasilla &#40;Hospital General La Mancha Centro&#44; Alc&#225;zar de San Juan&#41;&#59; M&#46; Luisa G&#243;mez Grande &#40;Hospital General de Ciudad Real&#44; Ciudad Real&#41;&#59; Antonio Albaya &#40;Hospital Universitario de Guadalajara&#44; Guadalajara&#41;&#59; Alfonso Canabal&#44; Luis Marina &#40;Hospital Virgen de la Salud&#44; Toledo&#41;&#46;</p> <p id="par0210" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Castilla y Le&#243;n&#58;</span> Juan B&#46; L&#243;pez Messa &#40;Complejo Asistencial de Palencia&#44; Palencia&#41;&#44; M&#46; Jes&#250;s L&#243;pez Pueyo &#40;Hospital General Yag&#252;e&#44; Burgos&#41;&#59; Zulema Ferreras &#40;Hospital Universitario de Salamanca&#44; Salamanca&#41;&#59; Santiago Macias &#40;Hospital General de Segovia&#44; Segovia&#41;&#59; Jos&#233; &#193;ngel Berezo&#44; Jes&#250;s Blanco Varela &#40;Hospital Universitario R&#237;o Hortega&#44; Valladolid&#41;&#44; A&#46; Andaluz Ojeda &#40;Hospital Universitario&#44; Valladolid&#41;&#59; Antonio &#193;lvarez Terrero &#40;Hospital Virgen de la Concha&#44; Zamora&#41;&#59; Fabiola Tena Ezpeleta &#40;Hospital Santa B&#225;rbara&#44; Soria&#41;&#46;</p> <p id="par0215" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Catalonia&#58;</span> Rosa M&#46; Catal&#225;n &#40;Hospital General de Vic&#44; Vic&#41;&#59; Miquel Ferrer&#44; Antoni Torres &#40;Hospital Cl&#237;nic&#44; Barcelona&#41;&#59; Sandra Barbadillo &#40;Hospital General de Catalunya &#8211; CAPIO&#44; Barcelona&#41;&#59; Llu&#237;s Cabr&#233; &#40;Hospital de Barcelona&#44; Barcelona&#41;&#59; Assumpta Rovira &#40;Hospital General de l&#8217;Hospitalet&#44; L&#8217;Hospitalet&#41;&#59; Francisco &#193;lvarez-Lerma&#44; Antonia V&#225;zquez&#44; Joan Nolla &#40;Hospital Del Mar&#44; Barcelona&#41;&#59; Francisco Fern&#225;ndez&#44; Joaquim Ram&#243;n Cervell&#243; &#40;Centro M&#233;dico Delfos&#44; Barcelona&#41;&#59; Rafael Ma&#241;&#233;z&#44; J&#46; Ball&#250;s&#44; Rosa M&#46; Granada &#40;Hospital de Bellvitge&#44; Barcelona&#41;&#59; Jordi Vall&#233;s&#44; Marta Ort&#237;z&#44; C&#46; Gu&#237;a &#40;Hospital de Sabadell&#44; Sabadell&#41;&#59; Fernando Arm&#233;star&#44; Joaquim P&#225;ez &#40;Hospital Dos De Mayo&#44; Barcelona&#41;&#59; Jordi Almirall&#44; Xavier Balanzo &#40;Hospital de Matar&#243;&#44; Matar&#243;&#41;&#59; Jordi Rello&#44; Elena Arnau&#44; Lluis Llopart&#44; Mercedes Palomar &#40;Hospital Vall d&#8217;Hebron&#44; Barcelona&#41;&#59; I&#241;aki Catal&#225;n &#40;Hospital Sant Joan de D&#233;u&#44; Manresa&#41;&#59; Josep M&#46; Sirvent&#44; Cristina Ferri&#44; Nerea L&#243;pez de Arbina &#40;Hospital Josep Trueta&#44; Girona&#41;&#59; Mariona Bad&#237;a&#44; Montserrat Valverd&#250;-Vidal&#44; Fernando Barcenilla &#40;Hospital Arnau de Vilanova&#44; Lleida&#41;&#59; M&#242;nica Magret &#40;Hospital Sant Joan de Reus&#44; Reus&#41;&#59; M&#46;F&#46; Esteban&#44; Jos&#233; Luna &#40;Hospital Verge de la Cinta&#44; Tortosa&#41;&#59; Juan M&#46; Nava&#44; J Gonz&#225;lez de Molina &#40;Hospital Universitario Mutua de Terrassa&#44; Terrassa&#41;&#59; Zoran Josic &#40;Hospital de Igualada&#44; Igualada&#41;&#59; Francisco Gurri &#40;Hospital Quir&#243;n&#44; Barcelona&#41;&#59; Alejandro Rodr&#237;guez&#44; Thiago Lisboa&#44; Diego de Mendoza&#44; Sandra Trefler &#40;Hospital Universitario Joan XXIII&#44; Tarragona&#41;&#44; Rosa Mar&#237;a D&#237;az &#40;Hospital San Camil&#44; Sant Pere de Ribes&#44; Barcelona&#41;&#46;</p> <p id="par0220" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Extremadura&#58;</span> Juli&#225;-Narv&#225;ez Jos&#233; &#40;<span class="elsevierStyleItalic">Hospital Infanta Cristina&#44; Badajoz</span>&#41;&#59; Alberto Fern&#225;ndez-Zapata&#44; Teresa Recio&#44; Abilio Arrascaeta&#44; M&#46; Jos&#233; Garc&#237;a-Ramos&#44; Elena Gallego &#40;<span class="elsevierStyleItalic">Hospital San Pedro de Alc&#225;ntara&#44; C&#225;ceres</span>&#41;&#59; F&#46; Bueno &#40;<span class="elsevierStyleItalic">Hospital Virgen del Puerto&#44; Plasencia</span>&#41;&#46;</p> <p id="par0225" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Galicia&#58;</span> M&#46; Lourdes Cordero&#44; Jos&#233; A&#46; Pastor&#44; Luis &#193;lvarez-Rocha &#40;<span class="elsevierStyleItalic">CHUAC&#44; A Coru&#241;a</span>&#41;&#59; Dolores Vila &#40;<span class="elsevierStyleItalic">Hospital Do Meixoeiro&#44; Vigo</span>&#41;&#59; Ana D&#237;az Lamas &#40;<span class="elsevierStyleItalic">Hospital Arquitecto Marcide&#44; Ferrol</span>&#41;&#59; Javier Blanco P&#233;rez&#44; M&#46; Ortiz Piquer &#40;<span class="elsevierStyleItalic">Hospital Xeral-Calde&#44; Lugo</span>&#41;&#59; Eleuterio Merayo&#44; Victor Jose L&#243;pez-Ciudad&#44; Juan Cortez&#44; Eva Vilaboy &#40;<span class="elsevierStyleItalic">Complejo Hospitalario de Ourense&#44; Ourense</span>&#41;&#59; Eva Maria Saborido &#40;<span class="elsevierStyleItalic">Hospital Montecelo&#44; Pontevedra</span>&#41;&#59; Raul Jos&#233; Gonz&#225;lez &#40;<span class="elsevierStyleItalic">H&#46; Miguel Dom&#237;nguez&#44; Pontevedra</span>&#41;&#59; Santiago Freita &#40;<span class="elsevierStyleItalic">Complejo Hospitalario de Pontevedra&#44; Pontevedra</span>&#41;&#46;</p> <p id="par0230" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">La Rioja&#58;</span> Jos&#233; Luis Monz&#243;n&#44; F&#233;lix Go&#241;i &#40;<span class="elsevierStyleItalic">Hospital San Pedro&#44; Logro&#241;o</span>&#41;&#46;</p> <p id="par0235" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Madrid&#58;</span> Frutos del Nogal S&#225;ez&#44; M&#46; Blasco Navalpotro &#40;<span class="elsevierStyleItalic">Hospital Severo Ochoa&#44; Madrid</span>&#41;&#59; M&#46; Carmen Garc&#237;a-Torrej&#243;n &#40;<span class="elsevierStyleItalic">Hospital Infanta Elena&#44; Madrid</span>&#41;&#59;C&#233;sar P&#233;rez-Calvo&#44; Diego L&#243;pez &#40;<span class="elsevierStyleItalic">Fundaci&#243;n Jim&#233;nez D&#237;az&#44; Madrid</span>&#41;&#59; Luis Arnaiz&#44; S&#46; S&#225;nchez-Alonso&#44; Carlos Velayos &#40;<span class="elsevierStyleItalic">Hospital Fuenlabrada&#44; Madrid</span>&#41;&#59; Francisco del R&#237;o&#44; Miguel &#193;ngel Gonz&#225;lez &#40;<span class="elsevierStyleItalic">Hospital Cl&#237;nico San Carlos&#44; Madrid</span>&#41;&#59; Mar&#237;a Cruz Mart&#237;n&#44; Jos&#233; M&#46; Molina &#40;<span class="elsevierStyleItalic">Hospital Nuestra Se&#241;ora de Am&#233;rica&#44; Madrid</span>&#41;&#59; Juan Carlos Montejo&#44; Mercedes Catal&#225;n &#40;<span class="elsevierStyleItalic">Hospital Universitario 12 de Octubre&#44; Madrid</span>&#41;&#59; Patricia Albert&#44; Ana de Pablo &#40;<span class="elsevierStyleItalic">Hospital del Sureste&#44; Arganda del rey</span>&#41;&#59;Jos&#233; Eugenio Guerrero&#44; Jaime Benitez Peyrat &#40;<span class="elsevierStyleItalic">Hospital Gregorio Mara&#241;&#243;n&#44; Madrid</span>&#41;&#59; Enrique Cerd&#225;&#44; Manuel Alvarez&#44; Carlos Pey &#40;<span class="elsevierStyleItalic">Hospital Infanta Cristina&#44; Madrid</span>&#41;&#59;Montse Rodr&#237;guez&#44; Eduardo Palencia &#40;<span class="elsevierStyleItalic">Hospital Infanta Leonor&#44; Madrid</span>&#41;&#59; Rafael Caballero &#40;<span class="elsevierStyleItalic">Hospital de San Rafael&#44; Madrid</span>&#41;&#59; Rafael Guerrero &#40;<span class="elsevierStyleItalic">Hospital Reina Sof&#237;a&#44; Madrid</span>&#41;&#59; Concepci&#243;n Vaquero&#44; Francisco Mariscal&#44; S&#46; Garc&#237;a &#40;<span class="elsevierStyleItalic">Hospital Infanta Sof&#237;a&#44; Madrid</span>&#41;&#59; Almudena Sim&#243;n &#40;<span class="elsevierStyleItalic">Hospital Nuestra Se&#241;ora del Prado&#44; Madrid</span>&#41;&#59; Nieves Carrasco &#40;<span class="elsevierStyleItalic">Hospital Universitario La Princesa&#44; Madrid</span>&#41;&#59; Isidro Prieto&#44; A Li&#233;tor&#44; R&#46; Ramos &#40;<span class="elsevierStyleItalic">Hospital Ram&#243;n y Cajal&#44; Madrid</span>&#41;&#59; Beatriz Galv&#225;n&#44; Juan C&#46; Figueira&#44; M&#46; Cruz Soriano &#40;<span class="elsevierStyleItalic">Hospital La Paz&#44; Madrid</span>&#41;&#59; P Gald&#243;s&#44; B&#225;rbara Balandin Moreno &#40;<span class="elsevierStyleItalic">Hospital Puerta de Hierro&#44; Madrid</span>&#41;&#59; Fern&#225;ndez del Cabo &#40;<span class="elsevierStyleItalic">Hospital Monte Pr&#237;ncipe&#44; Madrid</span>&#41;&#59; Cecilia Hermosa&#44; Federico Gordo &#40;<span class="elsevierStyleItalic">Hospital de Henares&#44; Madrid</span>&#41;&#59; Alejandro Algora &#40;<span class="elsevierStyleItalic">Hospital Universitario Fundaci&#243;n Alcorc&#243;n&#44; Madrid</span>&#41;&#59; Amparo Paredes &#40;<span class="elsevierStyleItalic">Hospital Sur de Alcorc&#243;n&#44; Madrid</span>&#41;&#59; J&#46;A&#46; Cambronero &#40;<span class="elsevierStyleItalic">Hospital Universitario Pr&#237;ncipe de Asturias&#44; Madrid</span>&#41;&#59; Sonia G&#243;mez-Rosado &#40;<span class="elsevierStyleItalic">Hospital de M&#243;stoles&#44; Madrid</span>&#41;&#46;</p> <p id="par0240" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Murcia&#58;</span> Sof&#237;a Mart&#237;nez &#40;Hospital Santa Mar&#237;a del Rosell&#44; Murcia&#41;&#59; F&#46; Felices Abad &#40;Hospital Universitario Reina Sof&#237;a&#44; Murcia&#41;&#59; Mariano Mart&#237;nez &#40;Hospital Universitario Virgen de la Arrixaca&#44; Murcia&#41;&#59; Sergio Manuel But&#237;&#44; Gil Rueda&#44; Francisco Garc&#237;a &#40;Hospital Morales Messeguer&#44; Murcia&#41;&#46;</p> <p id="par0245" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Navarre&#58;</span> Laura Macaya&#44; Enrique Marav&#237;-Poma&#44; I&#46; Jimenez Urra&#44; L&#46; Macaya Redin&#44; A Teller&#237;a &#40;<span class="elsevierStyleItalic">Hospital Virgen del Camino&#44; Pamplona</span>&#41;&#59; Josu Insansti &#40;<span class="elsevierStyleItalic">Hospital de Navarra&#44; Pamplona</span>&#41;&#46;</p> <p id="par0250" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Basque Country&#58;</span> Nagore Gonz&#225;lez&#44; Pilar Marco&#44; Loreto Vidaur &#40;<span class="elsevierStyleItalic">Hospital de Donostia&#44; San Sebasti&#225;n</span>&#41;&#59; B&#46; Santamar&#237;a &#40;<span class="elsevierStyleItalic">Hospital de Basurto&#44; Bilbao</span>&#41;&#59; Juan Carlos Vergara&#44; Jose Ramon Iruretagoyena Amiano &#40;<span class="elsevierStyleItalic">Hospital de Cruces&#44; Bilbao</span>&#41;&#59; Alberto Manzano &#40;<span class="elsevierStyleItalic">Hospital Santiago Ap&#243;stol&#44; Vitoria</span>&#41;&#59;Carlos Castillo Arenal &#40;<span class="elsevierStyleItalic">Hospital Txagorritxu&#44; Vitoria</span>&#41;&#46;</p> <p id="par0255" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Valencia&#58;</span> Jos&#233; Blanquer &#40;Hospital Clinic Universitari&#44; Valencia&#41;&#59; Roberto Reig Valero&#44; A&#46; Belenger&#44; Susana Altaba &#40;Hospital General de Castell&#243;n&#44; Castell&#243;n&#41;&#59; Bernab&#233; &#193;lvarez-S&#225;nchez &#40;Hospital General de Alicante&#44; Alicante&#41;&#59; Santiago Alberto Picos &#40;Hospital Torrevieja Salud&#44; Alicante&#41;&#59; &#193;ngel S&#225;nchez-Miralles &#40;Hospital San Juan&#44; Alicante&#41;&#59; Juan Bonastre&#44; M&#46; Palamo&#44; Javier Cebrian&#44; Jos&#233; Cu&#241;at &#40;Hospital La Fe&#44; Valencia&#41;&#59; Bel&#233;n Romero &#40;Hospital de Manises&#44; Valencia&#41;&#59; Rafael Zaragoza &#40;Hospital Dr&#46; Peset&#44; Valencia&#41;&#59; Virgilio Paricio &#40;Hospital de Requena&#44; Valencia&#41;&#59; Asunci&#243;n Marques&#44; S&#46; S&#225;nchez-Morcillo&#44; S&#46; Tormo &#40;Hospital de la Ribera&#44; Valencia&#41;&#59; J&#46; Latour &#40;H&#46; G&#46; Universitario de Elche&#44; Valencia&#41;&#44; M&#46; &#193;ngel Garc&#237;a &#40;Hospital de Sagunto&#44; Castell&#243;n&#41;&#46;</p>"
            "etiqueta" => "Annex 1"
            "titulo" => "List of investigators of the GETGAG&#47;SEMICYUC"
            "identificador" => "sec0050"
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          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Adjusted patient survival &#40;Cox regression analysis&#41; according to adherence to the treatment recommendations in both study periods&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Adherence variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Definition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Total adherence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dose of 150<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h and duration &#8805;10 days<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>Dose of 75<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h and duration &#60;10 days<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Partial adherence in dose&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dose of 150<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h but duration &#60;10 days<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>Dose of 75<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h but duration &#8805;10 days<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Partial adherence in duration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dose of 75<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h and duration &#8805;10 days<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>Dose of 150<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h and duration &#60;10 days<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Non-adherence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dose of 75<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h and duration of &#60;10 days<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>Dose of 150<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h and duration &#8805;10 days<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Patients with severity criteria and need for high doses&#46;</p>"
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            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Patients without severity criteria and requiring standard doses&#46;</p>"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Classification of the degrees of adherence to the antiviral treatment protocols&#46;</p>"
        ]
      ]
