scholarly journals Clinical manifestations, therapy and outcome of pandemic influenza a (H1N1) 2009 in hospitalized patients

2011 ◽  
Vol 68 (3) ◽  
pp. 248-256 ◽  
Author(s):  
Dragan Mikic ◽  
Darko Nozic ◽  
Miroslav Kojic ◽  
Svetlana Popovic ◽  
Dejan Hristovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Antiviral Therapy ◽  
Pandemic Influenza ◽  
Influenza A ◽  
Laboratory Tests ◽  
Fatal Outcome ◽  
Severe Illness ◽  
Influenza A H1n1

Background/Aim. Increasing number of epidemiological and clinical studies to date showed that the pandemic influenza A (H1N1) 2009, by its characteristics, significantly differs from infection caused by seasonal influenza. Therefore, the information about clinical spectrum of manifestations, risk factors for severe form of the disease, treatment and outcome in patients with novel flu are still collected. Methods. A total of 98 patients (mean age 32 ? 15 years, range 14-88 years) with the signs and symptoms of novel influenza were treated in the Clinic for Infectious and Tropical Diseases, Military Medical Academy. There were 74 (75.5%) patients with suspected influenza A (H1N1) 2009, 10 (10.2%) with the likelihood and 14 (14.3%) with the confirmed influenza. In all the patients we registered the basic demographic data, risk factors for severe disease, symptoms and signs of influenza, laboratory tests and chest radiography. We analyzed antiviral therapy use and disease outcome (survived, died). Results. The average time from the beginning of influenza A (H1N1) to the admission in hospital was 3 days (0-16 days) and from the moment of hospitalization to the Intensive Care Unit (ICU) admission was 2 days (0-5 days). There were 49 (50.0%) patients, 20-29 years of age and 5 (5.1%) patients older than 65. A total of 21 (21.4%) patients were with underlying disease, 18 (18.4%) were obese, 19 (19.4%) were cigarette smokers. All of the patients had fever, 81 (82.6%) cough, while dyspnea and diarrhea were registered in ? of the patients. In more than 75% of the patients laboratory tests were within normal limits. The realtime polymerase chain reaction (PCR) test for identification of influenza A (H1N1) 2009 was positive in 14 (77.8%), while pneumonia was verified in 30 (30.7%) of the patients. Six (6.1%) patients, mean age of 45 ? 14 years (31-59 years) were admitted to the ICU, of whom five (5.1%) had Adult Respiratory Distress Syndrome (ARDS). Risk factors were registered more frequently in the patients with acute respiratory failure (14.2% vs 4.9%, p < 0.05). A total of 67 (68.4%) patients received oseltamivir, 89 (90.1%) was applied to antibiotics and 64 (65.3%) were treated with a combined therapy. Antiviral therapy was applied to 43 (43.3%) patients in the first 48 hours from the onset of the disease, of whom only one (3.4%) developed ARDS. Fatal outcome was noted in 2.0% of the patients (2 of 98 patients) and in 33.3% of the patients treated in the ICU. Conclusion. Novel influenza A (H1N1) is most commonly manifested as a mild acute respiratory disease, which usually affects young healthy adults. A small number of the patients develop severe illness with acute respiratory failure and death. Patients seem to have benefit from antiviral therapy especially in first 48 hours.

Adult intensive-care patients with 2009 pandemic influenza A(H1N1) infection

2010 ◽  
Vol 139 (8) ◽  
pp. 1202-1209 ◽  
Author(s):  
C. FUHRMAN ◽  
I. BONMARIN ◽  
D. BITAR ◽  
T. CARDOSO ◽  
N. DUPORT ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Antiviral Therapy ◽  
Pandemic Influenza ◽  
Influenza A ◽  
Protective Factor ◽  
Severe Disease ◽  
Case Fatality ◽  
Icu Patients ◽  
Influenza A H1n1

SUMMARYIn France, the surveillance of hospitalized cases of pandemic influenza was implemented in July 2009 and restricted to intensive-care unit (ICU) patients in November. We described the characteristics of the 1065 adult patients admitted to ICUs and analysed risk factors for severe outcome (mechanical ventilation or death). Eighty-seven percent of cases were aged 15–64 years. The case-fatality ratio was 20%. The risk for severe outcome increased with age and obesity while this association was negative for chronic respiratory disease. Late antiviral therapy was associated with a severe outcome in ICU patients with risk factors (adjusted OR 2·0, 95% CI 1·4–3·0). This study confirms the considerable contribution of young adults to A(H1N1) 2009 mortality. It shows the role of obesity as an independent risk factor for severe disease, and of early antiviral therapy as a protective factor, at least in patients with risk factors.

