Author:
Cui Wei,Zhao Hongwen,Lu Xu,Wen Ying,Zhou Ying,Deng Baocheng,Wang Yu,Wang Wen,Kang Jian,Liu Pei
Abstract
Abstract
Background
During the spring of 2009, a pandemic influenza A (H1N1) virus emerged and spread globally. We describe the clinical characteristics and factors associated with the death of patients who were hospitalized with 2009 H1N1 influenza pneumonia in Shenyang, China, from November to December 2009.
Methods
We carried out a retrospective chart review of 68 patients who were hospitalized with pneumonia and confirmed to have 2009 H1N1 virus infection by a real time RT-PCR assay of respiratory specimens.
Results
Of the 68 patients we studied, 30 (44%) were admitted to an intensive care unit and 10 (14.7%) died. The median age of patients was 41 years (range, 18-66), and only one patient was over 65 years of age. The male to female ratio was 2.78:1 (50:18). Of the 68 patients, 23 (34%) had at least one underlying medical condition, 9 (13%) had a cigarette index ≥400 and 22 (32%) were obese. All patients underwent chest radiography on admission and the findings were consistent with pneumonia in all cases. All patients were treated with oseltamivir and treatment was initiated at a median time of seven days after the onset of illness. The laboratory test results indicated lymphopenia, hypoproteinemia and elevated lactic dehydrogenase and C reactive protein levels. Of the 68 patients, 33 (52%) showed a reduction in CD4 T cell counts. Of the 58 patients who survived, 31 (53%) had lymphopenia and 27 recovered from this condition after five days. Of the 10 patients who died, nine (90%) had lymphopenia and only two patients recovered from this condition after five days. Obesity and recovery from lymphopenia after five days were factors associated with death, as determined by multivariate logistic-regression analysis (obesity, odds ratio = 23.06; lymphocytopenia reversion, odds ration = 28.69).
Conclusions
During the evaluation period in Shenyang, China, 2009 H1N1 influenza caused severe illness requiring hospitalization in 68 patients, 10 (14.7%) of which died. Many of these patients were considered healthy adults and few were elderly (65 years or older). Obesity and lymphopenia, which was not restored after five days of treatment, were factors associated with poor outcomes of 2009 H1N1 influenza infection.
Publisher
Springer Science and Business Media LLC
Reference37 articles.
1. Swine-origin influenza A (H1N1) virus infections in a school -- New York City, April 2009. MMWR Morb Mortal Wkly Rep. 2009, 58: 470-472.
2. Swine influenza A (H1N1) infection in two children -- Southern California, March-April 2009. MMWR Morb Mortal Wkly Rep. 2009, 58: 400-402.
3. Outbreak of swine-origin influenza A (H1N1) virus infection -- Mexico, March-April 2009. MMWR Morb Mortal Wkly Rep. 2009, 58: 467-470.
4. Update: infections with a swine-origin influenza A (H1N1) virus -- United States and other countries, April 28, 2009. MMWR Morb Mortal Wkly Rep. 2009, 58: 431-433.
5. Naffakh N, van der Werf SV: April 2009: an outbreak of swine-origin influenza A(H1N1) virus with evidence for human-to-human transmission. Microbes Infect. 2009, 11: 725-728. 10.1016/j.micinf.2009.05.002.
Cited by
82 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献