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        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pandemic 2009&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>661&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pandemic 2010&#8211;2011&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>397&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Severity&#44; mean &#40;SD&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>APACHE II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;9 &#40;7&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#46;2 &#40;7&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>SOFA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;7 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;2 &#40;4&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Clinical manifestations&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Primary viral pneumonia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">546 &#40;69&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">267 &#40;67&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Exacerbated COPD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36 &#40;5&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Bacterial coinfection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">99 &#40;15&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76 &#40;19&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Care variables&#44; mean &#40;SD&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mean stay in ICU&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;53 &#40;14&#46;34&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;88 &#40;13&#46;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mean stay in hospital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#46;8 &#40;17&#46;83&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#46;01 &#40;16&#46;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Days from symptoms onset to hospital admission&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;28 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;92 &#40;3&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Days of hospital stay to admission to ICU&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;86 &#40;2&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;37 &#40;3&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Days of hospital stay to diagnosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;32 &#40;2&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;69 &#40;3&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Evolutive indicators&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Septic shock&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">295 &#40;45&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">224 &#40;56&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mechanical ventilation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">471 &#40;71&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">326 &#40;82&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Invasive mechanical ventilation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">404 &#40;61&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">269 &#40;66&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Prone decubitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">95 &#40;14&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">82 &#40;20&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Acute renal failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">136 &#40;21&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">112 &#40;39&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dialysis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;3&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;7&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mortality in ICU&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">144 &#40;21&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">119 &#40;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Treatment</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Treatment with oseltamivir&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">643 &#40;99&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">383 &#40;96&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Treatment with zanamivir&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;0&#46;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25 &#40;6&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Empirical antiviral treatment&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">463 &#40;72&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">274 &#40;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;517&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Days from symptoms onset to antiviral administration&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;7 &#40;2&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;7 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Early antiviral treatment &#40;&#60;48<span class="elsevierStyleHsp" style=""></span>h&#41;&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">153 &#40;23&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61 &#40;15&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Use of high antiviral drug doses&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">453 &#40;72&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">212 &#40;55&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Duration of antiviral treatment&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;6 &#40;4&#46;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;88 &#40;3&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Adherence to treatment protocol&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">267 &#40;43&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">145 &#40;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;075&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Patients with severity criteria&#58; high dose</th></tr><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Degrees of adherence&#58; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pandemic 2009&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>380&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Period 2010&#8211;2011&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>264&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Total adherence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">208 &#40;54&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">96 &#40;36&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Partial adherence in dose&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84 &#40;22&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61 &#40;23&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;774&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Partial adherence in duration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47 &#40;11&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52 &#40;19&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Non-adherence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41 &#40;9&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55 &#40;20&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Patients without severity criteria&#58; standard dose</th></tr><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Degrees of adherence&#58; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pandemic 2009&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>228&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Period 2010&#8211;2011&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>118&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Total adherence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59 &#40;25&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49 &#40;41&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Partial adherence in dose&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;7&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;12&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;177&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Partial adherence in duration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89 &#40;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;27&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;032&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Non-adherence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62 &#40;27&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;18&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Degrees of adherence in each period for patients with and without severity criteria&#46;</p>"
        ]
      ]
      4 => array:7 [
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        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">COPD&#58; chronic obstructive pulmonary disease&#59; ICU&#58; Intensive Care Unit&#59; HIV&#58; human immunodeficiency virus&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Pandemic period &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>661&#41;</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Post-pandemic period &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>396&#41;</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Survivors &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>517&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Deceased &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>144&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Survivors &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>277&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Deceased &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>119&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Level of severity</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>SOFA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;9 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;5 &#40;4&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;2 &#40;3&#46;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;6 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>APACHE II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;5 &#40;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;5 &#40;8&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#46;1 &#40;6&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;8&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Demographic factors</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Age&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&#46;8 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48 &#40;16&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;057&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&#46;5 &#40;14&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51&#46;9 &#40;14&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;113&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male sex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">287 &#40;55&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">91 &#40;63&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;209&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">184 &#40;66&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">85 &#40;71&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;590&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Comorbidities</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;1 condition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">353 &#40;69&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">154 &#40;79&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;051&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">205 &#40;73&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">94 &#40;79&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;316&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>COPD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87 &#40;16&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;14&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;467&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52 &#40;21&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26 &#40;24&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;203&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Asthma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69 &#40;13&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;8&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;829&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27 &#40;9&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Heart failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;11&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;034&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26 &#40;9&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;11&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;189&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Chronic renal failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;3&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;9&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;6&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;10&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62 &#40;12&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;14&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;555&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48 &#40;17&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;13&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;946&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Obesity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">180 &#40;35&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58 &#40;41&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;713&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">107 &#40;38&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;26&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Autoimmune disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;2&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;1&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;2&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;153&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hematological disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;3&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;14&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;5&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;23&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Neuromuscular disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;3&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;4&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;783&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;632&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>HIV infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;1&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;165&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;10&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pregnancy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;4&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;4&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;896&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;233&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Clinical presentation</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Viral pneumonia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">359 &#40;70&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97 &#40;67&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;178&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">186 &#40;66&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">81 &#40;68&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;844&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>EPOC exacerbation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;3&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;427&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;7&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;217&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Respiratory bacterial coinfection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">70 &#40;13&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;20&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;056&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45 &#40;16&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&#46;2 &#40;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;119&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Complications</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Septic shock&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">190 &#40;37&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">105 &#40;74&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">127 &#40;45&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97 &#40;91&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Multiorgan failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">283 &#40;55&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">125 &#40;88&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">133 &#40;47&#46;89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100 &#40;84&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Acute renal failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38 &#40;27&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49 &#40;17&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64 &#40;53&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Continuous renal replacement therapy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62 &#40;45&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;3&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;16&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Noninvasive mechanical ventilation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">125 &#40;24&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38 &#40;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;373&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">105 &#40;38&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37 &#40;31&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;766&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Invasive mechanical ventilation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">266 &#40;51&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">138 &#40;95&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">156 &#40;57&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">113 &#40;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Renal failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62 &#40;45&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51 &#40;18&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61 &#40;51&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Prone decubitus</td><td class="td" title="table-entry  " rowspan="2" align="char" valign="top">52 &#40;10&#46;2&#41;</td><td class="td" title="table-entry  " rowspan="2" align="char" valign="top">43 &#40;30&#46;7&#41;</td><td class="td" title="table-entry  " rowspan="2" align="char" valign="top">0&#46;002</td><td class="td" title="table-entry  " rowspan="2" align="char" valign="top">33 &#40;11&#46;9&#41;</td><td class="td" title="table-entry  " align="char" valign="top">49 &#40;41&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="char" valign="top">&#60;0&#46;001</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Treatment</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Treatment with oseltamivir&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">506 &#40;99&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">137 &#40;97&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68 &#40;96&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">115 &#40;96&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;322&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Treatment with zanamivir&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;475&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;5&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;7&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;973&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Empirical antiviral treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">371 &#40;74&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">92 &#40;67&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;207&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">196 &#40;72&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">78 &#40;67&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Days to start of antiviral treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;6 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;3 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;085&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;4 &#40;3&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;5 &#40;4&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;033&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Early antiviral treatment &#40;&#8804;48<span class="elsevierStyleHsp" style=""></span>h&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">129 &#40;25&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;17&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;361&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49 &#40;18&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;10&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;263&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Patients with severity criteria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">284 &#40;54&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">131 &#40;91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">160 &#40;57&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">112 &#40;94&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Use of high doses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">221 &#40;45&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49 &#40;40&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;113&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;26&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Use of high doses &#40;150<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">350 &#40;70&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">103 &#40;81&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;204&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">148 &#40;55&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64 &#40;55&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;147&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>More than 10 days of treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">276 &#40;56&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59 &#40;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">138 &#40;51&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47 &#40;40&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Duration of antiviral treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;79 &#40;3&#46;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;88 &#40;5&#46;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;34 &#40;3&#46;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;8 &#40;4&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Total adherence to treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">218 &#40;44&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49 &#40;40&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">113 &#40;42&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;27&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Vaccination&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;5&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;883&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Pandemic period</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Post-pandemic period</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37;CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37;CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">APACHE II score &#40;per point&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;06&#8211;1&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;05&#8211;1&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Hematological disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;26&#8211;3&#46;85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;39&#8211;3&#46;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Adherence to treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;32&#8211;0&#46;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;35&#8211;0&#46;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Early treatment &#40;&#60;48<span class="elsevierStyleHsp" style=""></span>h&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;56&nbsp;\t\t\t\t\t\t\n
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Degree of adherence to recommended antiviral treatment during the pandemic and post-pandemic periods of influenza A(H1N1)pdm09 in 148 intensive care units in Spain
Grado de adherencia al tratamiento antivírico recomendado durante la pandemia y periodo pospandémico de gripe A (H1N1)pdm09 en 148 unidades de cuidados intensivos españolas
L. Canadella, I. Martín-Loechesb, E. Díazb, S. Treflerc, S. Graud, J.C. Yebenese, J. Almiralle, M. Olonaf, F. Suredag, J. Blanquerh, A. Rodriguezc,i,
Corresponding author
, in representation of the GETGAG
a Department of Hospital Pharmacy, Hospital Universitario de Tarragona Joan XXIII, Universitat Rovira i Virgili, Institut d’Investigació Sanitària Pere Virgili, Tarragona, Spain
b Department of Intensive Care Medicine, Corporación Sanitaria Parc Taulí, CIBERES, Sabadell, Spain
c Department of Intensive Care Medicine, Hospital Universitario de Tarragona Joan XXIII, Universitat Rovira i Virgili, Institut d’Investigació Sanitària Pere Virgili, Tarragona, Spain
d Department of Hospital Pharmacy, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
e Department of Intensive Care Medicine, Hospital Universitario de Mataró, Mataró, Spain
f Department of Preventive Medicine – Hospital Universitario de Tarragona Joan XXIII, Tarragona, Spain
g Department of Clinical Pharmacology – Universidad Rovira i Virgili, Tarragona, Spain
h Department of Intensive Care Medicine, Hospital Clínico, Valencia, Spain
i Centros de Investigación Biomédica en Red Enfermedades Respiratorias, Tarragona, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">On facing the influenza A&#40;H1N1&#41; pandemic of early 2009&#44; the health authorities planned communication strategies&#44; ethical decision making protocols&#44; the stockpiling of antivirals and improvement of the capacity of the health system to offer adequate care for a large number of patients&#46; In this regard&#44; guidelines were traced and strategies were defined&#44; pooling the evidence available up to that time&#44; with a view to optimizing antiviral therapy&#46; In Spain&#44; with the purpose of guaranteeing adequate and homogeneous care for adults with severe influenza A&#40;H1N1&#41;pdm09 disease&#44;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">1&#44;2</span></a> the Ministry of Health designed an intervention protocol<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">3</span></a> based on the recommendations of the World Health Organization &#40;WHO&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0365"><span class="elsevierStyleSup">4&#44;5</span></a> However&#44; the mentioned protocol was established on the basis of the efficacy data of the neuraminidase inhibitors obtained from studies in patients with only mild or moderate forms of the disease&#46; As a result&#44; the true impact of antiviral treatment in critically ill patients was difficult to calibrate&#44; due to the lack of randomized studies in this special group of patients&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">During the pandemic period&#44; different health organizations<a class="elsevierStyleCrossRefs" href="#bib0365"><span class="elsevierStyleSup">4&#8211;7</span></a> agreed on the need to administer early antiviral treatment in the form of oseltamivir to all patients requiring hospital admission&#44; with progressing serious disease&#44; or who developed complications&#46; This strategy was to be applied independently of the previous health condition or vaccination history of the patient&#46; In this context&#44; the recommended oseltamivir dose for adults was 75<span class="elsevierStyleHsp" style=""></span>mg twice a day via the oral route&#46; On the other hand&#44; it was considered that certain patient groups might need a higher dose &#40;300<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">6&#44;8&#44;9</span></a> due to a possible decrease in intestinal absorption of the drug and&#47;or an increase in distribution volume when mechanical ventilation proved necessary and&#47;or in obese individuals&#46; The duration of the antiviral treatment in patients with mild or moderate disease was limited to 5 days &#40;the viral elimination time&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0375"><span class="elsevierStyleSup">7&#8211;9</span></a> while in critical patients&#44; where the viral elimination period could be significantly prolonged&#44;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">6&#44;8&#44;9</span></a> a longer treatment course of 10 days was advised&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The degree of global adherence to the clinical guidelines is highly variable but generally low&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">10&#8211;12</span></a> The antiviral treatment guides during the pandemic period 2009 and in the post-pandemic period 2010&#8211;2011 were applied according to the criteria of each Spanish Autonomous Community&#44; each health center&#44; and each individual prescriber&#46; We therefore postulate that there is a considerable difference between the treatment recommendations of the health authorities and the way in which they are actually implemented in clinical practice&#46; Despite the many publications on influenza A&#40;H1N1&#41;pdm09&#44; the degree of adherence to the antiviral treatment guides during the influenza A pandemic is not known&#46; We therefore aimed to evaluate the degree of adherence to the antiviral treatment recommendations in critical patients with influenza A infection in two periods&#44; pandemic and post-pandemic&#44; and to explore the association among adherence&#44; risk factors and mortality&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Materials and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">A secondary analysis of a prospective&#44; multicenter observational study was carried out&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Study population</span><p id="par0025" class="elsevierStylePara elsevierViewall">The study population consisted of two adult cohorts with confirmed influenza A&#40;H1N1&#41;pdm09 infection and admitted to 148 Spanish Intensive Care Units &#40;ICUs&#41;&#46; Other influenza viruses &#40;H3N2 or B&#41; were not included&#44; since the circulation of virus A &#40;H1N1&#41;pdm09 was predominant during the study periods&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Inclusion and exclusion criteria</span><p id="par0030" class="elsevierStylePara elsevierViewall">We included all patients with clinical data compatible with influenza and who presented fever &#40;&#62;38<span class="elsevierStyleHsp" style=""></span>&#176;C&#41;&#44; consistent respiratory symptoms characterized by cough&#44; sore throat&#44; flu-type disease or muscle pain&#44; acute respiratory failure&#44; and with microbiological confirmation of influenza A&#40;H1N1&#41;pdm09 infection&#46; Patients under 15 years of age were excluded&#44; as were those individuals with clinical manifestations compatible with flu syndrome but without microbiological confirmation of influenza A&#40;H1N1&#41;pdm09 infection&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Two periods were analyzed&#58; &#40;1&#41; one patient cohort admitted between