CLC number: R511.7
On-line Access: 2024-08-27
Received: 2023-10-17
Revision Accepted: 2024-05-08
Crosschecked: 2011-12-14
Cited: 2
Clicked: 7476
Li-hui Deng, Yi-lan Zeng, Ping Feng, Ya-ling Liu, Li-chun Wang, Yun Bai, Hong Tang. Clinical characteristics of critical patients with pandemic influenza A (H1N1) virus infection in Chengdu, China[J]. Journal of Zhejiang University Science B, 2012, 13(1): 49-55.
@article{title="Clinical characteristics of critical patients with pandemic influenza A (H1N1) virus infection in Chengdu, China",
author="Li-hui Deng, Yi-lan Zeng, Ping Feng, Ya-ling Liu, Li-chun Wang, Yun Bai, Hong Tang",
journal="Journal of Zhejiang University Science B",
volume="13",
number="1",
pages="49-55",
year="2012",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1100168"
}
%0 Journal Article
%T Clinical characteristics of critical patients with pandemic influenza A (H1N1) virus infection in Chengdu, China
%A Li-hui Deng
%A Yi-lan Zeng
%A Ping Feng
%A Ya-ling Liu
%A Li-chun Wang
%A Yun Bai
%A Hong Tang
%J Journal of Zhejiang University SCIENCE B
%V 13
%N 1
%P 49-55
%@ 1673-1581
%D 2012
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1100168
TY - JOUR
T1 - Clinical characteristics of critical patients with pandemic influenza A (H1N1) virus infection in Chengdu, China
A1 - Li-hui Deng
A1 - Yi-lan Zeng
A1 - Ping Feng
A1 - Ya-ling Liu
A1 - Li-chun Wang
A1 - Yun Bai
A1 - Hong Tang
J0 - Journal of Zhejiang University Science B
VL - 13
IS - 1
SP - 49
EP - 55
%@ 1673-1581
Y1 - 2012
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1100168
Abstract: Objective: The critical illness of pandemic influenza A (h1N1) virus infection may be associated with relatively poor outcomes. The objective of this study is to describe clinical features and factors associated with the deaths of critical patients. Methods: Medical records of 26 critical patients with h1N1 infection admitted from Sept. 1 to Dec. 31, 2009, were retrospectively reviewed. Diagnosis was established by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay. Results: The mean age of the patients was (40.4±18.4) years and 73.1% of them were male. Clinical manifestations included fever, cough, and sputum production. The laboratory findings included leukocytosis, lymphopenia, C-reaction protein, and lactic dehydrogenase elevation. In this series, 17 subjects survived and 9 died. The parameters between the deaths and survivors were compared, which included acute physiology and chronic health evaluation II (APACHE II) scores (23.8±10.1 vs. 14.3±6.6, P<0.05), sequential organ failure assessment (SOFA) scores (13.3±3.0 vs. 6.6±3.3, P<0.05), and multiple organ dysfunction syndrome (MODS) scores (7.4±2.5 vs. 3.3±1.7, P<0.05). The cases of deaths had higher incidences of cardiovascular failure (100% vs. 41.2%, P<0.05), renal failure (55.6% vs. 11.7%, P<0.05), encephalopathy (44.4% vs. 5.9%, P<0.05), hepatic failure (33.3% vs. 5.9%, P<0.05), and septic shock (33.3% vs. 17.6%, P<0.05). Conclusions: The critical patients with h1N1 infection have high APACHE II, SOFA, and MODS scores, which may be associated with an increased risk of death and complex clinical courses.
[1]Bautista, E., Chotpitayasunondh, T., Gao, Z., Harper, S.A., Shaw, M., Uyeki, T.M., Zaki, S.R., Hayden, F.G., Hui, D.S., Kettner, J.D., et al., 2010. Clinical aspects of pandemic 2009 influenza A (H1N1) virus infection. N. Engl. J. Med., 362(21):1708-1719.
[2]Bone, R.C., Balk, R.A., Cerra, F.B., Dellinger, R.P., Fein, A.M., Knaus, W.A., Schein, R.M., Sibbald, W.J., 1992. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/ SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest, 101(6):1644-1655.
[3]Cao, B., Li, X.W., Mao, Y., Wang, J., Lu, H.Z., Chen, Y.S., Liang, Z.A., Liang, L., Zhang, S.J., Zhang, B., et al., 2009a. Clinical features of the initial cases of 2009 pandemic influenza A (H1N1) virus infection in China. N. Engl. J. Med., 361(26):2507-2517.
