Risk factors for severe complications of the novel influenza A (H1N1): analysis of patients hospitalized in Italy

Bassetti, Matteo; Parisini, Andrea; Calzi, Anna; Pallavicini, Franco M. Bobbio; Cassola, Giovanni; Artioli, Stefania; Anselmo, Marco; Pagano, Gabriella; Rezza, Giovanni; Viscoli, Claudio

doi:10.1111/j.1469-0691.2010.03275.x

Cited by 28 publications

(29 citation statements)

References 6 publications

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“…However, few studies analyzed the epidemiology of pandemic influenza A (H1N1) virus in Italy, and most of them were retrospective or focused only on hospitalized patients [Bassetti et al, 2011]. In the present study, the circulation of pandemic influenza A (H1N1) virus in the adult population during the 2009-2010 respiratory season in Italy was evaluated prospectively through an active surveillance performed at an Emergency Department of a reference hospital.…”

Section: Discussionmentioning

confidence: 99%

“…Studies on the clinical spectrum of pandemic influenza A (H1N1) virus infection focused mainly on hospitalized patients affected by severe complications, sometimes requiring intensive care unit admission [Cao et al, 2009;Dawood et al, 2009;Domínguez-Cherit et al, 2009;Donaldson et al, 2009;Louie et al, 2009;Bassetti et al, 2011]. Little is known about the incidence of pandemic influenza A (H1N1) virus infection in patients seeking medical care for respiratory disease regardless of its severity.…”

Section: Introductionmentioning

confidence: 98%

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Prospective evaluation of epidemiological, clinical, and microbiological features of pandemic influenza A (H1N1) virus infection in Italy

Fabbiani

Sali

Cristo

et al. 2011

Journal of Medical Virology

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Since several characteristics of pandemic influenza A (H1N1) virus infection remain to be determined, this study aimed to describe clinical features and complications of patients infected with H1N1. Subjects affected by influenza-like illnesses and a control group of asymptomatic patients were enrolled prospectively at an Emergency Department from October 2009 to April 2010. At enrollment, clinical data and nasopharyngeal swabs for virological analyses were obtained. Ill subjects were followed until recovery and swabs were collected weekly in patients infected with H1N1. Of 318 patients enrolled, 92 (28.9%) were positive to H1N1. Patients infected with H1N1 were mainly young adults and complained classic influenza-like symptoms. Fever was observed for a median time of 5 (IQR 3-7) days. Hospitalization occurred in 27.7% with 2% requiring intensive care unit admission: median length of hospitalization was 6 days (IQR 5-9). Pneumonia was diagnosed in 19.6% of patients. A similar proportion of lower airways involvement and of clinical complications was observed in subjects testing positive or negative for H1N1. However, patients infected with H1N1 were younger and hospitalized for a shorter period as compared to the control group (P = 0.002 and P = 0.045, respectively). Older age, asthma/chronic obstructive pulmonary disease and hypertension were associated with an increased risk of pneumonia. Viral shedding was observed for at least 1 week in 21.3% of patients. Asymptomatic infection was uncommon (1.1%). Respiratory syndromes caused by H1N1 and factors associated with disease severity were investigated and compared to influenza-like illnesses of other origin. Such findings might contribute to improve clinical and epidemiological management of the disease.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Prospective evaluation of epidemiological, clinical, and microbiological features of pandemic influenza A (H1N1) virus infection in Italy

Fabbiani

Sali

Cristo

et al. 2011

Journal of Medical Virology

View full text Add to dashboard Cite

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“…Th is number varied in some studies [3,[8][9][10][11][12], as did the number of hospitalised patients associated with patient characteristics.…”

Section: Discussionmentioning

confidence: 99%

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

Örnek

Yalçın

Ekin

et al. 2011

Wien Klin Wochenschr

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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.

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“…(24) Although secondary outcomes, such as the frequency of mechanical ventilation requirement and length of hospital stay, were similar to influenza A (H1N1) infection who were admitted to four infectious disease facilities in Liguria. (30) That study included 81 patients, of whom 50% had pneumonia, 12% were admitted to ICU, and 3% died. The authors found that respiratory and neurocognitive impairment was associated with severe disease and death.…”

Section: Resultsmentioning

confidence: 99%

Pneumonia associada a influenza A (H1N1)

et al. 2011

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Objective: To describe the characteristics of patients with influenza A (H1N1)-associated pneumonia treated at two hospitals in the region of Liguria, Italy, as well as to describe their treatment and outcomes. Methods: This was a prospective observational study including all patients older than 16 years of age with a confirmed diagnosis of influenza A (H1N1) who were admitted to Villa Scassi Hospital, in the city of Genoa, Italy, or to the Sestri Levante General Hospital, in the city of Sestri Levante, Italy, between September of 2009 and January of 2010. The primary outcome measure was mortality within 60 days after diagnosis. Secondary outcome measures were the need for mechanical ventilation and the length of hospital stay. Results: Of the 40 patients with a confirmed diagnosis of influenza A (H1N1), 27 presented pneumonia during the study period. The mean age of the 27 patients was 42.8 ± 14.8 years, and the mean length of hospital stay was 11.6 ± 8.2 days. Of the 27 patients, 20 had respiratory failure, 4 underwent invasive mechanical ventilation, and 5 underwent noninvasive ventilation. One patient had comorbidities, developed multiple organ failure, and died. Conclusions: During the influenza A (H1N1) pandemic, the associated mortality rate was lower in Italy than in other countries, and cases reported in the country typically had a milder course than did those reported elsewhere. Nevertheless, 9 of our cases (33%) rapidly evolved to respiratory failure, requiring mechanical ventilation.

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Risk factors for severe complications of the novel influenza A (H1N1): analysis of patients hospitalized in Italy

Cited by 28 publications

References 6 publications

Prospective evaluation of epidemiological, clinical, and microbiological features of pandemic influenza A (H1N1) virus infection in Italy

Prospective evaluation of epidemiological, clinical, and microbiological features of pandemic influenza A (H1N1) virus infection in Italy

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

Pneumonia associada a influenza A (H1N1)

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