epidemiological weeks 23&#8211;52 of the year 2009&#44; corresponding to the pandemic&#59; and &#40;2&#41; another patient cohort during the post-pandemic period&#44; which registered the cases diagnosed between epidemiological weeks 50&#8211;52 of the 2010 and weeks 1&#8211;9 of 2011&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Data collection</span><p id="par0040" class="elsevierStylePara elsevierViewall">The data were obtained from a voluntary registry created by the Spanish Society of Intensive and Critical Care Medicine and Coronary Units &#40;<span class="elsevierStyleItalic">Sociedad Espa&#241;ola de Medicina Intensiva&#44; Cr&#237;tica y Unidades Coronarias</span>&#44; SEMICYUC&#41;&#46; The study was approved by the Institutional Review Board of the hospital coordinating the project &#40;<span class="elsevierStyleItalic">IRB NEUMAGRIP&#47;11809</span>&#41;&#46; The identity of the patients was kept anonymous&#44; and the obtainment of informed consent was not considered necessary&#44; due to the observational nature of the study and the sanitary urgency involved&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The data were reported by the supervising physician in each participating center using a voluntary registry form&#46; The confirmation of influenza A&#40;H1N1&#41;pdm09 infection was made by real-time PCR using nasopharyngeal smears or tracheal secretion samples in each institution or on a centralized basis in a reference &#40;core&#41; laboratory&#46; The criteria for admission to the ICU and the decisions referred to treatment for all the patients&#8211;including the need for intubation and the type of antibiotic or antiviral treatment provided&#8211;were established by the supervising physician&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Septic shock and organ failure &#40;SOFA score&#41; were established following the criteria of the American College of Chest Physicians and the Society of Critical Care Medicine&#46;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">13&#44;14</span></a> Primary viral pneumonia was defined by the presence of acute breathing difficulty and alveolar opacity in two or more lobes&#44; with negative respiratory and blood cultures during the acute phase of influenza virus infection&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">12</span></a> Community-acquired respiratory coinfection was defined as a bacterial or fungal infection diagnosed within the first two days of hospital stay&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">14</span></a> Those infections occurring after the first 48<span class="elsevierStyleHsp" style=""></span>h of stay were taken to be nosocomial processes&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Hematological disease was defined as that manifesting in patients with acute lymphoblastic leukemia&#44; acute myeloblastic leukemia&#44; chronic lymphocytic leukemia&#44; chronic myeloid leukemia&#44; Hodgkin lymphoma&#44; non-Hodgkin lymphoma&#44; myeloma&#44; or graft- vs -host disease&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">12</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Obese individuals were taken to be those with a body mass index &#40;BMI&#41; of &#62;30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">15</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Those patients previously vaccinated against influenza A&#40;H1N1&#41;pdm09 with the monovalent vaccine or the polyvalent vaccine for seasonal influenza 2010&#8211;2011 were defined as &#8220;vaccinated&#8221;&#46; Acute renal failure and its grades were diagnosed according to the Acute Kidney Injury &#40;AKI&#41; criteria&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">16</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">As regards antiviral therapy&#44; &#8220;early&#8221; treatment was taken to be therapy started within 48<span class="elsevierStyleHsp" style=""></span>h or less after the onset of symptoms&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">3</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Patients with &#8220;severity criteria&#8221; were defined as those presenting a combination of pneumonia&#44; obesity &#40;BMI<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41; and&#47;or invasive mechanical ventilation following the recommendations on antiviral treatment of the SEMICYUC&#46; According to these recommendations&#44; this group of patients could benefit from the administration of oseltamivir at high doses &#40;150<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h&#41; and with treatment durations of over 10 days&#44; on the grounds of the existence of an increased distribution volume&#46; For the rest of the patients&#44; i&#46;e&#46;&#44; &#8220;without severity criteria&#8221;&#44; standard doses and durations were recommended &#40;75<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h during less than 10 days&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">3</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">The variable &#8220;adherence&#8221; to the recommendations of antiviral treatment was established from the combination of the variables &#8220;severity criteria&#8221; and the duration and dosage of the antiviral treatment prescribed for each patient&#46; In this way we established four degrees of adherence&#44; as shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; We also studied adherence as a dichotomic variable where &#8220;total adherence&#8221; &#40;TA&#41; corresponded to patients who had received the treatment as recommended in terms of both dose and duration&#44; while the rest of the patients were considered to show &#8220;non-adherence&#8221; &#40;NA&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Statistical analysis</span><p id="par0085" class="elsevierStylePara elsevierViewall">Categorical variables were reported as values &#40;percentages&#41;&#44; and continuous variables as the mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation &#40;SD&#41; or median with the corresponding 25&#8211;75 interquartile ranges&#46; With regard to the demographic and clinical characteristics of the patients&#44; the differences between groups were evaluated using the chi-squared test or the Fisher exact test for categorical variables&#44; and the Student <span class="elsevierStyleItalic">t</span>-test or Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span>-test for continuous variables&#44; as appropriate&#46; The impact of the different variables upon mortality was analyzed using Cox regression analysis&#46;<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">17&#44;18</span></a> In order to avoid false associations&#44; the choice of variables entered in the analysis was decided by statistical criterion for those variables showing significance in the univariate analysis &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;1&#41;&#44; or based on the criterion of potential clinical relevance&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">In order to assess the possibility of a differential impact of the explanatory variables upon the results of each period&#44; the interactions between the explanatory variables and periods were used in the models&#46; The results are presented as hazard ratios &#40;HRs&#41;&#44; with 95&#37; confidence intervals &#40;95&#37;CI&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Lastly&#44; a post hoc analysis was made&#44; excluding those patients who died before the adherence objectives could be reached&#46; In this way we specifically analyzed adherence to the recommendations only in those patients who had completed treatment&#44; on a per protocol &#40;PP&#41; basis&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Statistical significance was considered for <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46; The SPSS version 16&#46;0 statistical package for MS Windows &#40;SPSS&#44; Chicago&#44; IL&#44; USA&#41; was used throughout&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Results</span><p id="par0105" class="elsevierStylePara elsevierViewall">The present analysis included a total of 1058 patients admitted to ICUs with confirmed influenza A&#40;H1N1&#41;pdm09 infection&#58; 661 patients &#40;62&#46;5&#37;&#41; were individuals infected during the pandemic of 2009&#44; and 397 &#40;37&#46;5&#37;&#41; were patients corresponding to the period 2010&#8211;2011 &#40;post-pandemic&#41;&#46; The variables related to antiviral treatment evaluated for each period are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; The patients of the post-pandemic period were comparatively in more serious condition and had greater organ dysfunction and a higher frequency of shock&#44; renal failure&#44; and need for mechanical ventilation and dialysis&#46; They also showed greater delays in diagnosis and admission to both hospital and the ICU&#46; Regarding treatment&#44; the post-pandemic period was characterized by a greater delay in the start of antiviral medication &#40;one day&#41; and a lesser indication of early empirical therapy&#44; as well as a generally lesser use of high doses&#44; and shorter durations of antiviral treatment&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">Global <span class="elsevierStyleItalic">total adherence</span> in the study was 41&#46;6&#37; and was greater during the pandemic period &#40;43&#46;9&#37;&#41; vs the period 2010&#8211;2011 &#40;38&#37;&#41;&#44; though the difference failed to reach statistical significance &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;07&#41;&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">On analyzing the degree of adherence according to the two patient categories established in the protocol &#40;presence or absence of severity criteria&#41;&#44; the percentage of patients with &#8220;severity criteria&#8221; requiring high doses was seen to be greater during the post-pandemic period &#40;68&#46;5&#37;&#41; than during the pandemic period &#40;62&#46;8&#37;&#41;&#44; though statistical significance was not reached &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;06&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows the different degrees of adherence according to the presence or absence of severity criteria in both study periods&#46; &#8220;Total adherence&#8221; was 54&#46;7&#37; for 2009 and decreased significantly to 36&#46;4&#37; during 2010&#8211;2011&#46; On the other hand&#44; non-adherence and partial adherence in time &#40;duration&#41; were more frequent in the post-pandemic period&#46; In contrast to the situation in patients with severity criteria&#44; those without such criteria showed a greater degree of &#8220;total adherence&#8221; during the post-pandemic period&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">The mortality rate was significantly higher &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; in the patients of the post-pandemic period 2010&#8211;2011 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>119&#59; 30&#37;&#41; than in those of the pandemic period &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>144&#59; 21&#46;8&#37;&#41;&#8211;this being associated to increased patient severity as scored by the APACHE II &#40;16&#46;2 &#91;7&#46;7&#93; vs 13&#46;9 &#91;7&#46;2&#93;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and increased organ dysfunction &#40;SOFA score upon admission 6&#46;2 &#91;4&#46;0&#93; vs 5&#46;7 &#91;3&#46;6&#93;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#41; for that period&#46; <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> shows the variables associated to mortality in both study periods&#46; On including the variables showing statistical significance in the multivariate analysis&#44; we found the APACHE II score&#44; hematological disease and adherence to treatment to be the variables independently associated to mortality &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#41;&#46; On the other hand&#44; early antiviral treatment was only found to be associated to survival in the pandemic period&#44; while human immunodeficiency virus &#40;HIV&#41; infection was associated to survival in the seasonal outbreak &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#41;&#46; The adjusted survival analysis showed adherence to the established antiviral treatment protocols to result in improved survival referred to both the global population &#40;HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;57&#59; 95&#37;CI&#58; 0&#46;431&#8211;0&#46;77&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and the two periods considered separately &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">The post hoc analysis identified only 23 patients &#40;2&#46;2&#37;&#41; who died before completing the treatment prescribed by the supervising physician&#59; these subjects were therefore excluded&#46; The final population for this analysis consisted of 1035 individuals&#46; Twelve of the deceased patients &#40;1&#46;2&#37;&#41; corresponded to the pandemic period and 11 &#40;1&#46;0&#37;&#41; to the post-pandemic period&#46; Global adherence was similar &#40;42&#46;6&#37;&#41; to that recorded for the total population&#44; without statistically significant differences between the periods&#46; In this population&#44; adherence to the recommendations &#40;HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;62&#59; 95&#37;CI&#58; 0&#46;43&#8211;0&#46;96&#41; and early antiviral treatment &#40;HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;64&#59; 95&#37;CI&#58; 0&#46;43&#8211;0&#46;95&#41; were the only variables independently associated to lesser mortality in the multivariate analysis&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Discussion</span><p id="par0130" class="elsevierStylePara elsevierViewall">The main finding of the present study was the low global adherence to the treatment recommendations referred to influenza A during the period 2009&#8211;2011&#44; and which proved more evident for the post-pandemic period&#46; Adherence to the treatment recommendations was low even among those patients considered to be at high risk&#46; In this particular subgroup of patients&#44; the management protocol was only followed in one out of every two individuals during the pandemic period&#44; and this situation was even worse in the post-pandemic period&#44; when only four out of every 10 patients adhered to the mentioned recommendations&#46; Another observation of great interest was that adherence to the treatment recommendations was associated to a 50&#37; decrease in mortality on considering the global population&#44; on distinguishing between the two periods&#44; and on excluding the early mortality cases&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Our findings are consistent with those obtained by other studies on treatment compliance in other populations&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11&#44;12</span></a> Seale et al&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">19</span></a> published the degree of adherence to the antiviral drug treatment protocol developed by the Health Protection Agency &#40;HPA&#41; of the United Kingdom for the pediatric population in ICUs&#46; The recommendations of the HPA were to start antiviral treatment early &#40;within the first 48<span class="elsevierStyleHsp" style=""></span>h after symptoms onset&#41; in this particular subgroup of patients&#46; The authors evaluated a total of 36 children&#44; of