scholarly journals Acute respiratory failure from pandemic influenza A (H1N1) in an intensive care unit in southern Brazil

Critical Care ◽  
2010 ◽  
Vol 14 (Suppl 1) ◽  
pp. P91 ◽  
Author(s):  
S Beduschi Filho ◽  
D Siqueira ◽  
SC Carvalho Flores ◽  
I Yoshiko Masukawa ◽  
L Kretzer ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Pandemic Influenza ◽  
Influenza A ◽  
Southern Brazil ◽  
Influenza A H1n1

scholarly journals Risk Factors for Severe Illness with 2009 Pandemic Influenza A (H1N1) Virus Infection in China

2011 ◽  
Vol 52 (4) ◽  
pp. 457-465 ◽  
Author(s):  
Hongjie Yu ◽  
Zijian Feng ◽  
Timothy M. Uyeki ◽  
Qiaohong Liao ◽  
Lei Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Virus Infection ◽  
Pandemic Influenza ◽  
Influenza A ◽  
H1n1 Virus ◽  
Severe Illness ◽  
Influenza A H1n1 ◽  
H1n1 Virus Infection

scholarly journals Risk factors for severe outcome of cases with pandemic influenza A(H1N1)pdm09

2015 ◽  
Vol 116 (06) ◽  
pp. 389-393 ◽  
Author(s):  
L. Hlavinkova ◽  
Z. Kristufkova ◽  
J. Mikas
Keyword(s):  
Risk Factors ◽  
Pandemic Influenza ◽  
Influenza A ◽  
Influenza A H1n1

scholarly journals Hospitalized Children with 2009 Pandemic Influenza A (H1N1): Comparison to Seasonal Influenza and Risk Factors for Admission to the ICU

PLoS ONE ◽  
2010 ◽  
Vol 5 (12) ◽  
pp. e15173 ◽  
Author(s):  
Dayanand Bagdure ◽  
Donna J. Curtis ◽  
Emily Dobyns ◽  
Mary P. Glodé ◽  
Samuel R. Dominguez
Keyword(s):  
Risk Factors ◽  
Pandemic Influenza ◽  
Influenza A ◽  
Seasonal Influenza ◽  
Hospitalized Children ◽  
Influenza A H1n1

scholarly journals Hospitalized Adult Patients with 2009 Pandemic Influenza A (H1N1) in Kaunas, Lithuania

Medicina ◽  
2011 ◽  
Vol 47 (1) ◽  
pp. 11-18 ◽  
Author(s):  
◽  
◽  
◽  
◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Symptom Onset ◽  
Pandemic Influenza ◽  
Influenza A ◽  
H1n1 Virus ◽  
Clinical Course ◽  
Antiviral Treatment ◽  
Course Of Illness ◽  
Influenza A H1n1 ◽  
Complicated Course

The objective of this study was to identify case characteristics and clinical course of the disease in patients hospitalized with 2009 pandemic influenza A (H1N1) infection during the first wave of the pandemic and to identify risk factors associated with the complicated course of illness. Material and methods. A retrospective study of adult cases of the laboratory-confirmed 2009 pandemic influenza A (H1N1) virus admitted to three hospitals in Kaunas between November 1, 2009, and March 15, 2010, was carried out. The main outcome measures were clinical characteristics, risk factors for complicated disease, treatment, and clinical course of the disease. Results. The study enrolled 121 of the 125 patients hospitalized due to 2009 pandemic influenza A (H1N1) virus infection. The median age was 31 years (range, 18–83); 5% of the patients were aged more than 65 years. Pregnant and postpartum women comprised 26% of all hospitalized cases. Nearly half (49.5%) of those who underwent chest radiography had findings consistent with pneumonia, which was bilateral in one-third of cases. The risk to have pandemic influenza complicated by pneumonia increased significantly with one-day delay from symptom onset to antiviral treatment (OR, 2.241; 95% CI, 1.354–3.710). More than half (57%) of the patients received antiviral treatment. In 45% of the treated patients, antiviral drugs were administered within 48 hours from symptom onset. Intensive care was required in 7.4% of the cases. The overall mortality was 5% (6/121). The median age of the patients who died was 43.5 years (range, 23–62); 4 patients had been previously healthy, 1 patient suffered from chronic lympholeukemia, and 1 patient was a pregnant woman. Conclusion. The 2009 pandemic influenza A (H1N1) caused considerable morbidity in a significant proportion of hospitalized adults. The main risk factor associated with the complicated course of illness was delayed antiviral treatment.

