Influenza A(H1N1)pdm09-related pneumonia and other complications

Abstract

Influenza A(H1N1)pdm09 virus infection was associated with significant morbidity, mainly among children and young adults. The majority of patients had self-limited mild-to-moderate uncomplicated disease. However, some patients developed severe illness and some died. In addition to respiratory complications, several complications due to direct and indirect effects on other body systems were associated with influenza A(H1N1)pdm09 virus infection. The main complications reported in hospitalized adults with influenza A(H1N1)pdm09 were pneumonia (primary influenza pneumonia and concomitant/secondary bacterial pneumonia), exacerbations of chronic pulmonary diseases (mainly chronic obstructive pulmonary disease and asthma), the need for intensive unit care admission (including mechanical ventilation, acute respiratory distress syndrome and septic shock), nosocomial infections and acute cardiac events. In experimentally infected animals, the level of pulmonary replication of the influenza A(H1N1)pdm09 virus was higher than that of seasonal influenza viruses. Pathological studies in autopsy specimens indicated that the influenza A(H1N1)pdm09 virus mainly targeted the lower respiratory tract, resulting in diffuse alveolar damage (edema, hyaline membranes, inflammation, and fibrosis), manifested clinically by severe acute respiratory distress syndrome with refractory hypoxemia. Influenza A(H1N1)pdm09-related pneumonia and other complications were associated with increased morbidity and mortality among hospitalized patients.

Influenza A Virus Reassortment Is Limited by Anatomical Compartmentalization following Coinfection via Distinct Routes

“…In addition to host factors, viral characteristics can increase the likelihood of LRT infection. In both animal models and natural human infection, the 2009 pandemic strain has exhibited a greater propensity for growth in the LRT than seasonal IAVs (17,(21)(22)(23)(24). In addition, zoonotic IAVs derived from avian hosts may favor the LRT over upper respiratory tract sites (25)(26)(27)(28)(29).…”

Saved by the pump: Two successful resuscitations utilising emergency department-initiated extracorporeal cardiopulmonary resuscitation in South Africa

“…[4] Since 2009, its use has gained renewed interest, mostly because the H1N1 epidemic has resulted in large numbers of patients with acute respiratory distress syndrome requiring more advanced modes of oxygenation than just mechanical ventilation. [5] Improved technology allowed bedside implementation, resulting in an overall safer, simpler intervention, with fewer complications and avoiding the need for a dedicated ECMO specialist or perfusionist to look after the ECMO circuit. In 2009, a UK-based multicentre randomised controlled trial studying the efficacy and economic assessment of conventional ventilatory support v. extracorporeal membrane oxygenation for severe adult respiratory failure, known as the CESAR trial, provided the first piece of evidence supporting the use of extracorporeal life support (ECLS) in respiratory failure.…”

The morphologic characteristic of the inner organs lesion in the acute respiratory distress syndrome of the viral and bacterial etiology

“…Таким образом, вирусная пневмония была выявлена у 44 человек (29,1%), вирусно-бактериальная -в 99 наблюдениях (65,6%) и в 8 случаях (5,3%) возбудитель не был идентифицирован. Обращает на себя внимание более частое развитие бактериальной коинфекции на фоне вирусной пневмонии (в 65,6% случаев) по сравнению с данными других авторов [15,16,17].…”