which nine had been treated before publication of the guide and the rest after its implementation&#46; The prescription rate for oseltamivir upon admission to the ICU increased significantly from 11&#37; &#40;1&#47;9&#41; to 50&#37; &#40;9&#47;18&#41; &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#41;&#46; As can be seen&#44; despite this improvement in compliance&#44; in the end only one out of every two children were treated in line with the recommendations&#46; On the other hand&#44; Fietje et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a> on analyzing oseltamivir prescription practice in The Netherlands during the pandemic&#44; recorded an increase of 100&#37; with respect to 2008&#46; The aim of the study was to determine whether the dispensation of oseltamivir complied with the prescription recommendations of the national guides for the pandemic&#46; In addition&#44; an analysis was made of the use of this drug by the patients&#44; based on a questionnaire&#46; A total of 630 patients were contacted&#44; and 361 &#40;57&#46;3&#37;&#41; completed the questionnaire&#46; Thirty-seven percent of the subjects &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>111&#41; received oseltamivir in the absence of any criterion justifying such prescription&#46; Regarding patient adherence&#44; the results reflected strong compliance&#44; since 97&#46;4&#37; of the patients started the prescribed treatment and 90&#46;8&#37; adhered to the established duration of therapy&#46; On the other hand&#44; Hersh et al&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">21</span></a> evaluated the degree of adherence to the guidelines of the United States Centers for Disease Control and Prevention &#40;CDC&#41; regarding the prescription of antiviral drugs during the influenza A&#40;H1N1&#41; pandemic of 2009 in the United States&#46; In contrast to the abovementioned study&#44; the frequency of prescription was found to be no different during the influenza A&#40;H1N1&#41;pdm09 period &#40;58&#37;&#41; with respect to earlier years &#40;59&#37;&#41;&#46; During the pandemic&#44; antivirals were prescribed for only 47&#37; of the patients under two years of age and for 68&#37; of the patients over 65 years of age&#46; These results indicate infrautilization of antiviral treatment in these risk groups with possible complications that can be prevented&#44; and suggest opportunities for improving implementation of the public health guides in clinical practice&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Our results suggest that adherence to the treatment protocols is a variable independently associated to mortality&#46; A decrease of close to 50&#37; was observed both in general and on considering the different periods&#8211;in concordance with the existing literatures&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">22&#44;23</span></a> Failure to comply with the treatment guides in severe community-acquired pneumonia is related to increased morbidity-mortality&#44; as well as to increased hospital stay and healthcare costs&#46;<a class="elsevierStyleCrossRefs" href="#bib0300"><span class="elsevierStyleSup">24&#8211;26</span></a> However&#44; few studies have evaluated the impact of adherence to the antiviral treatment recommendations upon mortality in critical patients in ICUs during the pandemic of 2009 and in the post-pandemic period 2010&#8211;2011&#46; These recommendations were based on the cumulative body of experience gained with seasonal influenza &#40;1970&#8211;2008&#41;&#44; where early treatment with neuraminidase inhibitors reduced the severity and duration of the disorder&#44; as well as the risk of complications&#46;<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">27&#44;28</span></a> However&#44; in comparison with seasonal influenza &#40;non-pandemic H1N1 or H3N2&#41;&#44; influenza A&#40;H1N1&#41;pdm09 behaves differently&#8211;not only because it affects younger individuals&#44; but also because of its capacity to produce rapid and severe lung damage&#44; with the development of acute respiratory distress syndrome and death secondary to refractory respiratory failure&#46; In this special context&#44; it is difficult to extrapolate the impact of antiviral treatment from studies in which the included patients show only mild or moderate disease caused by some other type of virus A&#46; Controversy therefore exists regarding the impact of antiviral treatment upon infection caused by influenza A&#40;H1N1&#41;pdm09&#44; since there are no randomized and controlled studies in critical patients that have firmly demonstrated its usefulness&#46; A review<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">29</span></a> of 11 published studies showed &#40;albeit with important methodological limitations&#41; that the complications of influenza A&#40;H1N1&#41;pdm09 are reduced by the use of antivirals in patients at both low and high risk&#46; On the other hand&#44; Jain et al&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">30</span></a> found the only variable independently associated to mortality to be the administration of oseltamivir within the first 48<span class="elsevierStyleHsp" style=""></span>h&#44; while Dominguez-Cherit et al&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">31</span></a> reported greater survival &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#46;4&#41; in patients who received antivirals&#46; Three retrospective studies were published in 2011&#44;<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">32&#8211;34</span></a> with results in this same line&#46; However&#44; and despite the fact that different publications of the Cochrane Library<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">27&#44;28&#44;35</span></a> reveal no benefit with oseltamivir in terms of the prevention and&#47;or treatment of seasonal influenza&#44; the studies considered in those reviews did not include critical patients&#46; On the other hand&#44; these data are in contrast to those obtained by the Spanish multicenter GETGAG study&#44;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">22</span></a> which evidenced a decrease in mortality among patients receiving early antiviral treatment&#46; In this same sense&#44; a recent international study on the effectiveness of antiviral treatment during the pandemic period&#44; including over 29&#44;000 patients&#44; documented a decrease in mortality risk among the patients that received antiviral therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">23</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">The present study has a number of limitations that must be commented&#44; though its findings are relevant and of great interest&#46; The main limitation is referred to the analysis of adherence&#44; which only considers adhesion to the treatment recommendations in relation to the known risk factors&#46; Although our results show a decrease in mortality risk when following the treatment recommendations for influenza A&#40;H1N1&#41;pdm09&#44; the type of analysis performed does not allow us to establish a cause-effect relationship&#44; since other uncontrolled variables &#40;confounding factors&#41; could influence the results&#46; In this regard&#44; it is possible that those patients who followed the treatment recommendations also received more adequate medical care&#44; and hence the impact upon mortality may not have been determined only by administration of the antiviral drug&#46; However&#44; the objective of the study was to evaluate adherence to the recommendations of treatment in general&#44; considering the known severity factors&#46; Furthermore&#44; after adjusting the model for risk by means of the multivariate analysis and excluding those patients with early mortality in a post hoc analysis&#44; adherence to the treatment recommendations remained as a factor independently associated to mortality&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">On the other hand&#44; the body of data included in this study is representative of prescription practice and the use of antivirals in Spanish ICUs&#44; but such data cannot be extrapolated to other ICUs or to other types of patients&#46; Lastly&#44; it must be mentioned that there may have been uncontrolled social&#44; economical or healthcare factors that could have contributed to the lack of adherence to the treatment recommendations&#44; as has been recognized in a recent editorial&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">36</span></a> However&#44; because of the characteristics of the study&#44; it was not possible to analyze these variables&#46; Consequently&#44; our findings must be interpreted with caution&#44; and within the limitations of its design&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">In conclusion&#44; the results of the present study reveal a low level of adherence to antiviral treatment in critical patients and a close association between this situation and mortality&#46; Adherence was found to be even lower in the post-pandemic period&#44; in which the recorded mortality was higher than during the pandemic period&#46; The introduction of educational and diffusion programs designed to increase adherence to the treatment recommendations should be considered before each winter season&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conflicts of interest</span><p id="par0160" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">This study was endorsed by the Spanish Society of Intensive and Critical Care Medicine and Coronary Units &#40;<span class="elsevierStyleItalic">Sociedad Espa&#241;ola de Medicina Intensiva&#44; Cr&#237;tica y Unidades Coronarias</span>&#44; SEMICYUC&#41;&#46; The SEMICYUC has not influenced the study design&#59; data collection&#44; analysis or interpretation&#59; drafting of the manuscript&#59; or the decision to submit the study for publication&#46; The content of the manuscript is the responsibility of the authors&#44; and does not necessarily reflect the official view of the SEMICYUC&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To determine the degree of antiviral treatment recommendations adherence and its impact to critical ill patients affected by influenza A&#40;H1N1&#41;pdm09 mortality&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Design</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Secondary analysis of prospective study&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Setting</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Intensive care &#40;UCI&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Patients</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Patients with influenza A&#40;H1N1&#41;pdm09 in the 2009 pandemic and 2010&#8211;11 post-pandemic periods&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Variables</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Adherence to recommendations was classified as&#58; total &#40;AT&#41;&#59; partial in doses &#40;PD&#41;&#59; partial in time &#40;PT&#41;&#44; and non-adherence &#40;NA&#41;&#46; Viral pneumonia&#44; obesity and mechanical ventilation were considered severity criteria for the administration of high antiviral dose&#46; The analysis was performed using <span class="elsevierStyleItalic">t</span>-test or &#8220;chi&#8221; square&#46; Survival analysis was performed and adjusted by Cox regression analysis&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Results</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A total of 1058 patients&#44; 661 &#40;62&#46;5&#37;&#41; included in the pandemic and 397 &#40;37&#46;5&#37;&#41; in post-pandemic period&#44; respectively&#46; Global adherence was achieved in 41&#46;6&#37; &#40;43&#46;9&#37; and 38&#46;0&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;07&#44; respectively&#41;&#46; Severity criteria were similar in both periods &#40;68&#46;5&#37; vs&#46; 62&#46;8&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;06&#41;&#46; The AT was 54&#46;7&#37; in pandemic and 36&#46;4&#37; in post-pandemic period&#44; respectively &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#46; The NA &#40;19&#46;7&#37; vs&#46; 11&#46;3&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; and PT &#40;20&#46;8&#37; vs&#46; 9&#46;9&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41; were more frequent in the post-pandemic period&#46; The mortality rate was higher in the post-pandemic period &#40;30&#37; vs&#46; 21&#46;8&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; APACHE <span class="elsevierStyleSmallCaps">II</span> &#40;HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;09&#41; and hematologic disease &#40;HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;2&#41; were associated with a higher mortality and adherence &#40;HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;47&#41; was a protective factor&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusions</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A low degree of adherence to the antiviral treatment was observed in both periods&#46; Adherence to antiviral treatment recommendations was associated with lower mortality rates and should be recommended in critically ill patients with suspected influenza A&#40;H1N1&#41;pdm09&#46;</p></span>"
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        "resumen" => "<span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Objetivo</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Evaluar el grado de adherencia a las recomendaciones sobre el tratamiento antiv&#237;rico y su impacto en la mortalidad de pacientes cr&#237;ticos afectados por gripe A &#40;H1N1&#41;pdm09&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Dise&#241;o</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis secundario de estudio prospectivo&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">&#193;mbito</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Medicina intensiva &#40;UCI&#41;&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Pacientes</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Pacientes con gripe A &#40;H1N1&#41;pdm09 en el periodo pand&#233;mico 2009 y pospand&#233;mico 2010&#8211;11&#46;</p></span> <span id="abst0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Variables</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">La adherencia a las recomendaciones se clasific&#243; en&#58; total &#40;AT&#41;&#44; parcial dosis &#40;PD&#41;&#44; parcial tiempo &#40;PT&#41; y no adherencia &#40;NA&#41;&#46; La neumon&#237;a v&#237;rica&#44; obesidad y ventilaci&#243;n mec&#225;nica fueron considerados criterios de gravedad para el uso de dosificaciones elevadas de antiv&#237;rico &#40;CG&#41;&#46; An&#225;lisis mediante &#171;chi&#187; cuadrado y t-test&#46; Supervivencia mediante regresi&#243;n de Cox&#46;</p></span> <span id="abst0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 1&#46;058 pacientes&#44; 661 &#40;62&#44;5&#37;&#41; en pandemia y 397 &#40;37&#44;5&#37;&#41; en pospandemia&#46; La AT global del estudio fue del 41&#44;6&#37; &#40;el 43&#44;9&#37; y el 38&#37;&#44; respectivamente&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;07&#41;&#46; Los pacientes con criterios de gravedad no fueron diferentes en ambos periodos &#40;un 68&#44;5&#37; y un 62&#44;8&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;06&#41;&#46; En estos pacientes la AT fue del 54&#44;7&#37; durante el 2009 y del 36&#44;4&#37; en pospandemia &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46; La NA &#40;19&#44;7&#37; vs&#46; 11&#44;3&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; y la PT &#40;20&#44;8&#37; vs&#46; 9&#44;9&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; fueron m&#225;s frecuentes durante la pospandemia&#46; La mortalidad fue mayor en la pospandemia &#40;30&#37; vs&#46; 21&#44;8&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; El APACHE II &#40;HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;09&#41; y la enfermedad hematol&#243;gica &#40;HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;2&#41; se asociaron a mortalidad y la adherencia &#40;HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;47&#41; fue un factor protector&#46;</p></span> <span id="abst0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conclusiones</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Se evidencia un bajo grado de adherencia al tratamiento en ambos periodos&#46; La adherencia al tratamiento antiv&#237;rico se asocia con menor mortalidad y deber&#237;a ser recomendada en pacientes cr&#237;ticos afectados por gripe A &#40;H1N1&#41;pdm09&#46;</p></span>"
