Clinical characteristics of children and adults hospitalized for influenza virus infection

Leung, Chiang-Hsiang; Tseng, Hsiang-Kuang; Wang, Weisheng; Chiang, Hsiu-Tzy; Wu, Alice Ying-Jung; Liu, Chang-Pan

doi:10.1016/j.jmii.2013.06.002

Cited by 42 publications

(36 citation statements)

References 23 publications

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“…Our data support this finding, in that, among the proven cases of influenza virus, 49.2% had CAP, 25.8% had SAS with acute pneumonia, and up to 50% of patients had signs of respiratory distress. Neurological, hemodynamic, and cardiovascular complications have also previously been described in the context of severe infections that have been complicated by influenza [ 27 , 28 ]; in the present study, 12% of patients with influenza had hemodynamic disorders and 6% had neurological disorders. Some of the sepsis-like events that were observed in the group with hemodynamic failure could be related to frequent bacterial superinfection, which has been described in such patients [ 29 ].…”

Section: Discussionsupporting

confidence: 74%

Influenza virus infections among patients attending emergency department according to main reason to presenting to ED: A 3-year prospective observational study during seasonal epidemic periods

Casalino¹,

Antoniol²,

Fidouh³

et al. 2017

PLoS ONE

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ObjectiveThe role of influenza virus in patients presenting at ED during seasonal-epidemic periods has not previously been specified. Our objective was to determine its frequency according to clinical presentation.MethodsThis is a prospective observational study conducted during three-consecutive seasonal Influenza epidemics (2013–2015), including patients presenting i) community-acquired pneumonia (CAP); ii) severe acute symptoms (SAS): respiratory failure (RF), hemodynamic failure (HF), cardiac failure (CF), and miscellaneous symptoms (M); iii) symptoms suggesting influenza (PSSI). Patients were tested for influenza using specific PCR on naso-pharyngeal swabs.ResultsOf 1,239 patients, virological samples were taken from 784 (63.3%), 213 (27.2%) of whom were positive for the influenza virus: CAP 52/177 (29.4%), SAS 115/447 (25.7%) and PSSI 46/160 (28.8%) (p = 0.6). In the SAS group positivity rates were: RF 76/263 (28.9%), HF 5/29 (17.2%), CF 15/68 (22.1%), and M 19/87 (21.8%) (p = 0.3). Among the major diagnostic categories, the influenza virus positivity rates were: asthma 60/231 (26%), acute exacerbation of chronic obstructive pulmonary disease 18/86 (20.9%), HIV 5/21 (23.8%) and cardiac failure 33/131 (25.2%). The positivity of the samples has not been associated (p>0.1) nor the presence of signs of severity or admission rate in medical ward nor intensive care unit.ConclusionsOur results indicate that during seasonal influenza epidemics, Influenza virus-positivity rate is similar in patients attending ED for influenza-compatible clinical features, patients with acute symptoms including pneumonia, respiratory, hemodynamic and cardiac distress, and patients presenting for acute decompensation of chronic respiratory and cardiac diseases.

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Section: Discussionsupporting

confidence: 74%

Influenza virus infections among patients attending emergency department according to main reason to presenting to ED: A 3-year prospective observational study during seasonal epidemic periods

Casalino¹,

Antoniol²,

Fidouh³

et al. 2017

PLoS ONE

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“…The mean body temperature between the group of survived and deceased patients showed no statistically significant correlation (38.7 ± 0.7 vs 38.4+ 0.8) p = ns. The other clinical symptoms that were analyzed did not differ among themselves in the group of survived patients and those that died, although the latter group complained on cough, dizziness, dyspnea and chest pain [23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Lethal Outcome in Patients with Severe Form of Influenza

