We compared clinical presentation, complications and outcome in patients with influenza A (H1N1) and seasonal influenza pneumonia.The group of patients with influenza A (H1N1) pneumonia consisted of 75 patients. 52 patients with pneumonia associated with seasonal influenza were included for comparison.Patients with pneumonia associated with novel H1N1 influenza were younger (mean age 39.7 yrs versus 69.6 yrs) and had fewer chronic comorbidities and less alcoholism. Infiltrates were more extensive and frequently interstitial. Respiratory failure was more frequent (those with an arterial oxygen tension/inspiratory oxygen fraction ratio ,200 28% versus 12%, p50.042), leading to a higher rate of intensive care unit (ICU) admission and mechanical ventilation (29.3% versus 7.7% (p,0.0030) and 18.7% versus 2% (p,0.0045)). Mortality was twice as high in patients with novel H1N1 (12% versus 5.8%; p50.238), although this was not significant, and was attributable to pneumonia in most instances (77.8% versus 0%; p50.046).Younger age, fewer comorbidities, more extensive radiographic extension and more severe respiratory compromise, and ICU admissions are key features of the clinical presentation of patients with novel H1N1-associated pneumonia compared with seasonal influenza pneumonia.
The decision to hospitalize a patient with CAP due to 2009 H1N1 influenza should not be based on current CAP severity scores, as they underestimate mortality rates in a significant number of patients. Patients with obesity or wheezing should be considered at an increased risk for mortality.
Introducción: La pandemia de coronavirus, iniciada en Wuhan el 2019, ha trastocado al mundo y afectado profundamente a la actividad quirúrgica al restringir el número de intervenciones en forma dramática, después de los reportes iniciales de mortalidad postoperatoria sobre el 20% en pacientes operados portadores de COVID. El objetivo del presente estudio fue evaluar las cifras de mortalidad quirúrgica, en pacientes intervenidos quirúrgicamente durante la pandemia del COVID-19.Materiales y métodos: Cohorte retrospectiva de pacientes operados entre el 15 de marzo 2020 y el 31 de julio 2020 en un centro universitario. Se evaluó variables clínicas asociadas a la intervención quirúrgica y coinfeccion por SARS-CoV2.Resultados: Se analizaron 344 pacientes quienes presentaron una mortalidad global de 6,1%. Se realizó examen de PCR para COVID a 153 pacientes.Presentaron un riesgo de mortalidad significativo los pacientes: PCR COVID+ (22,7%), p=0,01, portadores de hipertensión arterial (11,6%) p=0,03 y mayores de 60 años (12,4%) p<0,001.No fueron factores estadísticamente significativos de mayor riesgo de mortalidad, las siguientes variables: género, obesidad, diabetes mellitus, patología oncológica, cirugía de urgencia y clasificación de ASA.Al analizar dos subgrupos se observó que los pacientes menores de 60 años COVID negativo presentaron una cifra de mortalidad de 1,26%, versus 36,3% en los mayores de 60 años, COVID positivos (p=0,01).Discusión: Los resultados del presente estudio sugieren que se debe realizar los mayores esfuerzos para descartar la infección por SARS-CoV2 en la evaluación preoperatoria para disminuir los riesgos de mortalidad postoperatoria.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.