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            "apendice" => "<p id="par0175" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Andalusia&#58;</span> Pedro Cobo &#40;Hospital Punta de Europa&#44; Algeciras&#41;&#59; Javier Martins &#40;Hospital Santa Ana Motril&#44; Granada&#41;&#59; Cecilia Carbayo &#40;Hospital Torrec&#225;rdenas&#44; Almer&#237;a&#41;&#59; Emilio Robles-Musso&#44; Antonio C&#225;rdenas&#44; Javier Fierro &#40;Hospital del Poniente&#44; Almer&#237;a&#41;&#59; Oca&#241;a Fern&#225;ndez &#40;Hospital Huercal&#8211;Overa&#44; Almer&#237;a&#41;&#59; Rafael Sierra &#40;Hospital Puerta del Mar&#44; C&#225;diz&#41;&#59; M&#46; Jes&#250;s Huertos &#40;Hospital Puerto Real&#44; C&#225;diz&#41;&#59; Juan Carlos Pozo&#44; R&#46; Guerrero &#40;Hospital Reina Sof&#237;a&#44; C&#243;rdoba&#41;&#59; Enrique M&#225;rquez &#40;Hospital Infanta Elena&#44; Huelva&#41;&#59; Manuel Rodr&#237;guez-Carvajal &#40;Hospital Juan Ram&#243;n Jim&#233;nez&#44; Huelva&#41;&#59; Antonio Jare&#241;o &#40;Hospital del SAS de Jerez&#44; Jerez de la Frontera&#41;&#59; Jos&#233; Pomares&#44; Jos&#233; Luis Ballesteros &#40;Hospital Universitario San Cecilio&#44; Granada&#41;&#59; Yolanda Fern&#225;ndez&#44; Francisco Lobato&#44; Jos&#233; F&#46; Prieto&#44; Jos&#233; Albofedo-S&#225;nchez &#40;Hospital Costa del Sol&#44; Marbella&#41;&#59; Pilar Mart&#237;nez &#40;Hospital Virgen de la Victoria&#44; M&#225;laga&#41;&#59; Miguel &#193;ngel D&#237;az Castellanos &#40;Hospital Santa Ana de Motril&#44; Granada&#41;&#59; Guillermo Sevilla &#40;Cl&#237;nica Sagrado Coraz&#243;n&#44; Sevilla&#41;&#59; Jos&#233; Garnacho-Montero&#44; Rafael Hinojosa&#44; Esteban Fern&#225;ndez &#40;Hospital Virgen del Roc&#237;o&#44; Sevilla&#41;&#59; Ana Loza&#44; Crist&#243;bal Le&#243;n &#40;Hospital Universitario Nuestra Se&#241;ora de Valme&#44; Sevilla&#41;&#59; &#193;ngel Arenzana &#40;Hospital Virgen de la Macarena&#44; Sevilla&#41;&#44; Dolores Oca&#241;a &#40;Hospital de la Inmaculada&#44; Sevilla&#41;&#59; In&#233;s Navarrete &#40;Hospital Virgen de las Nieves&#44; Granada&#41;&#46;</p> <p id="par0180" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Arag&#243;n&#58;</span> Manuel Luis Avellanas&#44; Arantxa Lander&#44; S&#46; Garrido Ram&#237;rez de Arellano&#44; M&#46;I&#46; Marquina Lacueva &#40;<span class="elsevierStyleItalic">Hospital San Jorge&#44; Huesca</span>&#41;&#59; Pilar Luque &#40;<span class="elsevierStyleItalic">Hospital Lozano Blesa&#44; Zaragoza</span>&#41;&#59; Ignacio Gonz&#225;lez &#40;<span class="elsevierStyleItalic">Hospital Miquel Servet&#44; Zaragoza</span>&#41;&#59; Jose M&#46; Mont&#243;n &#40;<span class="elsevierStyleItalic">Hospital Obispo Polanco&#44; Teruel</span>&#41;&#59; Jose M&#46; D&#237;az&#44; Pilar L&#243;pez-Reina&#44; Sergio S&#225;ez &#40;<span class="elsevierStyleItalic">Hospital Virgen de la Salud&#44; Teruel</span>&#41;&#46;</p> <p id="par0185" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Asturias&#58;</span> Lisardo Iglesias&#44; Carmen Pascual Gonz&#225;lez &#40;Hospital Universitario Central de Asturias &#8211; HUCA&#44; Oviedo&#41;&#59; Quiroga &#40;Hospital de Cabue&#241;es&#44; Gij&#243;n&#41;&#59; &#193;gueda Garc&#237;a-Rodr&#237;guez &#40;Hospital Valle del Nal&#243;n&#44; Langreo&#41;&#46;</p> <p id="par0190" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Balearic Islands&#58;</span> Lorenzo Socias&#44; Pedro Ib&#225;nez&#44; Marc&#237;o Borges-Sa&#44; A&#46; Socias&#44; del Castillo A &#40;<span class="elsevierStyleItalic">Hospital Son LLatzer&#44; Palma de Mallorca</span>&#41;&#59; Ricard Jord&#224; Marcos &#40;<span class="elsevierStyleItalic">Cl&#237;nica Rotger&#44; Palma de Mallorca</span>&#41;<span class="elsevierStyleItalic">&#59;</span> Jos&#233; M&#46; Bonell &#40;<span class="elsevierStyleItalic">USP&#46; Cl&#237;nica Palmaplanas&#44; Palma de Mallorca</span>&#41;&#59; Ignacio Amestar&#225;n &#40;<span class="elsevierStyleItalic">Hospital Son Dureta&#44; Palma de Mallorca</span>&#41;&#46;</p> <p id="par0195" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Canary Islands&#58;</span> Sergio Ruiz-Santana&#44; Juan Jos&#233; D&#237;az &#40;<span class="elsevierStyleItalic">Hospital Dr Negr&#237;n&#44; Las Palmas de Gran Canaria</span>&#41;&#59; Montserrat Sis&#243;n &#40;<span class="elsevierStyleItalic">Hospital Doctor Jos&#233; Molina&#44; Lanzarote</span>&#41;&#59; David Hern&#225;ndez&#44; Ana Trujillo&#44; Luis Regalado &#40;<span class="elsevierStyleItalic">Hospital General la Palma&#44; La Palma</span>&#41;&#59; Leonardo Lorente &#40;<span class="elsevierStyleItalic">Hospital Universitario de Canarias&#44; Tenerife</span>&#41;&#59; Mar Mart&#237;n &#40;<span class="elsevierStyleItalic">Hospital de la Candelaria&#44; Tenerife</span>&#41;&#44; Sergio Mart&#237;nez&#44; J&#46;J&#46; C&#225;ceres &#40;<span class="elsevierStyleItalic">Hospital Insular de Gran Canaria</span>&#41;&#46;</p> <p id="par0200" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Cantabria&#58;</span> Borja Suberviola&#44; P&#46; Ugarte &#40;Hospital Universitario Marqu&#233;s de Valdecilla&#44; Santander&#41;&#46;</p> <p id="par0205" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Castilla La Mancha&#58;</span> Fernando Garc&#237;a-L&#243;pez &#40;Hospital General&#44; Albacete&#41;&#59; &#193;ngel &#193;lvaro Alonso&#44; Antonio Pasilla &#40;Hospital General La Mancha Centro&#44; Alc&#225;zar de San Juan&#41;&#59; M&#46; Luisa G&#243;mez Grande &#40;Hospital General de Ciudad Real&#44; Ciudad Real&#41;&#59; Antonio Albaya &#40;Hospital Universitario de Guadalajara&#44; Guadalajara&#41;&#59; Alfonso Canabal&#44; Luis Marina &#40;Hospital Virgen de la Salud&#44; Toledo&#41;&#46;</p> <p id="par0210" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Castilla y Le&#243;n&#58;</span> Juan B&#46; L&#243;pez Messa &#40;Complejo Asistencial de Palencia&#44; Palencia&#41;&#44; M&#46; Jes&#250;s L&#243;pez Pueyo &#40;Hospital General Yag&#252;e&#44; Burgos&#41;&#59; Zulema Ferreras &#40;Hospital Universitario de Salamanca&#44; Salamanca&#41;&#59; Santiago Macias &#40;Hospital General de Segovia&#44; Segovia&#41;&#59; Jos&#233; &#193;ngel Berezo&#44; Jes&#250;s Blanco Varela &#40;Hospital Universitario R&#237;o Hortega&#44; Valladolid&#41;&#44; A&#46; Andaluz Ojeda &#40;Hospital Universitario&#44; Valladolid&#41;&#59; Antonio &#193;lvarez Terrero &#40;Hospital Virgen de la Concha&#44; Zamora&#41;&#59; Fabiola Tena Ezpeleta &#40;Hospital Santa B&#225;rbara&#44; Soria&#41;&#46;</p> <p id="par0215" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Catalonia&#58;</span> Rosa M&#46; Catal&#225;n &#40;Hospital General de Vic&#44; Vic&#41;&#59; Miquel Ferrer&#44; Antoni Torres &#40;Hospital Cl&#237;nic&#44; Barcelona&#41;&#59; Sandra Barbadillo &#40;Hospital General de Catalunya &#8211; CAPIO&#44; Barcelona&#41;&#59; Llu&#237;s Cabr&#233; &#40;Hospital de Barcelona&#44; Barcelona&#41;&#59; Assumpta Rovira &#40;Hospital General de l&#8217;Hospitalet&#44; L&#8217;Hospitalet&#41;&#59; Francisco &#193;lvarez-Lerma&#44; Antonia V&#225;zquez&#44; Joan Nolla &#40;Hospital Del Mar&#44; Barcelona&#41;&#59; Francisco Fern&#225;ndez&#44; Joaquim Ram&#243;n Cervell&#243; &#40;Centro M&#233;dico Delfos&#44; Barcelona&#41;&#59; Rafael Ma&#241;&#233;z&#44; J&#46; Ball&#250;s&#44; Rosa M&#46; Granada &#40;Hospital de Bellvitge&#44; Barcelona&#41;&#59; Jordi Vall&#233;s&#44; Marta Ort&#237;z&#44; C&#46; Gu&#237;a &#40;Hospital de Sabadell&#44; Sabadell&#41;&#59; Fernando Arm&#233;star&#44; Joaquim P&#225;ez &#40;Hospital Dos De Mayo&#44; Barcelona&#41;&#59; Jordi Almirall&#44; Xavier Balanzo &#40;Hospital de Matar&#243;&#44; Matar&#243;&#41;&#59; Jordi Rello&#44; Elena Arnau&#44; Lluis Llopart&#44; Mercedes Palomar &#40;Hospital Vall d&#8217;Hebron&#44; Barcelona&#41;&#59; I&#241;aki Catal&#225;n &#40;Hospital Sant Joan de D&#233;u&#44; Manresa&#41;&#59; Josep M&#46; Sirvent&#44; Cristina Ferri&#44; Nerea L&#243;pez de Arbina &#40;Hospital Josep Trueta&#44; Girona&#41;&#59; Mariona Bad&#237;a&#44; Montserrat Valverd&#250;-Vidal&#44; Fernando Barcenilla &#40;Hospital Arnau de Vilanova&#44; Lleida&#41;&#59; M&#242;nica Magret &#40;Hospital Sant Joan de Reus&#44; Reus&#41;&#59; M&#46;F&#46; Esteban&#44; Jos&#233; Luna &#40;Hospital Verge de la Cinta&#44; Tortosa&#41;&#59; Juan M&#46; Nava&#44; J Gonz&#225;lez de Molina &#40;Hospital Universitario Mutua de Terrassa&#44; Terrassa&#41;&#59; Zoran Josic &#40;Hospital de Igualada&#44; Igualada&#41;&#59; Francisco Gurri &#40;Hospital Quir&#243;n&#44; Barcelona&#41;&#59; Alejandro Rodr&#237;guez&#44; Thiago Lisboa&#44; Diego de Mendoza&#44; Sandra Trefler &#40;Hospital Universitario Joan XXIII&#44; Tarragona&#41;&#44; Rosa Mar&#237;a D&#237;az &#40;Hospital San Camil&#44; Sant Pere de Ribes&#44; Barcelona&#41;&#46;</p> <p id="par0220" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Extremadura&#58;</span> Juli&#225;-Narv&#225;ez Jos&#233; &#40;<span class="elsevierStyleItalic">Hospital Infanta Cristina&#44; Badajoz</span>&#41;&#59; Alberto Fern&#225;ndez-Zapata&#44; Teresa Recio&#44; Abilio Arrascaeta&#44; M&#46; Jos&#233; Garc&#237;a-Ramos&#44; Elena Gallego &#40;<span class="elsevierStyleItalic">Hospital San Pedro de Alc&#225;ntara&#44; C&#225;ceres</span>&#41;&#59; F&#46; Bueno &#40;<span class="elsevierStyleItalic">Hospital Virgen del Puerto&#44; Plasencia</span>&#41;&#46;</p> <p id="par0225" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Galicia&#58;</span> M&#46; Lourdes Cordero&#44; Jos&#233; A&#46; Pastor&#44; Luis &#193;lvarez-Rocha &#40;<span class="elsevierStyleItalic">CHUAC&#44; A Coru&#241;a</span>&#41;&#59; Dolores Vila &#40;<span class="elsevierStyleItalic">Hospital Do Meixoeiro&#44; Vigo</span>&#41;&#59; Ana D&#237;az Lamas &#40;<span class="elsevierStyleItalic">Hospital Arquitecto Marcide&#44; Ferrol</span>&#41;&#59; Javier Blanco P&#233;rez&#44; M&#46; Ortiz Piquer &#40;<span class="elsevierStyleItalic">Hospital Xeral-Calde&#44; Lugo</span>&#41;&#59; Eleuterio Merayo&#44; Victor Jose L&#243;pez-Ciudad&#44; Juan Cortez&#44; Eva Vilaboy &#40;<span class="elsevierStyleItalic">Complejo Hospitalario de Ourense&#44; Ourense</span>&#41;&#59; Eva Maria Saborido &#40;<span class="elsevierStyleItalic">Hospital Montecelo&#44; Pontevedra</span>&#41;&#59; Raul Jos&#233; Gonz&#225;lez &#40;<span class="elsevierStyleItalic">H&#46; Miguel Dom&#237;nguez&#44; Pontevedra</span>&#41;&#59; Santiago Freita &#40;<span class="elsevierStyleItalic">Complejo Hospitalario de Pontevedra&#44; Pontevedra</span>&#41;&#46;</p> <p id="par0230" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">La Rioja&#58;</span> Jos&#233; Luis Monz&#243;n&#44; F&#233;lix Go&#241;i &#40;<span class="elsevierStyleItalic">Hospital San Pedro&#44; Logro&#241;o</span>&#41;&#46;</p> <p id="par0235" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Madrid&#58;</span> Frutos del Nogal S&#225;ez&#44; M&#46; Blasco Navalpotro &#40;<span class="elsevierStyleItalic">Hospital Severo Ochoa&#44; Madrid</span>&#41;&#59; M&#46; Carmen Garc&#237;a-Torrej&#243;n &#40;<span class="elsevierStyleItalic">Hospital Infanta Elena&#44; Madrid</span>&#41;&#59;C&#233;sar P&#233;rez-Calvo&#44; Diego L&#243;pez &#40;<span class="elsevierStyleItalic">Fundaci&#243;n Jim&#233;nez D&#237;az&#44; Madrid</span>&#41;&#59; Luis Arnaiz&#44; S&#46; S&#225;nchez-Alonso&#44; Carlos Velayos &#40;<span class="elsevierStyleItalic">Hospital Fuenlabrada&#44; Madrid</span>&#41;&#59; Francisco del R&#237;o&#44; Miguel &#193;ngel Gonz&#225;lez &#40;<span class="elsevierStyleItalic">Hospital Cl&#237;nico San Carlos&#44; Madrid</span>&#41;&#59; Mar&#237;a Cruz Mart&#237;n&#44; Jos&#233; M&#46; Molina &#40;<span class="elsevierStyleItalic">Hospital Nuestra Se&#241;ora de Am&#233;rica&#44; Madrid</span>&#41;&#59; Juan Carlos Montejo&#44; Mercedes Catal&#225;n &#40;<span class="elsevierStyleItalic">Hospital Universitario 12 de Octubre&#44; Madrid</span>&#41;&#59; Patricia Albert&#44; Ana de Pablo &#40;<span class="elsevierStyleItalic">Hospital del Sureste&#44; Arganda del rey</span>&#41;&#59;Jos&#233; Eugenio Guerrero&#44; Jaime Benitez Peyrat &#40;<span class="elsevierStyleItalic">Hospital Gregorio Mara&#241;&#243;n&#44; Madrid</span>&#41;&#59; Enrique Cerd&#225;&#44; Manuel Alvarez&#44; Carlos Pey &#40;<span class="elsevierStyleItalic">Hospital Infanta Cristina&#44; Madrid</span>&#41;&#59;Montse Rodr&#237;guez&#44; Eduardo Palencia &#40;<span class="elsevierStyleItalic">Hospital Infanta Leonor&#44; Madrid</span>&#41;&#59; Rafael Caballero &#40;<span class="elsevierStyleItalic">Hospital de San Rafael&#44; Madrid</span>&#41;&#59; Rafael Guerrero &#40;<span class="elsevierStyleItalic">Hospital Reina Sof&#237;a&#44; Madrid</span>&#41;&#59; Concepci&#243;n Vaquero&#44; Francisco Mariscal&#44; S&#46; Garc&#237;a &#40;<span class="elsevierStyleItalic">Hospital Infanta Sof&#237;a&#44; Madrid</span>&#41;&#59; Almudena Sim&#243;n &#40;<span class="elsevierStyleItalic">Hospital Nuestra Se&#241;ora del Prado&#44; Madrid</span>&#41;&#59; Nieves Carrasco &#40;<span class="elsevierStyleItalic">Hospital Universitario La Princesa&#44; Madrid</span>&#41;&#59; Isidro Prieto&#44; A Li&#233;tor&#44; R&#46; Ramos &#40;<span class="elsevierStyleItalic">Hospital Ram&#243;n y Cajal&#44; Madrid</span>&#41;&#59; Beatriz Galv&#225;n&#44; Juan C&#46; Figueira&#44; M&#46; Cruz Soriano &#40;<span class="elsevierStyleItalic">Hospital La Paz&#44; Madrid</span>&#41;&#59; P Gald&#243;s&#44; B&#225;rbara Balandin Moreno &#40;<span class="elsevierStyleItalic">Hospital Puerta de Hierro&#44; Madrid</span>&#41;&#59; Fern&#225;ndez del Cabo &#40;<span class="elsevierStyleItalic">Hospital Monte Pr&#237;ncipe&#44; Madrid</span>&#41;&#59; Cecilia Hermosa&#44; Federico Gordo &#40;<span class="elsevierStyleItalic">Hospital de Henares&#44; Madrid</span>&#41;&#59; Alejandro Algora &#40;<span class="elsevierStyleItalic">Hospital Universitario Fundaci&#243;n Alcorc&#243;n&#44; Madrid</span>&#41;&#59; Amparo Paredes &#40;<span class="elsevierStyleItalic">Hospital Sur de Alcorc&#243;n&#44; Madrid</span>&#41;&#59; J&#46;A&#46; Cambronero &#40;<span class="elsevierStyleItalic">Hospital Universitario Pr&#237;ncipe de Asturias&#44; Madrid</span>&#41;&#59; Sonia G&#243;mez-Rosado &#40;<span class="elsevierStyleItalic">Hospital de M&#243;stoles&#44; Madrid</span>&#41;&#46;</p> <p id="par0240" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Murcia&#58;</span> Sof&#237;a