scholarly journals Procalcitonin in patients with influenza A (H1N1) infection and acute respiratory failure

2011 ◽  
Vol 9 (1) ◽  
pp. 52-55
Author(s):  
Péricles Almeida Delfino Duarte ◽  
Carla Sakuma de Oliveira Bredt ◽  
Gerson Luís Bredt Jr ◽  
Amaury César Jorge ◽  
Alisson Venazzi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Hospital Mortality ◽  
Acute Respiratory Failure ◽  
Influenza A ◽  
Laboratory Data ◽  
Sepsis Group ◽  
Influenza A H1n1 ◽  
Low Serum

ABSTRACT Objective: To verify serum procalcitonin levels of patients with acute respiratory failure secondary to influenza A (H1N1) upon their admission to the Intensive Care Unit and to compare these results to values found in patients with sepsis and trauma admitted to the same unit. Methods: Analysis of records of patients infected with influenza A (H1N1) and respiratory failure admitted to the General Intensive Care Unit during in a period of 60 days. The values of serum procalcitonin and clinical and laboratory data were compared to those of all patients admitted with sepsis or trauma in the previous year. Results: Among patients with influenza A (H1N1) (n = 16), the median serum procalcitonin level upon admission was 0.11 ng/mL, lower than in the sepsis group (p < 0.001) and slightly lower than in trauma patients. Although the mean values were low, serum procalcitonin was a strong predictor of hospital mortality in patients with influenza A (H1N1). Conclusion: Patients with influenza A (H1N1) with severe acute respiratory failure presented with low serum procalcitonin values upon admission, although their serum levels are predictors of hospital mortality. The kinetics study of this biomarker may be a useful tool in the management of this group of patients.

scholarly journals A case-control study of risk factors for death from 2009 pandemic influenza A(H1N1): is American Indian racial status an independent risk factor?

2015 ◽  
Vol 144 (2) ◽  
pp. 315-324 ◽  
Author(s):  
T. W. HENNESSY ◽  
D. BRUDEN ◽  
L. CASTRODALE ◽  
K. KOMATSU ◽  
L. M. ERHART ◽  
...  
Keyword(s):  
Risk Factors ◽  
American Indian ◽  
Pandemic Influenza ◽  
Influenza A ◽  
Conditional Logistic Regression ◽  
Healthcare Access ◽  
Case Control ◽  
Medical Attention ◽  
Modifiable Factors ◽  
Influenza A H1n1

SUMMARYHistorically, American Indian/Alaska Native (AI/AN) populations have suffered excess morbidity and mortality from influenza. We investigated the risk factors for death from 2009 pandemic influenza A(H1N1) in persons residing in five states with substantial AI/AN populations. We conducted a case-control investigation using pandemic influenza fatalities from 2009 in Alaska, Arizona, New Mexico, Oklahoma and Wyoming. Controls were outpatients with influenza. We reviewed medical records and interviewed case proxies and controls. We used multiple imputation to predict missing data and multivariable conditional logistic regression to determine risk factors. We included 145 fatal cases and 236 controls; 22% of cases were AI/AN. Risk factors (P < 0·05) included: older age [adjusted matched odds ratio (mOR) 3·2, for >45 years vs. <18 years], pre-existing medical conditions (mOR 7·1), smoking (mOR 3·0), delayed receipt of antivirals (mOR 6·5), and barriers to healthcare access (mOR 5·3). AI/AN race was not significantly associated with death. The increased influenza mortality in AI/AN individuals was due to factors other than racial status. Prevention of influenza deaths should focus on modifiable factors (smoking, early antiviral use, access to care) and identifying high-risk persons for immunization and prompt medical attention.

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