Severe virus influenza A H1N1 related pneumonia and community-acquired pneumonia: differences in the evolution

Abstract

ObjectiveTo analyze the clinical, laboratory and evolution data of patients with severe influenza A H1N1 pneumonia and compare the data with that of patients with severe community-acquired bacterial pneumonia. MethodsCohort and retrospective study. All patients admitted to the intensive care unit between May 2009 and December 2010 with a diagnosis of severe pneumonia caused by the influenza A H1N1 virus were included in the study. Thirty patients with severe community-acquired pneumonia admitted within the same period were used as a control group. Severe community-acquired pneumonia was defined as the presence of at least one major severity criteria (ventilator or vasopressor use) or two minor criteria. ResultsThe data of 45 patients were evaluated. Of these patients, 15 were infected with H1N1. When compared to the group with community-acquired pneumonia, patients from the H1N1 group had significantly lower leukocyte counts on admission (6,728±4,070 versus 16,038±7,863; p<0.05) and lower C-reactive protein levels (Day 2: 15.1±8.1 versus 22.1±10.9 mg/dL; p<0.05). The PaO2/FiO2 ratio values were lower in the first week in patients with H1N1. Patients who did not survive the H1N1 severe pneumonia had significantly higher levels of C-reactive protein and higher serum creatinine levels compared with patients who survived. The mortality rate was significantly higher in the H1N1 group than in the control group (53% versus 20%; p=0.056, respectivelly). ConclusionDifferences in the leukocyte count, C-reactive protein concentrations and oxygenation profiles may contribute to the diagnosis and prognosis of patients with severe influenza A H1N1 virus-related pneumonia and community-acquired pneumonia.

Characteristics of influenza pneumonia patients admitted to the ICU due to hypoxemic respiratory failure

“…Pregnancy was present in one patient and she was underwent C/S in the ICU. obesity which has bMI > 30, pregnancy, and diabetes mellitus were the most frequently seen comorbid conditions (2,(10)(11)(12). Contrary to the literature, obesity was not seen as a risk factor in this study.…”

“…Mortality rates among these patients admitted to ICU were reported around 16-41% and most of these patients need invasive ventilatory support (2,17,10). In this study survival rate was found 78% at patients who had NIV success while Teke et al reported this data as 92% (12).…”

“…Since 2009 different types of influenza virus have been detected which led to pneumonia with hypoxemic respiratory failure (1). Many of these patients may require mechanical ventilation and intensive care unit (ICU) support (2). Although non-invasive ventilation (NIV) is increasingly used in hypoxemic respiratory failure many of these patients still may need intubation (3)(4)(5).…”

Circulating rather than alveolar extracellular DNA levels predict outcomes in influenza: a cohort study

“…All patients were confirmed to be positive for H1N1 infection by real-time PCR analysis of nasopharyngeal swabs. According to the diagnostic criteria for severe influenza described as previous reports [25,29], 30 patients were diagnosed with severe illness, and 27 of them underwent bronchoalveolar lavage within 7 days post admission to ICU. The healthy control BALF were collected the unilateral healthy lung from 12 patients with benign lung nodules or unilateral pulmonary hemorrhage.…”

Effectiveness of the Influenza Vaccine in Preventing Hospitalizations of Patients with Influenza Community-Acquired Pneumonia

“…Although many national and international investigators and organizations report annual estimates of influenza vaccine effectiveness for prevention of influenza infection in the community, few studies report estimates for the prevention of hospitalizations due to influenza-CAP, the most severe form of the infection [11][12][13].…”