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Complications and outcomes of pandemic 2009 Influenza A (H1N1) virus infection in hospitalized adults: how do they differ from those in seasonal influenza?
- Source :
-
The Journal of infectious diseases [J Infect Dis] 2011 Jun 15; Vol. 203 (12), pp. 1739-47. - Publication Year :
- 2011
-
Abstract
- Background: It is unclear whether pandemic 2009 influenza A (pH1N1) infection caused more significant disease among hospitalized adults than seasonal influenza.<br />Methods: A prospective, observational study was conducted in adults hospitalized with polymerase chain reaction-confirmed pH1N1 infection in 2 acute-care general hospitals from June 2009 to May 2010 (n = 382). Complications and outcomes were described and compared with those in a seasonal influenza cohort (2007-2008, same hospitals; n = 754).<br />Results: Hospitalized patients with pH1N1 influenza were younger than those with seasonal influenza (mean age ± standard deviation, 47 ± 20 vs 70 ± 19 years) and fewer had comorbid conditions (48% vs 64%). The rate of positive immunofluorescence assay results was low (54% vs 84%), and antiviral use was frequent (96% vs 52%). Most patients in both cohorts developed complicated illnesses (67.8% vs 77.1%), but patients with pH1N1 influenza had higher rates of extrapulmonary complications (23% vs 16%; P = .004) and intensive care unit admission and/or death (patient age <35 years, 2.3% vs 0%; 35-65 years, 12.4% vs 3.2%; >65 years, 13.5% vs 8.5%; adjusted odds ratio [OR] 2.13; 95% confidence interval [CI], 1.25-3.62; P = .005). Patients who received antiviral treatment within 96 h after onset had better survival (log-rank test, P < .001). However, without timely treatment, the mortality risk was higher with pH1N1 infection (9.0% vs 5.8% for seasonal influenza; adjusted OR, 6.85; 95% CI, 1.64-28.65; P = .008]. Bacterial superinfection worsened outcomes.<br />Conclusions: Adults hospitalized for pH1N1 influenza had significant complications and mortality despite being younger than patients with seasonal influenza. Antiviral treatment within 96 h may improve survival.
- Subjects :
- Adolescent
Adult
Age Distribution
Aged
Antiviral Agents therapeutic use
China epidemiology
Comorbidity
Female
Hospitalization
Humans
Influenza, Human drug therapy
Influenza, Human mortality
Logistic Models
Male
Middle Aged
Polymerase Chain Reaction
Prospective Studies
Risk Factors
Seasons
Treatment Outcome
Young Adult
Influenza A Virus, H1N1 Subtype isolation & purification
Influenza, Human complications
Influenza, Human epidemiology
Pandemics
Subjects
Details
- Language :
- English
- ISSN :
- 1537-6613
- Volume :
- 203
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- The Journal of infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 21606532
- Full Text :
- https://doi.org/10.1093/infdis/jir187