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Abelleira R, Ruano-Ravina A, Lama A, Barbeito G, Toubes ME, Domínguez-Antelo C, González-Barcala FJ, Rodríguez-Núñez N, Marcos PJ, Pérez del Molino ML, Valdés L. Influenza A H1N1 Community-Acquired Pneumonia: Characteristics and Risk Factors-A Case-Control Study. Can Respir J 2019; 2019:4301039. [PMID: 31007805 PMCID: PMC6441515 DOI: 10.1155/2019/4301039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/06/2019] [Accepted: 02/19/2019] [Indexed: 12/28/2022] Open
Abstract
Introduction Influenza A H1N1 community-acquired pneumonia (CAP) is a quite frequent respiratory disease. Despite being considered more serious than other CAPs, there are very few studies comparing its characteristics with noninfluenza CAP. We aim to establish the differences between pneumonia due to H1N1 virus and pneumonia not caused by H1N1 influenza virus and to determine the probability that a pneumonia is due to an H1N1 virus infection based on the most relevant variables. Methods We used a case-control study where cases were H1N1 CAP patients with confirmed microbiological diagnosis and controls were patients with CAP admitted to hospital. H1N1 and other influenza types were discarded among controls. We calculated the probability of being a case or control using multivariate logistic regression. Results We included 99 cases and 270 controls. Cases were younger than controls (53 vs 71 years, respectively). Mortality was much higher for H1N1 patients (13% vs 0.3%), and admission to intensive care unit was more frequent for H1N1 cases. The variables most associated with presenting H1N1 CAP were bilateral affectation on chest X-rays (OR: 5.70; 95% CI 2.69-10.40), followed by presence of arthromyalgias, with cases presenting close to three times more arthromyalgias compared to controls. Low leukocytes count and high AST values were also significantly associated with H1N1 CAP. H1N1 CAPs are characterized by bilateral affectation, low leukocyte count, presence of arthromyalgias, and high AST. Conclusions A few and easy to obtain clinical parameters might be extremely useful to distinguish H1N1 CAP from CAPs of other origin.
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Affiliation(s)
- Romina Abelleira
- Service of Pneumology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Group of Epidemiology, Public Health and Evaluation of Health Services, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Adriana Lama
- Service of Pneumology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Gema Barbeito
- Service of Microbiology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - María E. Toubes
- Service of Pneumology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Cristina Domínguez-Antelo
- Critical Care Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Francisco J. González-Barcala
- Service of Pneumology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
- Interdisciplinary Research Group in Pneumology, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Nuria Rodríguez-Núñez
- Service of Pneumology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Pedro J. Marcos
- Service of Pneumology, University Hospital of A Coruña, A Coruña, Spain
| | - María L. Pérez del Molino
- Service of Microbiology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Luis Valdés
- Service of Pneumology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
- Interdisciplinary Research Group in Pneumology, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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Ylipalosaari P, Ala-Kokko TI, Laurila J, Ahvenjärvi L, Syrjälä H. ICU-treated influenza A(H1N1) pdm09 infections more severe post pandemic than during 2009 pandemic: a retrospective analysis. BMC Infect Dis 2017; 17:728. [PMID: 29162037 PMCID: PMC5697104 DOI: 10.1186/s12879-017-2829-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 11/12/2017] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND We compared in a single mixed intensive care unit (ICU) patients with influenza A(H1N1) pdm09 between pandemic and postpandemic periods. METHODS Retrospective analysis of prospectively collected data in 2009-2016. Data are expressed as median (25th-75th percentile) or number (percentile). RESULTS Seventy-six influenza A(H1N1) pdm09 patients were admitted to the ICU: 16 during the pandemic period and 60 during the postpandemic period. Postpandemic patients were significantly older (60 years vs. 43 years, p < 0.001) and less likely to have epilepsy or other neurological diseases compared with pandemic patients (5 [8.3%] vs. 6 [38%], respectively; p = 0.009). Postpandemic patients were more likely than pandemic patients to have cardiovascular disease (24 [40%] vs. 1 [6%], respectively; p = 0.015), and they had higher scores on APACHE II (17 [13-22] vs. 14 [10-17], p = 0.002) and SAPS II (40 [31-51] vs. 31 [25-35], p = 0.002) upon admission to the ICU. Postpandemic patients had higher maximal SOFA score (9 [5-12] vs. 5 [4-9], respectively; p = 0.03) during their ICU stay. Postpandemic patients had more often septic shock (40 [66.7%] vs. 8 [50.0%], p = 0.042), and longer median hospital stays (15.0 vs. 8.0 days, respectively; p = 0.006). During 2015-2016, only 18% of the ICU- treated patients had received seasonal influenza vaccination. CONCLUSIONS Postpandemic ICU-treated A(H1N1) pdm09 influenza patients were older and developed more often septic shock and had longer hospital stays than influenza patients during the 2009 pandemic.
