Asthma in patients hospitalized with pandemic influenza A(H1N1)pdm09 virus infection–United States, 2009

BMC Infectious Diseases

Seema Jain¹  Lyn Finelli¹  Alicia M Fry¹  Jacek Skarbinski¹  Anna M Bramley¹  John J McKenna² 

[1] Influenza Division, Centers for Disease Control and Prevention Atlanta, Atlanta, GA, USA;Present address: 1929 Huxley St., Madison, WI, 53704, USA

关键词: H1N1pdm09;    ICU;    Hospitalization;    Influenza A virus;    Asthma;   

Others  :  1158459
DOI  :  10.1186/1471-2334-13-57

 received in 2012-08-23, accepted in 2013-01-29,  发布年份 2013

【 摘 要 】

Background

Asthma was the most common co-morbidity among patients hospitalized with pandemic influenza A(H1N1)pdm09 [pH1N1] infection. The objective was to compare characteristics of hospitalized pH1N1 patients with and without asthma and assess factors associated with severity among asthma patients.

Methods

Patient data were derived from two 2009 pandemic case-series of U.S. pH1N1 hospitalizations. A case was defined as a person ≥ 2 years old hospitalized with laboratory-confirmed pH1N1. Asthma status was determined through chart review.

Results

Among 473 cases, 29% had asthma. Persons with asthma were more likely to be 2–17 years old (39% vs. 30%, p = 0.04) and black (29% vs. 18%, p < 0.01), and have chronic obstructive pulmonary disease (13% vs. 9%, p = 0.04) but less likely to have pneumonia (37% vs. 47%, p = 0.05), need mechanical ventilation (13% vs. 23%, p = 0.02), and die (4% vs. 10%, p = 0.04) than those without asthma. Among patients with asthma, those admitted to an intensive care unit (ICU) or who died (n = 38) compared with survivors not admitted to an ICU (n = 99) were more likely to have pneumonia on admission (60% vs. 27%, p < 0.01) or acute respiratory distress syndrome (24% vs. 0%, p < 0.01) and less likely to receive influenza antiviral agents ≤ 2 days of admission (73% vs. 92%, p = 0.02).

Conclusions

The majority of persons with asthma had an uncomplicated course; however, severe disease, including ICU admission and death, occurred in asthma patients who presented with pneumonia. Influenza antiviral agents should be started early in hospitalized patients with suspected influenza, including those with asthma.

【 授权许可】

   
2013 McKenna et al; licensee BioMed Central Ltd.

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