Full Text:   <3296>

CLC number: R511.7

On-line Access: 2011-12-30

Received: 2011-05-23

Revision Accepted: 2011-10-27

Crosschecked: 2011-12-14

Cited: 2

Clicked: 7293

Citations:  Bibtex RefMan EndNote GB/T7714

-   Go to

Article info.
1. Reference List
Open peer comments

Journal of Zhejiang University SCIENCE B 2012 Vol.13 No.1 P.49-55

http://doi.org/10.1631/jzus.B1100168


Clinical characteristics of critical patients with pandemic influenza A (H1N1) virus infection in Chengdu, China


Author(s):  Li-hui Deng, Yi-lan Zeng, Ping Feng, Ya-ling Liu, Li-chun Wang, Yun Bai, Hong Tang

Affiliation(s):  Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, China, Division of Infectious Diseases, State Key Laboratory of Biotherapy, Sichuan University, Chengdu 610041, China, Chengdu Infectious Disease Hospital, Chengdu 610041, China

Corresponding email(s):   htang6198@hotmail.com

Key Words:  Critical illness, H1N1, Infection, Influenza A virus, Mortality


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.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[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>

Please provide your name, email address and a comment





Journal of Zhejiang University-SCIENCE, 38 Zheda Road, Hangzhou 310027, China
Tel: +86-571-87952783; E-mail: cjzhang@zju.edu.cn
Copyright © 2000 - 2024 Journal of Zhejiang University-SCIENCE