Severe H1N1 2009 influenza infection in adults: the French experience

Abstract

Le registre Reva-Grippe-SRLF a permis de colliger les données de 562 patients infectés par le virus grippal H1N1 2009 et hospitalisés en réanimation. La mortalité globale de ces patients a été de 20 %. Le recours à la ventilation invasive, l'insuffisance cardiaque, l'immunodépres-sion étaient associés à la mortalité. Trois cent quarante et un (82 %) des 417 patients ventilés présentaient un syndrome de détresse respiratoire aiguë (SDRA). Cent soixante-neuf (30 %) présentaient une co-infection bacté-rienne. La corticothérapie était associée à une surmortalité chez les patients atteints de SDRA. Le taux d'occupation lié aux patients grippés a franchi le seuil de 15 % dans de nombreux services de réanimation. Pour citer cette revue : Réanimation 20 (2011).Mots clés Grippe · H1N1 · Pandémie · Pneumonie · Réanimation · Syndrome de détresse respiratoire aiguë · Corticoïdes · Ventilation mécanique Abstract The REVA-Flu-SRLF register allowed collection of data from 562 patients infected with H1N1 influenza virus 2009 and hospitalized in the intensive care unit (ICU). The overall mortality of these patients was 20%. The use of invasive ventilation, heart failure, and immunosuppression were associated with mortality. Three hundred forty-one (82%) among the 417 mechanically ventilated patients had an acute respiratory distress syndrome (ARDS). One hundred sixty-nine (30%) had a bacterial co-infection. Corticosteroid therapy was associated with an increased mortality in patients with ARDS. The occupancy rate associated with influenza patients crossed the threshold of 15% in many ICUs. To cite this journal: Réanimation 20 (2011).

Bacterial Pulmonary Co-Infections on ICU Admission: Comparison in Patients with SARS-CoV-2 and Influenza Acute Respiratory Failure: A Multicentre Cohort Study

“…In comparison, patients with SARS-CoV-2 pneumonia had more GNB co-infections; the causal agents isolated were, in descending order of frequency, Enterobacteriaceae and Haemophilus spp. Such results were in agreement with previous findings that in influenza pneumonia, the two bacteria most frequently identified were first S. Pneumoniae and then S. aureus with average rates of 40% and 20%, respectively [ 1 , 2 , 24 ]. In SARS-CoV-2 pneumonia, S aureus was more frequently prevalent than S. pneumoniae , accounting for 30% vs. 20% of documented co-infections [ 4 , 9 , 10 , 16 ]; other major etiologic agents of co-infections were Haemophilus in more than 10% of the cases [ 4 , 9 , 13 , 15 ] and Enterobacter spp.…”

“…However, the results of these reviews should be cautiously interpreted due to the great heterogeneity of the studies. In contrast, an increased risk of mortality was observed for respiratory bacterial co-infection in patients admitted to an ICU with severe influenza pneumonia [ 2 ]. For instance, Rice et al reported that co-infections due to S. aureus were associated with an increased risk of death [ 24 ].…”

“…Respiratory co-infection on admission in patients with influenza pneumonia is known to be frequent—from 19% to 47% depending on the study [ 1 , 2 , 3 ]. Such co-infections are also reported to be associated with an added risk of mortality, which varies according to the type of documented pathogen and the presence of co-morbidities [ 2 ] ( Table S1 ).…”