Predictors of Mortality in Hospitalized Children with Pandemic H1N1 Influenza 2009 in Pune, India

Kinikar, Aarti; Kulkarni, Anjali; Valvi, Chhaya; Mave, Vidya; Gupte, Nikhil; Khadse, Sandhya; Bhardwaj, Renu; Kagal, Anju; Puranik, Shaila C.; Gupta, Amita; Bollinger, Robert C.; Jamkar, Arun

doi:10.1007/s12098-011-0578-7

Cited by 18 publications

(19 citation statements)

References 11 publications

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“…Estimates ranged from 0% to 50% (97% of the estimates) for the hospitalization ICU risk. The highest overall estimates were reported in 4 studies from Germany, India, and Iran, with estimates of 53%-96% (16,(18)(19)(20).…”

Section: Resultsmentioning

confidence: 91%

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Hospitalization Fatality Risk of Influenza A(H1N1)pdm09: A Systematic Review and Meta-Analysis

Wong¹,

Kelly²,

Cheung³

et al. 2015

Am. J. Epidemiol.

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During the 2009 influenza pandemic, uncertainty surrounding the severity of human infections with the influenza A(H1N1)pdm09 virus hindered the calibration of the early public health response. The case fatality risk was widely used to assess severity, but another underexplored and potentially more immediate measure is the hospitalization fatality risk (HFR), defined as the probability of death among H1N1pdm09 cases who required hospitalization for medical reasons. In this review, we searched for relevant studies published in MEDLINE (PubMed) and EMBASE between April 1, 2009, and January 9, 2014. Crude estimates of the HFR ranged from 0% to 52%, with higher estimates from tertiary-care referral hospitals in countries with a lower gross domestic product, but in wealthy countries the estimate was 1%-3% in all settings. Point estimates increased substantially with age and with lower gross domestic product. Early in the next pandemic, estimation of a standardized HFR may provide a picture of the severity of infection, particularly if it is presented in comparison with a similarly standardized HFR for seasonal influenza in the same setting.

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Section: Resultsmentioning

confidence: 91%

“…The highest overall HFR estimate (52%) was found in a study conducted at a referral hospital in India (15). When estimates were stratified by age, the highest HFRs for children, adults, and the elderly were 16%, 68%, and 33% respectively, all in India (15)(16)(17).…”

Section: Resultsmentioning

confidence: 95%

Hospitalization Fatality Risk of Influenza A(H1N1)pdm09: A Systematic Review and Meta-Analysis

Wong¹,

Kelly²,

Cheung³

et al. 2015

Am. J. Epidemiol.

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“…In another pediatric study in India, Kinikar et al reported that 18% of patients hospitalized with confirmed influenza A (H1N1) virus developed ARDS (24). In this study, 9 of the 15 children who died were found to have histologic pulmonary findings reflective of ARDS at autopsy.…”

Section: Epidemiology Of Rsv and Influenza-induced Ardsmentioning

confidence: 99%

“…Perhaps the most widely used, oseltamivir results in a significant decrease in duration of symptoms as well as severity of illness with early treatment (<48 h of symptoms) (142). Use of oseltamivir in severe cases of influenza A (H1N1) has become standard practice (24, 143), although some studies have shown increased resistance (144). Randolph et al conducted a retrospective study of 838 children admitted to the PICU with confirmed influenza A (H1N1) infection (145).…”

Section: Treatment Options Available For Rsv and Influenza A (H1n1) Vmentioning

confidence: 99%

Viral Infection in the Development and Progression of Pediatric Acute Respiratory Distress Syndrome

2016

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Viral infections are an important cause of pediatric acute respiratory distress syndrome (ARDS). Numerous viruses, including respiratory syncytial virus (RSV) and influenza A (H1N1) virus, have been implicated in the progression of pneumonia to ARDS; yet the incidence of progression is unknown. Despite acute and chronic morbidity associated with respiratory viral infections, particularly in “at risk” populations, treatment options are limited. Thus, with few exceptions, care is symptomatic. In addition, mortality rates for viral-related ARDS have yet to be determined. This review outlines what is known about ARDS secondary to viral infections including the epidemiology, the pathophysiology, and diagnosis. In addition, emerging treatment options to prevent infection, and to decrease disease burden will be outlined. We focused on RSV and influenza A (H1N1) viral-induced ARDS, as these are the most common viruses leading to pediatric ARDS, and have specific prophylactic and definitive treatment options.

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“…Of the 2,321 references screened, 23 studies were included in the final analysis ( Figure 1). Fourteen studies were case-control studies [15,[31][32][33][34][35][36][37][38][39][40][41][42][43], and nine studies were cohort studies [44][45][46][47][48][49][50][51][52]. In total, 6,105 subjects were analyzed, with 4,700 subjects in case-control studies and 1,405 subjects in cohort studies.…”

Section: Study Characteristicsmentioning

confidence: 99%

Do corticosteroids reduce the mortality of influenza A (H1N1) infection? A meta-analysis

et al. 2015

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IntroductionCorticosteroids are used empirically in influenza A (H1N1) treatment despite lack of clear evidence for effective treatment. This study aims to assess the efficacy of corticosteroids treatment for H1N1 infection.MethodsSystematic review and meta-analysis were used to estimate the efficacy of corticosteroids for the prevention of mortality in H1N1 infection. Databases searched included MEDLINE, EMBASE, PubMed, Cochrane Central Register of Controlled Clinical Trials and so on, and bibliographies of retrieved articles, from April 2009 to October 2014. We included both cohort studies and case-control studies reported in English or Chinese that compared treatment effects between corticosteroids and non-corticosteroids therapy in inpatients with H1N1 virus infection. Cohort studies employed mortality as outcome, and case-control studies employed deaths as cases and survivors as controls; both were assessed in this meta-analysis.ResultsIn total twenty-three eligible studies were included. Both cohort studies (nine studies, n = 1,405) and case-control studies (14 studies, n = 4,700) showed a similar trend toward increased mortality (cohort studies relative risk was 1.85 with 95% confidence interval (CI) 1.46 to 2.33; case-control studies odds ratio was 4.22 with 95% CI 3.10 to 5.76). The results from both subgroup analyses and sensitive analyses were consistent with each other, showing that steroid treatment is associated with mortality. However, considering the fact that corticosteroids were tend to be used in sickest case-patients and heterogeneity was observed between studies, we cannot make a solid conclusion.ConclusionsAvailable evidence did not support the use of corticosteroids as standard care for patients with severe influenza. We conclude that further research is required.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-015-0764-5) contains supplementary material, which is available to authorized users.

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Predictors of Mortality in Hospitalized Children with Pandemic H1N1 Influenza 2009 in Pune, India

Abstract: Hypoxia, ARDS and use of corticosteroids in children with ARDS who were mechanically ventilated were the factors associated with increased odds of mortality. Necropsy also suggested bacterial co-infection as a risk factor.

Cited by 18 publications

References 11 publications

Hospitalization Fatality Risk of Influenza A(H1N1)pdm09: A Systematic Review and Meta-Analysis

Hospitalization Fatality Risk of Influenza A(H1N1)pdm09: A Systematic Review and Meta-Analysis

Viral Infection in the Development and Progression of Pediatric Acute Respiratory Distress Syndrome

Do corticosteroids reduce the mortality of influenza A (H1N1) infection? A meta-analysis

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