Predicting mortality in hospitalized patients with 2009 H1N1 influenza pneumonia

Riquelme, Raúl; Jimenez, Paula Gonzalez; Videla, Alejandro J.; Lopez, Heather P.; Chalmers, James D.; Singanayagam, Aran; Riquelme, Mauricio; Peyrani, Paula; Wiemken, Timothy; Arbo, Guillermo; Benchetrit, Guillermo; Rioseco, María Luisa; Ayesu, Kwabena; Klotchko, Alena; Marzoratti, Lucia; Raya, Mario; Figueroa, Sandra B.; Saavedra, Federico; Pryluka, Daniel; Inzunza, C.; Torres, Antoni; Alvare, P.; Fernández, Patricia; Barros, Maria Itala Otacilia Silva; Gomez, Yessica; Contreras, C.; Rello, Jordi; Bordón, José; Feldman, Charles; Arnold, Forest W.; Nakamatsu, Raul; Riquelme, Jaime A.; Blasi, Francesco; Aliberti, Stefano; Cosentini, Roberto; Lopardo, Gustavo; Gnoni, Martin; Welte, Tobias; Saad, Mustafa; Guardiola, José M.; Ramirez, Julio A.

doi:10.5588/ijtld.10.0539

Cited by 60 publications

(39 citation statements)

References 9 publications

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“…Wheezing is one of the manifestations of asthma and a previous report indicated that wheezing is associated with influenza mortality [16]. In the present study, total 43.8% of subjects presented wheezing and 33.7% presented both pneumonia and wheezing.…”

Section: Discussionsupporting

confidence: 59%

Systemic Corticosteroids and Early Administration of Antiviral Agents for Pneumonia with Acute Wheezing due to Influenza A(H1N1)pdm09 in Japan

et al. 2012

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BackgroundPneumonia patients with wheezing due to influenza A(H1N1)pdm09 were frequently treated with systemic corticosteroids in Japan although systemic corticosteroid for critically ill patients with pneumonia caused by influenza A(H1N1)pdm09 has been controversial. Applicability of systemic corticosteroid treatment needs to be evaluated.Methods/Principal FindingsWe retrospectively reviewed 89 subjects who were diagnosed with influenza A(H1N1)pdm09 and admitted to a national hospital, Tokyo during the pandemic period. The median age of subjects (45 males) was 8 years (range, 0–71). All subjects were treated with antiviral agents and the median time from symptom onset to initiation of antiviral agents was 2 days (range, 0–7). Subjects were classified into four groups: upper respiratory tract infection, wheezing illness, pneumonia with wheezing, and pneumonia without wheezing. The characteristics of each group was evaluated. A history of asthma was found more frequently in the wheezing illness (55.6%) and pneumonia with wheezing (43.3%) groups than in the other two groups (p = 0.017). Corticosteroid treatment was assessed among subjects with pneumonia. Oxygen saturation was lower in subjects receiving corticosteroids (steroid group) than in subjects not receiving corticosteroids (no-steroid group) (p<0.001). The steroid group required greater oxygen supply than the no-steroid group (p<0.001). No significant difference was found by the Kaplan-Meier method between the steroid and the no-steroid groups in hours to fever alleviation from the initiation of antiviral agents and hospitalization days. In logistic regression analysis, wheezing, pneumonia and oxygen saturation were independent factors associated with using systemic corticosteroids.ConclusionPatients with wheezing and a history of asthma were frequently found in the study subjects. Systemic corticosteroids together with early administration of antiviral agents to pneumonia with wheezing and possibly without wheezing did not result in negative clinical outcomes and may prevent progression to severe pneumonia in this study population.

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Section: Discussionsupporting

confidence: 59%

Systemic Corticosteroids and Early Administration of Antiviral Agents for Pneumonia with Acute Wheezing due to Influenza A(H1N1)pdm09 in Japan

et al. 2012

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“…Three of the most common clinical scores-CURB-65, APACHE II, and SOFA-were evaluated, all of which have been used to evaluate the severity of viral and bacterial CAP (15,19,31). Recently, studies demonstrated that CURB-65 is not a good predictor of the severity of pneumonia caused by influenza A (H1N1)pdm09 (29,36). In a previous study, the authors demonstrated that the SOFA score was the best severity predictor in CAP cases, including those patients infected with influenza A (H1N1)pdm09 (32), similar to this study.…”

Section: Discussionmentioning

confidence: 99%

TGF-β Blood Levels Distinguish Between Influenza A (H1N1)pdm09 Virus Sepsis and Sepsis due to Other Forms of Community-Acquired Pneumonia

et al. 2015

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There is a strong interest in finding adequate biomarkers to aid in the diagnosis and prognosis of influenza A (H1N1)pdm09 virus infection. In this study, serum levels of inflammatory cytokines and laboratory markers were evaluated to assess their usefulness as biomarkers of influenza A (H1N1)pdm09 and their association with fatal cases. Serum samples of consecutive patients with a clinical presentation suggestive of influenza A (H1N1)pdm09 and progression to sepsis were evaluated. Serum inflammatory cytokines and routine laboratory tests were performed and correlated with positivity for influenza A (H1N1)pdm09 influenza by real time reverse transcription polymerase chain reaction and the results of three clinical severity scores (Sequential Organ Failure Assessment [SOFA], CURB-65, and Acute Physiology and Chronic Health Evaluation II [APACHE II]). High SOFA scores and some of its individual components, but not CURB-65 or APACHE II scores, correlate with fatal cases regardless of etiology. Total and unconjugated bilirubin, Ca + + , Cl -, prothrombin times, and partial thromboplastin times discriminate influenza A (H1N1)pdm09 from other causes of community-acquired pneumonia.

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“…Notably, in the most recent H1N1 epidemic, cigarette smoking increased the risk for hospitalization in the context of this illness (65), further adding to the clinical relevance of this association. Chronic exposure to alcohol in animal models enhances the severity of influenza infection (35) and has also been associated with the development of seasonal influenza, but not specifically H1N1 (47). Improved understanding of the relationship between smoking, AUDs, and influenza could be important given pneumonia that commonly occurs after primary influenza infections.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary cytokine composition differs in the setting of alcohol use disorders and cigarette smoking

Burnham

Kovacs

Davis

2013

American Journal of Physiology-Lung Cellular and Molecular Phys

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Predicting mortality in hospitalized patients with 2009 H1N1 influenza pneumonia

Cited by 60 publications

References 9 publications

Systemic Corticosteroids and Early Administration of Antiviral Agents for Pneumonia with Acute Wheezing due to Influenza A(H1N1)pdm09 in Japan

Systemic Corticosteroids and Early Administration of Antiviral Agents for Pneumonia with Acute Wheezing due to Influenza A(H1N1)pdm09 in Japan

TGF-β Blood Levels Distinguish Between Influenza A (H1N1)pdm09 Virus Sepsis and Sepsis due to Other Forms of Community-Acquired Pneumonia

Pulmonary cytokine composition differs in the setting of alcohol use disorders and cigarette smoking

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