Mart&#237;nez &#40;Hospital Santa Mar&#237;a del Rosell&#44; Murcia&#41;&#59; F&#46; Felices Abad &#40;Hospital Universitario Reina Sof&#237;a&#44; Murcia&#41;&#59; Mariano Mart&#237;nez &#40;Hospital Universitario Virgen de la Arrixaca&#44; Murcia&#41;&#59; Sergio Manuel But&#237;&#44; Gil Rueda&#44; Francisco Garc&#237;a &#40;Hospital Morales Messeguer&#44; Murcia&#41;&#46;</p> <p id="par0245" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Navarre&#58;</span> Laura Macaya&#44; Enrique Marav&#237;-Poma&#44; I&#46; Jimenez Urra&#44; L&#46; Macaya Redin&#44; A Teller&#237;a &#40;<span class="elsevierStyleItalic">Hospital Virgen del Camino&#44; Pamplona</span>&#41;&#59; Josu Insansti &#40;<span class="elsevierStyleItalic">Hospital de Navarra&#44; Pamplona</span>&#41;&#46;</p> <p id="par0250" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Basque Country&#58;</span> Nagore Gonz&#225;lez&#44; Pilar Marco&#44; Loreto Vidaur &#40;<span class="elsevierStyleItalic">Hospital de Donostia&#44; San Sebasti&#225;n</span>&#41;&#59; B&#46; Santamar&#237;a &#40;<span class="elsevierStyleItalic">Hospital de Basurto&#44; Bilbao</span>&#41;&#59; Juan Carlos Vergara&#44; Jose Ramon Iruretagoyena Amiano &#40;<span class="elsevierStyleItalic">Hospital de Cruces&#44; Bilbao</span>&#41;&#59; Alberto Manzano &#40;<span class="elsevierStyleItalic">Hospital Santiago Ap&#243;stol&#44; Vitoria</span>&#41;&#59;Carlos Castillo Arenal &#40;<span class="elsevierStyleItalic">Hospital Txagorritxu&#44; Vitoria</span>&#41;&#46;</p> <p id="par0255" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Valencia&#58;</span> Jos&#233; Blanquer &#40;Hospital Clinic Universitari&#44; Valencia&#41;&#59; Roberto Reig Valero&#44; A&#46; Belenger&#44; Susana Altaba &#40;Hospital General de Castell&#243;n&#44; Castell&#243;n&#41;&#59; Bernab&#233; &#193;lvarez-S&#225;nchez &#40;Hospital General de Alicante&#44; Alicante&#41;&#59; Santiago Alberto Picos &#40;Hospital Torrevieja Salud&#44; Alicante&#41;&#59; &#193;ngel S&#225;nchez-Miralles &#40;Hospital San Juan&#44; Alicante&#41;&#59; Juan Bonastre&#44; M&#46; Palamo&#44; Javier Cebrian&#44; Jos&#233; Cu&#241;at &#40;Hospital La Fe&#44; Valencia&#41;&#59; Bel&#233;n Romero &#40;Hospital de Manises&#44; Valencia&#41;&#59; Rafael Zaragoza &#40;Hospital Dr&#46; Peset&#44; Valencia&#41;&#59; Virgilio Paricio &#40;Hospital de Requena&#44; Valencia&#41;&#59; Asunci&#243;n Marques&#44; S&#46; S&#225;nchez-Morcillo&#44; S&#46; Tormo &#40;Hospital de la Ribera&#44; Valencia&#41;&#59; J&#46; Latour &#40;H&#46; G&#46; Universitario de Elche&#44; Valencia&#41;&#44; M&#46; &#193;ngel Garc&#237;a &#40;Hospital de Sagunto&#44; Castell&#243;n&#41;&#46;</p>"
            "etiqueta" => "Annex 1"
            "titulo" => "List of investigators of the GETGAG&#47;SEMICYUC"
            "identificador" => "sec0050"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Adjusted patient survival &#40;Cox regression analysis&#41; according to adherence to the treatment recommendations in both study periods&#46;</p>"
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        "tipo" => "MULTIMEDIATABLA"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Adherence variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Definition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Total adherence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dose of 150<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h and duration &#8805;10 days<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>Dose of 75<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h and duration &#60;10 days<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Partial adherence in dose&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dose of 150<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h but duration &#60;10 days<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>Dose of 75<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h but duration &#8805;10 days<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Partial adherence in duration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dose of 75<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h and duration &#8805;10 days<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>Dose of 150<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h and duration &#60;10 days<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Non-adherence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dose of 75<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h and duration of &#60;10 days<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>Dose of 150<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h and duration &#8805;10 days<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pandemic 2009&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>661&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pandemic 2010&#8211;2011&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>397&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Severity&#44; mean &#40;SD&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>APACHE II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;9 &#40;7&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#46;2 &#40;7&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>SOFA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;7 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;2 &#40;4&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Clinical manifestations&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Primary viral pneumonia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">546 &#40;69&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">267 &#40;67&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Exacerbated COPD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36 &#40;5&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Bacterial coinfection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">99 &#40;15&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76 &#40;19&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Care variables&#44; mean &#40;SD&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mean stay in ICU&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;53 &#40;14&#46;34&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;88 &#40;13&#46;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mean stay in hospital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#46;8 &#40;17&#46;83&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#46;01 &#40;16&#46;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Days from symptoms onset to hospital admission&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;28 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;92 &#40;3&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Days of hospital stay to admission to ICU&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;86 &#40;2&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;37 &#40;3&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Days of hospital stay to diagnosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;32 &#40;2&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;69 &#40;3&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Evolutive indicators&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Septic shock&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">295 &#40;45&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">224 &#40;56&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mechanical ventilation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">471 &#40;71&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">326 &#40;82&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Invasive mechanical ventilation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">404 &#40;61&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">269 &#40;66&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Prone decubitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">95 &#40;14&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">82 &#40;20&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Acute renal failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">136 &#40;21&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">112 &#40;39&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dialysis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;3&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;7&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mortality in ICU&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">144 &#40;21&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">119 &#40;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Treatment</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Treatment with oseltamivir&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">643 &#40;99&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">383 &#40;96&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Treatment with zanamivir&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;0&#46;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25 &#40;6&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Empirical antiviral treatment&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">463 &#40;72&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">274 &#40;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;517&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Days from symptoms onset to antiviral administration&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;7 &#40;2&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;7 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Early antiviral treatment &#40;&#60;48<span class="elsevierStyleHsp" style=""></span>h&#41;&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">153 &#40;23&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61 &#40;15&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Use of high antiviral drug doses&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">453 &#40;72&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">212 &#40;55&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Duration of antiviral treatment&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;6 &#40;4&#46;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;88 &#40;3&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Adherence to treatment protocol&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">267 &#40;43&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">145 &#40;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;075&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => "xTab902810.png"
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          "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Comparison of different variables defining antiviral treatment between the two periods&#46;</p>"
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        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:2 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Patients with severity criteria&#58; high dose</th></tr><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Degrees of adherence&#58; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pandemic 2009&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>380&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Period 2010&#8211;2011&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>264&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Total adherence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">208 &#40;54&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">96 &#40;36&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Partial adherence in dose&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84 &#40;22&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61 &#40;23&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;774&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Partial adherence in duration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47 &#40;11&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52 &#40;19&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Non-adherence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41 &#40;9&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55 &#40;20&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab902812.png"
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            1 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Patients without severity criteria&#58; standard dose</th></tr><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Degrees of adherence&#58; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pandemic 2009&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>228&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Period 2010&#8211;2011&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>118&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Total adherence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59 &#40;25&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49 &#40;41&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Partial adherence in dose&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;7&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;12&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;177&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Partial adherence in duration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89 &#40;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;27&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;032&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Non-adherence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62 &#40;27&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;18&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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        "descripcion" => array:1 [
          "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Degrees of adherence in each period for patients with and without severity criteria&#46;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "tbl0020"
