Pneumonia in patients with novel influenza A (H1N1) virus in Southeastern Turkey

Abstract

The objective of this study was to describe the clinical characteristics and the radiological and laboratory findings of the hospitalised patients who had novel, laboratory-confirmed, swine-origin influenza A virus (S-OIV) infection with pneumonia. Between October and December 2009, 56 patients hospitalised for pneumonia who were tested for S-OIV infection were retrospectively evaluated. Thirty-three patients had positive S-OIV infections. In addition, 23 of the 56 patients who had negative test results for S-OIV infection were compared with the positive group. The mortality rate amongst the patients with S-OIV infection was 24.2%. Of the 33 patients, 42.4% had at least one underlying medical condition and 4 (12%) patients were pregnant or postpartum. Fourteen patients (42.4%) with S-OIV infection were followed up in an intensive care unit. The most common symptom was dyspnea. The mean peak body temperature during hospital stay (39.42 ± 0.70) was higher in this group than in the negative group (38.51 ± 1.05) (p = 0.001). Thrombocytopenia, increased creatine kinase and elevated lactate dehydrogenase levels were statistically significant. Bilateral infiltration was more common in the patients with S-OIV infection. Although some laboratory, radiological and clinical data show a significant difference between the patients with S-OIV pneumonia and the negative group, each patient presenting with signs of pneumonia during pandemia should be tested for Influenza A.

Clinical Factors Predictive of Pneumonia Caused by Pandemic 2009 H1N1 Influenza Virus

“…10,11 In our study, both factors were not associated with pneumonia. Compared with results of a previous study, 1 we found positive and negative independent predictors for pneumonia caused by H1N1 virus.…”

Mortality and severity related factors during the admission: H1N1 pneumonia

“…The WHO's writing committee report supports that the young and middle-aged people have been frequently affected by the H1N1 viruses (1). Similar to our study, most of the studies have shown that H1N1 pneumonia can be more severe among the young and middle-aged people (1)(2)(3)(18)(19)(20). In our study, 24% of the mortality cases consisted of patients aged 44 years or less than 44 years.…”

“…This result suggests that the symptom of restlessness reflects the severity of pneumonia or ARDS as a simple physical examination finding during the admission. During the admission, the normal or belownormal counts of leukocytes together with lymphocytopenia, elevations in levels of serum AST, LDH, CK, and creatinine have been reported among the patients having severe H1N1 pneumonia (1,2,9,(18)(19)(20)(21). Similarly, among our patients, there was a significant elevation in the levels of serum LDH, CK, CK-MB, CRP AST, ALT in addition to the slight increase in the counts of leukocyte.…”

“…On the contrary with our study, Indavarapu et al (25) reported that NLR lower than 2 is related to the presence of H1N1 infection at the moment of admission. The H1N1 pneumonia can be accompanied by bacterial infections (1)(2)(3)(17)(18)(19)21,26). Furthermore, it has reported that the risk of mortality increases due to bacterial co-infections (1).…”

Occurrence of AH1N1 viral infection and clinical features in symptomatic patients who received medical care during the 2009 influenza pandemic in Central Mexico

“…Very few clinical features might be relatively specific to flu viral infections [27,46,47], such as the presence of clear rhinorrhea that relates to the hemmagglutinin inhibiting effect on the surface glycoproteins that protect the respiratory tract cilia [4]. Respiratory diseases caused by influenza and parainfluenza viruses, adenoviruses or syncytial respiratory virus usually produce similar unspecific clinical symptomatology, characterized by fever, chills, malaise, headache, myalgia or cough [48].…”