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Affiliation(s)
- Pekka Ylipalosaari
- Department of Infection Control, Oulu University Hospital, Box 21, FIN-90029 Oulu, OYS Finland
| | - Tero I. Ala-Kokko
- Department of Anesthesiology, Division of Intensive Care, Oulu University Hospital, FIN-90029 Oulu, OYS Finland
- Medical Research Center, Research Group of Surgery, Anesthesiology and Intensive Care, University of Oulu, Oulu, Finland
| | - Jouko Laurila
- Department of Anesthesiology, Division of Intensive Care, Oulu University Hospital, FIN-90029 Oulu, OYS Finland
- Medical Research Center, Research Group of Surgery, Anesthesiology and Intensive Care, University of Oulu, Oulu, Finland
| | - Lauri Ahvenjärvi
- Department of Radiology, Oulu University Hospital, FIN-90029 Oulu, OYS Finland
| | - Hannu Syrjälä
- Department of Infection Control, Oulu University Hospital, Box 21, FIN-90029 Oulu, OYS Finland
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Boikos C, Caya C, Doll MK, Kraicer-Melamed H, Dolph M, Delisle G, Winters N, Gore G, Quach C. Safety and effectiveness of neuraminidase inhibitors in situations of pandemic and/or novel/variant influenza: a systematic review of the literature, 2009-15. J Antimicrob Chemother 2017; 72:1556-1573. [PMID: 28204554 DOI: 10.1093/jac/dkx013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 01/05/2017] [Indexed: 01/02/2023] Open
Abstract
Objectives To review systematically the published literature evaluating neuraminidase inhibitor (NI) safety and effectiveness in situations of pandemic and novel/variant influenza. Methods We searched six online databases using comprehensive search criteria for observational studies and randomized controlled trials investigating the effects of NI treatment, prophylaxis or outbreak control in patients of all ages. Results Overall, 165 studies were included (95% observational), which were generally of low methodological quality due to lack of adjustment for confounding variables. In studies reporting adjusted estimates in general populations, NI treatment appeared likely to be effective against mortality (primarily if administered within 48 h of symptom onset) and potentially effective in reducing pneumonia. NIs appeared effective in reducing secondary transmission when indicated for prophylaxis. Limited, low-quality data suggest NIs are likely safe in general populations and may be safe in pregnant women and children. Data are scarce regarding safety of NIs in adults and high-risk individuals. Conclusions Most included studies were observational, statistically underpowered and at high risk of reporting biased and/or confounded effect estimates. NI treatment appeared likely effective in reducing mortality (cause unspecified) and pneumonia in general populations, with increasing benefit when administered with 48 h of symptom onset. NI pre- or post-exposure prophylaxis is likely effective in reducing secondary transmission of influenza in a general population. Our evidence suggests NIs are likely safe to use in the general population; however, data for children and pregnant women are limited. Knowledge gaps persist in specific populations such as Aboriginals, high-risk individuals and the elderly.
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Affiliation(s)
- C Boikos
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada
| | - C Caya
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada
| | - M K Doll
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada
| | - H Kraicer-Melamed
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada
| | - M Dolph
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada
| | | | - N Winters
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada
| | - G Gore
- Life Sciences Library, McGill University, Montreal, QC, Canada
| | - C Quach
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada.,Department of Pediatrics, Division of Infectious Diseases, The Montreal Children's Hospital, Montreal, QC, Canada.,Department of Microbiology, Infectious Disease, and Immunology, University of Montreal, Montreal, QC, Canada
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Chao CM, Lai CC, Chan KS, Cheng KC, Chou W, Yuan KS, Chen CM. Outcomes of patients with severe influenza infection admitted to intensive care units: a retrospective study in a medical centre. J Med Microbiol 2017; 66:1421-1428. [DOI: 10.1099/jmm.0.000593] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- Chien-Ming Chao
- Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan, ROC
| | - Chih-Cheng Lai
- Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan, ROC
| | - Khee-Siang Chan
- Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan, ROC
| | - Kuo-Chen Cheng
- Department of Safety Health and Environment, Chung Hwa University of Medical Technology, Tainan, Taiwan, ROC
- Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan, ROC
| | - Willy Chou
- Department of Recreation and Health-Care Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan, ROC
| | - Kuo-Shu Yuan
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan, ROC
- Department of Business Management, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC
| | - Chin-Ming Chen
- Department of Recreation and Health-Care Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan, ROC
- Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan, ROC
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Aslan FG, Altındiş M. Güncel Viral Etkenler; ZİKA, CHİKUNGUNYA, EBOLA, ENTEROVİRUS D68, MERS CoV, İnfluenza. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2016. [DOI: 10.30934/kusbed.358635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Tumwine JK. Infectious diseases and chronic care in Africa. Afr Health Sci 2015; 15:v-vii. [PMID: 26124825 DOI: 10.4314/ahs.v15i2.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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