        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">COPD&#58; chronic obstructive pulmonary disease&#59; ICU&#58; Intensive Care Unit&#59; HIV&#58; human immunodeficiency virus&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Pandemic period &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>661&#41;</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Post-pandemic period &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>396&#41;</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Survivors &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>517&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Deceased &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>144&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Survivors &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>277&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Deceased &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>119&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Level of severity</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>SOFA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;9 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;5 &#40;4&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;2 &#40;3&#46;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;6 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>APACHE II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;5 &#40;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;5 &#40;8&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#46;1 &#40;6&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;8&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Demographic factors</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Age&#44; mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&#46;8 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48 &#40;16&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;057&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&#46;5 &#40;14&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51&#46;9 &#40;14&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;113&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male sex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">287 &#40;55&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">91 &#40;63&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;209&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">184 &#40;66&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">85 &#40;71&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;590&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Comorbidities</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;1 condition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">353 &#40;69&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">154 &#40;79&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;051&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">205 &#40;73&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">94 &#40;79&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;316&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>COPD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87 &#40;16&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;14&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;467&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52 &#40;21&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26 &#40;24&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;203&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Asthma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69 &#40;13&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;8&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;829&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27 &#40;9&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Heart failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;11&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;034&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26 &#40;9&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;11&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;189&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Chronic renal failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;3&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;9&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;6&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;10&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62 &#40;12&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;14&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;555&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48 &#40;17&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;13&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;946&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Obesity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">180 &#40;35&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58 &#40;41&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;713&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">107 &#40;38&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;26&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Autoimmune disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;2&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;1&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;2&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;153&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hematological disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;3&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;14&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;5&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;23&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Neuromuscular disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;3&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;4&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;783&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;632&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>HIV infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;1&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;165&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;10&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pregnancy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;4&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;4&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;896&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;233&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Clinical presentation</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Viral pneumonia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">359 &#40;70&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97 &#40;67&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;178&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">186 &#40;66&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">81 &#40;68&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;844&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>EPOC exacerbation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;3&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;427&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;7&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;217&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Respiratory bacterial coinfection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">70 &#40;13&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;20&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;056&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45 &#40;16&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&#46;2 &#40;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;119&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Complications</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Septic shock&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">190 &#40;37&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">105 &#40;74&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">127 &#40;45&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97 &#40;91&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Multiorgan failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">283 &#40;55&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">125 &#40;88&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">133 &#40;47&#46;89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100 &#40;84&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Acute renal failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38 &#40;27&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49 &#40;17&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64 &#40;53&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Continuous renal replacement therapy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62 &#40;45&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;3&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;16&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Noninvasive mechanical ventilation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">125 &#40;24&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38 &#40;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;373&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">105 &#40;38&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37 &#40;31&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;766&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Invasive mechanical ventilation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">266 &#40;51&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">138 &#40;95&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">156 &#40;57&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">113 &#40;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Renal failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62 &#40;45&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51 &#40;18&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61 &#40;51&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Prone decubitus</td><td class="td" title="table-entry  " rowspan="2" align="char" valign="top">52 &#40;10&#46;2&#41;</td><td class="td" title="table-entry  " rowspan="2" align="char" valign="top">43 &#40;30&#46;7&#41;</td><td class="td" title="table-entry  " rowspan="2" align="char" valign="top">0&#46;002</td><td class="td" title="table-entry  " rowspan="2" align="char" valign="top">33 &#40;11&#46;9&#41;</td><td class="td" title="table-entry  " align="char" valign="top">49 &#40;41&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " rowspan="2" align="char" valign="top">&#60;0&#46;001</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Treatment</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Treatment with oseltamivir&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">506 &#40;99&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">137 &#40;97&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68 &#40;96&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">115 &#40;96&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;322&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Treatment with zanamivir&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;475&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;5&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;7&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;973&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Empirical antiviral treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">371 &#40;74&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">92 &#40;67&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;207&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">196 &#40;72&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">78 &#40;67&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Days to start of antiviral treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;6 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;3 &#40;3&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;085&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;4 &#40;3&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;5 &#40;4&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;033&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Early antiviral treatment &#40;&#8804;48<span class="elsevierStyleHsp" style=""></span>h&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">129 &#40;25&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;17&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;361&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49 &#40;18&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;10&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;263&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Patients with severity criteria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">284 &#40;54&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">131 &#40;91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">160 &#40;57&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">112 &#40;94&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Use of high doses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">221 &#40;45&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49 &#40;40&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;113&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;26&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Use of high doses &#40;150<span class="elsevierStyleHsp" style=""></span>mg&#47;12<span class="elsevierStyleHsp" style=""></span>h&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">350 &#40;70&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">103 &#40;81&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;204&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">148 &#40;55&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64 &#40;55&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;147&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>More than 10 days of treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">276 &#40;56&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59 &#40;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">138 &#40;51&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47 &#40;40&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Duration of antiviral treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;79 &#40;3&#46;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;88 &#40;5&#46;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;34 &#40;3&#46;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;8 &#40;4&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Total adherence to treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">218 &#40;44&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49 &#40;40&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">113 &#40;42&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;27&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Vaccination&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;5&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;883&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Pandemic period</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Post-pandemic period</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37;CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95&#37;CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">APACHE II score &#40;per point&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;06&#8211;1&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;05&#8211;1&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Hematological disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;26&#8211;3&#46;85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;39&#8211;3&#46;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Adherence to treatment&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;35&#8211;0&#46;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Early treatment &#40;&#60;48<span class="elsevierStyleHsp" style=""></span>h&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;32&#8211;0&#46;97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;83&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Positive HIV serological test&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;96&#8211;7&#46;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;058&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;63&#8211;6&#46;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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Article information
ISSN: 21735727
Original language: English
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