Asthma in patients hospitalized with pandemic influenza A(H1N1)pdm09 virus infection–United States, 2009

McKenna, John J.; Bramley, Anna M.; Skarbinski, Jacek; Fry, Alicia M.; Finelli, Lyn; Jain, Seema

doi:10.1186/1471-2334-13-57

Cited by 39 publications

(39 citation statements)

References 19 publications

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“…These results are consistent with previous studies reporting that one-third of the patients in the United States hospitalized with influenza had asthma [15]. In addition, a recent study by McKenna et al reported an overlap in asthma and chronic obstructive pulmonary disease (COPD) in over 20% of the 50-64-years and 65-years-and-older age groups [15]. However, because these patients are not regularly monitored by spirometer, it is difficult to determine whether they had asthma, COPD, or both asthma and COPD [16].…”

Section: Discussionsupporting

confidence: 93%

Influenza-Related Hospitalizations and Associated Comorbidities in Nebraska: 2007-2011

Han¹,

Gonzalez²,

Chisanga³

et al. 2014

AID

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Objective: Influenza afflicts approximately 5% -20% of the US population annually. Although prevalence statistics are useful, they are insufficient to understand completely influenza on a health care system. This study estimated Nebraska's annual hospitalization and comorbidity rates due to influenza from 2007 to 2011. Methods: Influenza was defined according to ICD-9-CM primary codes beginning with 487 or 488 in hospital discharge records. The comorbidities of patients with influenza were defined according to ICD-9-CM secondary diagnosis codes. Results: The highest yearly age-adjusted hospitalization rates were 30.6 and 31.1 per 100,000 populations for 2008 and 2009, respectively. In 2008, the highest hospitalization rate was among those aged 65 yrs and older; in 2009, the highest rate was among those younger than 5 yrs. Asthma was the most frequent comorbidity overall and among those younger than 50 yrs. Conversely, hypertension and heart failure were the most frequent comorbidities among those aged 50 yrs and older. Conclusion: These findings provide a better understanding of the influenza burden and may contribute to developing more effective influenza prevention strategies.

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Section: Discussionsupporting

confidence: 93%

Influenza-Related Hospitalizations and Associated Comorbidities in Nebraska: 2007-2011

Han¹,

Gonzalez²,

Chisanga³

et al. 2014

AID

View full text Add to dashboard Cite

show abstract

“…This high rate in CF patients compared to the general population (hospitalization rate 7–20%) should be interpreted with caution, though [13]. For medical staff confronted with CF patients experiencing a H1N1 infection, the need for hospitalization was difficult to estimate at the beginning of the pandemic phase due to lack of experience with the clinical course of the disease.…”

Section: Discussionmentioning

confidence: 99%

Influenza A(H1N1)pdm09 and Cystic Fibrosis Lung Disease: A Systematic Meta-Analysis

Renk

Regamey²,

Hartl

2014

PLoS ONE

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BackgroundTo systematically assess the literature published on the clinical impact of Influenza A(H1N1)pdm09 on cystic fibrosis (CF) patients.MethodsAn online search in PUBMED database was conducted. Original articles on CF patients with Influenza A(H1N1)pdm09 infection were included. We analyzed incidence, symptoms, clinical course and treatment.ResultsFour surveys with a total of 202 CF patients infected by Influenza A(H1N1)pdm09 were included. The meta-analysis showed that hospitalisation rates were higher in CF patients compared to the general population. While general disease symptoms were comparable, the clinical course was more severe and case fatality rate (CFR) was higher in CF patients compared to asthmatics and the general population.ConclusionsEvidence so far suggests that CF patients infected with Influenza A(H1N1)pdm09 show increased morbidity and a higher CFR compared to patients with other chronic respiratory diseases and healthy controls. Particularly, CF patients with advanced stage disease seem to be more susceptible to severe lung disease. Accordingly, early antiviral and antibiotic treatment strategies are essential in CF patients. Preventive measures, including vaccination as well as hygiene measures during the influenza season, should be reinforced and improved in CF patients.

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“…Asthma, a complicated disease involving multiple intrinsic and extrinsic parameters, is a major underlying condition associated with respiratory infections. Clear clinical and epidemiological data demonstrate that asthmatics are at high risk of hospitalization during influenza epidemics; however, recent studies show that asthmatics were less likely to die from pH1N1 and suffer less severe symptoms and outcomes once hospitalized 3 , 4 , 5 , 7 , 8 , 9 . As the existing models typically utilize influenza viruses as initiators or exacerbators of asthma in mice, 17 , 18 the question of how the asthmatic hosts’ immune response to influenza differs from that of the normal host has not been previously addressed.…”

Section: Discussionmentioning

confidence: 99%

The immune profile associated with acute allergic asthma accelerates clearance of influenza virus

et al. 2014

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Asthma was the most common comorbidity in hospitalized patients during the 2009 influenza pandemic. For unknown reasons, hospitalized asthmatics had less severe outcomes and were less likely to die from pandemic influenza. Our data with primary human bronchial cells indicate that changes intrinsic to epithelial cells in asthma may protect against cytopathology induced by influenza virus. To further study influenza virus pathogenesis in allergic hosts, we aimed to develop and characterize murine models of asthma and influenza comorbidity to determine structural, physiological and immunological changes induced by influenza in the context of asthma. Aspergillus fumigatus-sensitized and -challenged C57BL/6 mice were infected with pandemic H1N1 influenza virus, either during peak allergic inflammation or during airway remodeling to gain insight into disease pathogenesis. Mice infected with the influenza virus during peak allergic inflammation did not lose body weight and cleared the virus rapidly. These mice exhibited high eosinophilia, preserved airway epithelial cell integrity, increased mucus, reduced interferon response and increased insulin-like growth factor-1. In contrast, weight loss and viral replication kinetics in the mice that were infected during the late airway remodeling phase were equivalent to flu-only controls. These mice had neutrophils in the airways, damaged airway epithelial cells, less mucus production, increased interferons and decreased insulin-like growth factor-1. The state of the allergic airways at the time of influenza virus infection alters host responses against the virus. These murine models of asthma and influenza comorbidity may improve our understanding of the epidemiology and pathogenesis of viral infections in humans with asthma.

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Asthma in patients hospitalized with pandemic influenza A(H1N1)pdm09 virus infection–United States, 2009

Cited by 39 publications

References 19 publications

Influenza-Related Hospitalizations and Associated Comorbidities in Nebraska: 2007-2011

Influenza-Related Hospitalizations and Associated Comorbidities in Nebraska: 2007-2011

Influenza A(H1N1)pdm09 and Cystic Fibrosis Lung Disease: A Systematic Meta-Analysis

The immune profile associated with acute allergic asthma accelerates clearance of influenza virus

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