[4]Cao, B., Li, X.W., Shu, Y.L., Jiang, N.J., Chen, S.J., Xu, X.Y., Chen, W., National Influenza A Pandemic (H1N1) 2009 Clinical Investigation Group, 2009b. Clinical and epidemiologic characteristics of 3 early cases of influenza A pandemic (H1N1) virus 2009 infection, People’s Republic of China, 2009. Emerg. Infect. Dis., 15(9):1418-1422.
[5]Centers for Disease Control and Prevention, 2009a. Swine influenza A (H1N1) infection in two children—Southern California, March-April 2009. MMWR Morb. Mortal. Wkly. Rep., 58(15):400-402.
[6]Centers for Disease Control and Prevention, 2009b. Update: infections with a swine-origin influenza A (H1N1) virus—United States and other countries, April 28, 2009. MMWR Morb. Mortal. Wkly. Rep., 58(16):431-433.
[7]Centers for Disease Control and Prevention, 2009c. Outbreak of swine-origin influenza A (H1N1) virus infection— Mexico, March-April 2009. MMWR Morb. Mortal. Wkly. Rep., 58(17):467-470.
[8]Centers for Disease Control and Prevention, 2009d. Swine-origin influenza A (H1N1) virus infections in a school—New York City, April 2009. MMWR Morb. Mortal. Wkly. Rep., 58 (17):470-472.
[9]Centers for Disease Control and Prevention, 2009e. Hospitalized patients with novel influenza A (H1N1) virus infection—California, April-May, 2009. MMWR Morb. Mortal. Wkly. Rep., 58(19):536-541.
[10]Dawood, F.S., Jain, S., Finelli, L., Shaw, M.W., Lindstrom, S., Garten, R.J., Gubareva, L.V., Xu, X., Bridges, C.B., Uyeki, T.M., Novel Swine-Origin Influenza A (H1N1) Virus Investigation Team, 2009. Emergence of a novel swine-origin influenza A (H1N1) virus in humans. N. Engl. J. Med., 360 (25):2605-2615.
[11]Domínguez-Cherit, G., Lapinsky, S.E., Macias, A.E., Pinto, R., Espinosa-Perez, L., de la Torre, A., Poblano-Morales, M., Baltazar-Torres, J.A., Bautista, E., Martinez, A., et al., 2009. Critically ill patients with 2009 influenza A (H1N1) in Mexico. JAMA, 302(17):1880-1887.
[12]Fiore, A.E., Shay, D.K., Broder, K., Iskander, J.K., Uyeki, T.M., Mootrey, G., Bresee, J.S., Cox, N.S., Centers for Disease Control and Prevention (CDC), Advisory Committee on Immunization Practices (ACIP), 2008. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2008. MMWR Recomm. Rep., 57(RR-7):1-60.
[13]Harper, S.A., Bradley, J.S., Englund, J.A., File, T.M., Gravenstein, S., Hayden, F.G., McGeer, A.J., Neuzil, K.M., Pavia, A.T., Tapper, M.L., et al., 2009. Seasonal influenza in adults and children-diagnosis, treatment, chemoprophylaxis, and institutional outbreak management: clinical practice guidelines of the Infectious Diseases Society of America. Clin. Infect. Dis., 48(8):1003-1032.
[14]Iwata, K., Shinya, K., Makino, A., Yoshida, H., Kinoshita, S., Ohji, G., Kato, K., 2010. A case of pandemic 2009 influenza A (H1N1) in a patient with HIV infection. J. Infect. Chemother., 16(4):298-300.
[15]Jamieson, D.J., Honein, M.A., Rasmussen, S.A., Williams, J.L., Swerdlow, D.L., Biggerstaff, M.S., Lindstrom, S., Louie, J.K., Christ, C.M., Bohm, S.R., et al., 2009. H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet, 374(9688):451-458.
[16]Knaus, W.A., Draper, E.A., Wagner, D.P., Zimmerman, J.E., 1985. APACHE II: a severity of disease classification system. Crit. Care Med., 13(10):818-829.
[17]Louie, J.K., Acosta, M., Winter, K., Jean, C., Gavali, S., Schechter, R., Vugia, D., Harriman, K., Matyas, B., Glaser, C.A., et al., 2009. Factors associated with death or hospitalization due to pandemic 2009 influenza A (H1N1) infection in California. JAMA, 302(17):1896-1902.
[18]Louie, J.K., Acosta, M., Jamieson, D.J., Honein, M.A., for the California Pandemic (H1N1) Working Group, 2010. Severe 2009 H1N1 influenza in pregnant and postpartum women in California. N. Engl. J. Med., 362(1):27-35.
