2009 pandemic Influenza A (H1N1): clinical and laboratory characteristics in pediatric and adult patients and in patients with pulmonary involvement

Abstract

Please cite this paper as: Lee and Liu et al. (2012) 2009 pandemic Influenza A (H1N1): clinical and laboratory characteristics in pediatric and adult patients and in patients with pulmonary involvement. Influenza and Other Respiratory Viruses 6(601), e152–e161. Background To better understand clinical and laboratory characteristics in children, adults, and patients with lung involvement suffering 2009 pandemic influenza A (H1N1). Methods A total of 442 patients with 2009 pandemic influenza A (H1N1) were retrospectively analyzed. Results Comparing to their adult counterpart (n = 55), pediatric patients (n = 387) had significantly higher frequencies of fever, rhinorrhea, cough, sore throat, nausea/vomiting, and longer length of fever; lower frequencies of chest pain and dyspnea; higher incidence of lymphopenia; and lower incidence of elevated serum C‐reactive protein. Among the 227 patients with radiographs available, lung involvement was found in 19 (8·4%) (52·6% consolidation and 47·4% interstitial infiltrations), including 18 children and one adult. One child with lung consolidation died of multiorgan failure. Significant findings in patients with lung involvement included predominant young age (≤10 years), prolonged fever, and delayed oseltamivir therapy (≥48 hours after onset of illness); higher frequencies of dyspnea, nausea/vomiting, and altered consciousness; and higher incidences of leukopenia, elevated serum creative kinase, and lactic dehydrogenase. Conclusions Among patients with 2009 pandemic influenza A (H1N1), we found significant difference in clinical manifestations between children and adults, and significant differences in clinical and laboratory manifestations between patients with lung involvement and those without. On the basis of data from this study and the existing literature, early treatment with oseltamivir is recommended for patients with 2009 pandemic influenza A (H1N1), regardless of age.

Comparison of Clinical Features on Admission Between Coronavirus Disease 2019 and Influenza A among Children: A Retrospective Study in China

“…IA and COVID-19 are two infections sharing similar spectrums of symptoms. In addition, studies have shown that these symptoms occur in similar frequencies in adult IA and COVID-19 patients [3,5,10,13,14]. In this study of pediatric patients, however, COVID-19 caused fewer symptoms in spite of the exclusion of the asymptomatic cases.…”

“…In uenza A (IA) virus and SARS-CoV-2 cause similar symptoms such as fever and cough, especially at the early stages of the disease. However, contrary to COVID-19, studies have shown that IA manifests more symptoms in children than in adult [5]. Therefore, it is necessary to study the symptomological disparities between the two diseases in pediatric patients.…”

Lactate dehydrogenase, an independent risk factor of severe COVID-19 patients: a retrospective and observational study

“…In addition, the serum levels of LDH increased in pneumocystis pneumonia (PcP) patients, probably was due to lung injury [ 13 , 14 ]. Among patients who were infected during the 2009 influenza A (H1N1) pandemic, 77.8% whose laboratory test showed LDH > 225U/L had lung involvement, without differences between adult and children [ 15 ], which indicated that LDH elevation was associated with various pathogens including viruses, and was relevant to lung injury. Furthermore, there was a case reported in 2017 that a patient with human Zika virus infection had markedly elevated LDH, which was associated with 70% mortality in further a Zika-infected animal study.…”

Baseline chest X-ray in coronavirus disease 19 (COVID-19) patients: association with clinical and laboratory data

“…A recent study [19] found that LDH can be recognized as an important predictive factor for severe COVID-19 manifestations. It must be emphasized that during the 2009 influenza A (H1N1) pandemic, 77.8% of patients whose laboratory data indicated elevation of LDH, had lung involvement, suggesting that LDH elevation was associated with multiple pathogenic factors including viruses, and was important to lung injury [20]. In addition, Henry et al [19] recently demonstrated that elevated LDH values were associated with the risk of developing severe disease (sixfold increase) and mortality (16-fold increase).…”