Cvetanovska¹,

Milenkovik²,

Uroshevik³

et al. 2016

Prilozi

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Introduction: Clinical manifestations of influenza range from relatively mild and self-limiting respiratory infections to severe clinical manifestations with significant morbidity and mortality. The awareness of predictive indicators for the lethal outcome of influenza is of particular significance in making timely and exact decision for adequate treatment. The aim of this study was to identify the factors in patients with a severe form of influenza, resulting in lethal outcome. Materials and methods:The investigation was a prospective group comparison conducted at the University Clinic for Infectious Diseases in Skopje, R. Macedonia in the period from January 01, 2012 to January 01, 2015. The study included adult patients with a severe form of influenza who were further categorized into a group of either survived patients or a group of deceased patients. Demographic, clinical and biochemical data were noted in all patients included in the study on admission. The variables of the univariate analysis that showed a significant difference in terms of the outcome were used for creating multivariate logistic and regression analysis of the outcome as dependent factors. The independent predictors for lethal outcome in severe cases of influenza were identified by using logistic regression. Results: The study included 87 patients with a severe form of clinical and laboratory confirmed influenza. The patients were divided in two groups: survived (n = 75) and deceased (n = 75). The overall mortality was 13.79%. Multivariate analysis conducted on admission to hospital identified cardiovascular comorbid diseases (p = 0.014), urea values higher than 8.3 U/L (p = 0.045) and SAPS score (p = 0.048) as independent predictors of the outcome in patients with severe form of influenza. Influenza patients with cardiovascular diseases had 2.024 times greater risk of death from influenza in comparison to the patients having influenza without history of such a disease (OR = 2.024 95% CI 1.842-17.337). Patients with serum urea values higher than 8.3 U/L had 1.89 times higher chance of death compared to patients with normal values (OR = 1.89 95% CI 1.091-11.432). The increase of the SAPS score in one point increased the chance of death in patients with influenza by 1.2% (OR = 1.12 95% CI 1.01-2.976). The ROC analysis indicated that cardiovascular diseases, increased urea values and SAPS score in combination act as a good prognostic model for the fatal outcome. The global authenticity of this predictive model to foresee lethal outcome amounts to 80%, sensitivity being 82%, and specificity 70%. Conclusion: Cardiovascular diseases, increased values of urea over 8.3 mmol/l and SAPS score are independent predictive indicators for lethal outcome in severe influenza. Early identification of the outcome predictors in patients with severe influenza will allow implementation of adequate medical treatment and will contribute to decreasing of mortality in patients with severe form of influenza.

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“…The effects of concurrent infections on testing results, especially on cytokines and acute reaction proteins, should be considered. Concurrent infections may aggravate autoimmune disease by innate immunity, and may lead to immediate changes in acute reaction proteins (74). After treatment, the change in antibody levels might introduce slight variation in antibody positivity and antibody levels.…”

Section: Quantitative Traits In Myasthenia Gravis (Mg): Endophenotypementioning

confidence: 99%

Precision medicine in myasthenia graves: begin from the data precision

Hong

Xie

et al. 2016

Ann. Transl. Med.

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Myasthenia gravis (MG) is a prototypic autoimmune disease with overt clinical and immunological heterogeneity. The data of MG is far from individually precise now, partially due to the rarity and heterogeneity of this disease. In this review, we provide the basic insights of MG data precision, including onset age, presenting symptoms, generalization, thymus status, pathogenic autoantibodies, muscle involvement, severity and response to treatment based on references and our previous studies. Subgroups and quantitative traits of MG are discussed in the sense of data precision. The role of disease registries and scientific bases of precise analysis are also discussed to ensure better collection and analysis of MG data.

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Clinical characteristics of children and adults hospitalized for influenza virus infection

Cited by 42 publications

References 23 publications

Influenza virus infections among patients attending emergency department according to main reason to presenting to ED: A 3-year prospective observational study during seasonal epidemic periods

Influenza virus infections among patients attending emergency department according to main reason to presenting to ED: A 3-year prospective observational study during seasonal epidemic periods

Factors Associated with Lethal Outcome in Patients with Severe Form of Influenza

Precision medicine in myasthenia graves: begin from the data precision

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