[19]Marshall, J.C., Cook, D.J., Christou, N.V., Bernard, G.R., Sprung, C.L., Sibbald, W.J., 1995. Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome. Crit. Care Med., 23(10):1638-1652.
[20]Mu, Y.P., Zhang, Z.Y., Chen, X.R., Xi, X.H., Lu, Y.F., Tang, Y.W., Lu, H.Z., 2010. Clinical features, treatments and prognosis of the initial cases of pandemic influenza H1N1 2009 virus infection in Shanghai China. QJM, 103(5):311-317.
[21]Naffakh, N., van der Werf, S., 2009. April 2009: an outbreak of swine-origin influenza A (H1N1) virus with evidence for human-to-human transmission. Microbes Infect., 11(8-9):725-728.
[22]Rasmussen, S., Jamieson, D., Bresee, J., 2008. Pandemic influenza and pregnant women. Emerg. Infect. Dis., 14(1):95-100.
[23]Schrag, S.J., Shay, D.K., Gershman, K., Thomas, A., Craig, A.S., Schaffner, W., Harrison, L.H., Vugia, D., Clogher, P., Lynfield, R., et al., 2006. Multistate surveillance for laboratory confirmed, influenza-associated hospitalizations in children: 2003–2004. Pediatr. Infect. Dis. J., 25(5):395-400.
[24]Smith, J.R., Ariano, R.E., Toovey, S., 2010. The use of antiviral agents for the management of severe influenza. Crit. Care Med., 38(s4):e43-e51.
[25]The ANZIC Influenza Investigators and Australasian Maternity Outcomes Surveillance System, 2010. Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study. BMJ, 340(mar18 3):c1279.
[26]Thompson, W.W., Shay, D.K., Weintraub, E., Brammer, L., Cox, N., Anderson, L.J., Fukuda, K., 2003. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA, 289(2):179-186.
[27]Thompson, W.W., Shay, D.K., Weintraub, E., Brammer, L., Bridges, C.B., Cox, N.J., Fukuda, K., 2004. Influenza-associated hospitalizations in the United States. JAMA, 292(11):1333-1340.
[28]Tomizuka, T., Takayama, Y., Shobayashi, T., Fukushima, Y., Suzuki, Y., 2010. Underlying medical conditions and hospitalization for pandemic (H1N1) 2009, Japan. Emerg. Infect. Dis., 16(10):1646-1647.
[29]Vincent, J.L., Moreno, R., Takala, J., Willatts, S., de Mendonça, A., Bruining, H., Reinhart, C.K., Suter, P.M., Thijs, L.G., 1996. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med., 22(7):707-710.
[30]World Health Organization, 2009a. CDC Protocol of Realtime RTPCR for Swine Influenza A (H1N1). World Health Organization, Geneva. Available from http://www.who. int/csr/resources/publications/swineflu/CDCrealtimeRTPCRprotocol_20090428.pdf [Accessed on Oct. 26, 2010]
[31]World Health Organization, 2009b. Global Alert and Response (GAR)—Pandemic (H1N1) 2009 Guidance Documents. World Health Organization, Geneva. Available from http://www.who.int/csr/resources/publications/swineflu/en/ [Accessed on Oct. 26, 2010]
[32]World Health Organization, 2009c. Influenza A (H1N1)— Update 14. World Health Organization, Geneva. Available from http://www.who.int/csr/don/2009_05_04a/en/ index.html [Accessed on Oct. 26, 2010]
[33]World Health Organization, 2010. WHO Guidelines for Pharmacological Management of Pandemic Influenza A (H1N1) 2009 and Other Influenza Viruses. World Health Organization, Geneva. Available from http://www.who. int/csr/resources/publications/swineflu/h1n1_use_antivirals_ 20090820/en/index.html [Accessed on Oct. 26, 2010]
[34]Xi, X., Xu, Y., Jiang, L., Li, A., Duan, J., Du, B., Chinese Critical Care Clinical Trial Group, 2010. Hospitalized adult patients with 2009 influenza A (H1N1) in Beijing, China: risk factors for hospital mortality. BMC Infect. Dis., 10:256.
[35]Zheng, Y., He, Y., Deng, J., Lu, Z., Wei, J., Yang, W., Tang, Z., Li, B., Zhang, J., Wang, L., et al., 2011. Hospitalized children with 2009 influenza a (H1N1) infection in Shenzhen, China, November-December 2009. Pediatr. Pulmonol., 46(3):246-252.
Open peer comments: Debate/Discuss/Question/Opinion
<1>