Is influenza A(H1N1) pneumonia more severe than other community-acquired pneumonias? Results of the GiViTI survey of 155 Italian ICUs

Abstract

This study confirmed the specific features of critically ill A(H1N1) patients (i.e., young age, pregnancy, obesity). The pandemic did not increase ICU workload compared with other periods. A(H1N1) pneumonia did not have a higher risk of death than CAP of different origin among patients admitted to the ICU.

The Intensive Care Global Study on Severe Acute Respiratory Infection (IC-GLOSSARI): a multicenter, multinational, 14-day inception cohort study

“…These patients had considerably higher mortality rates and longer lengths of stay compared to patients without SARI. The in-hospital mortality rate in our cohort was similar to rates reported in patients with severe community-acquired pneumonia in previous studies [17,20,30]. This can be explained by the frequent occurrence of organ failure in these patients.…”

“…Repeated outbreaks of SARI-related epidemics represent a major healthcare problem [1][2][3][4]. Several studies have investigated the epidemiology and clinical characteristics of SARI, with a special emphasis on viral etiology [13][14][15][16][17] or on the subset of patients admitted to the ICU with severe community-acquired pneumonia [17][18][19][20][21][22]. To the best of our knowledge, our study is the first to investigate this issue in a large prospective, multinational cohort of critically ill patients with SARI, providing a global view of this condition worldwide.…”

“…Ortiz and collaborators [32] Hospital 12 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) Limitation of therapy in-hospital, n (%) DNR 72 (11.9) WH/WD 57 (9.4) about 28,000 adults are hospitalized for influenza-associated critical illness in the USA annually. A recent biasadjusted meta-analysis [33] confirmed that influenza vaccine was effective in preventing hospitalization from influenza and/or pneumonia and all-cause mortality in community-dwelling elderly.…”

Recommendations of the Infectious Diseases Work Group (GTEI) of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) and the Infections in Critically Ill Patients Study Group (GEIPC) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) for the diagnosis and treatment of influenza A/H1N1 in seriously ill adults admitted to the Intensive Care Unit

“…The initial clinical picture of influenza A/H1N1 is very similar to that of seasonal influenza or even nonspecific (influenza-like) viral processes. 65,66 Its rapid evolution, with serious respiratory complications, made it necessary among other aspects to investigate which laboratory variables could help quickly identify those patients likely to suffer a poorer clinical course. 67---69 The first studies made in this sense found increased levels of lactate dehydrogenase (LDH) and creatine phosphokinase (CPK) to be more frequent in patients with confirmed influenza A/H1N1 than in those with a negative diagnosis despite the presence of similar clinical manifestations.…”

Unmet Medical Needs in Life‐Threatening Infections – Caring for the Critically Ill

“…The 2009 influenza A (H1N1) pandemic did not significantly affect ICU occupancy rates and, compared with community-acquired pneumonia of other origins, H1N1 pneumonia was associated with the same risk of death when potential confounders were taken into consideration [26]. However, this pandemic more commonly affected young people, many of whom developed severe respiratory failure requiring extracorporeal lung assist support.…”