Factors associated with death in hospitalized pneumonia patients with 2009 H1N1 influenza in Shenyang, China

BMC Infectious Diseases

Research Article

Wen Wang¹  Ying Wen¹  Baocheng Deng¹  Yu Wang¹  Pei Liu¹  Wei Cui¹  Xu Lu¹  Ying Zhou¹  Hongwen Zhao²  Jian Kang² 

[1] Department of Infectious Diseases, the First Affiliated Hospital, China Medical University, Shenyang, China;Department of Respiratory Medicine, the First Affiliated Hospital, China Medical University, Shenyang, China;

关键词: Chronic Obstructive Pulmonary Disease;    Influenza;    Intensive Care Unit Admission;    Antiviral Therapy;    Oseltamivir;   

DOI  :  10.1186/1471-2334-10-145

 received in 2010-01-07, accepted in 2010-05-31,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundDuring the spring of 2009, a pandemic influenza A (H1N1) virus emerged and spread globally. We describe the clinical characteristics and factors associated with the death of patients who were hospitalized with 2009 H1N1 influenza pneumonia in Shenyang, China, from November to December 2009.MethodsWe carried out a retrospective chart review of 68 patients who were hospitalized with pneumonia and confirmed to have 2009 H1N1 virus infection by a real time RT-PCR assay of respiratory specimens.ResultsOf the 68 patients we studied, 30 (44%) were admitted to an intensive care unit and 10 (14.7%) died. The median age of patients was 41 years (range, 18-66), and only one patient was over 65 years of age. The male to female ratio was 2.78:1 (50:18). Of the 68 patients, 23 (34%) had at least one underlying medical condition, 9 (13%) had a cigarette index ≥400 and 22 (32%) were obese. All patients underwent chest radiography on admission and the findings were consistent with pneumonia in all cases. All patients were treated with oseltamivir and treatment was initiated at a median time of seven days after the onset of illness. The laboratory test results indicated lymphopenia, hypoproteinemia and elevated lactic dehydrogenase and C reactive protein levels. Of the 68 patients, 33 (52%) showed a reduction in CD4 T cell counts. Of the 58 patients who survived, 31 (53%) had lymphopenia and 27 recovered from this condition after five days. Of the 10 patients who died, nine (90%) had lymphopenia and only two patients recovered from this condition after five days. Obesity and recovery from lymphopenia after five days were factors associated with death, as determined by multivariate logistic-regression analysis (obesity, odds ratio = 23.06; lymphocytopenia reversion, odds ration = 28.69).ConclusionsDuring the evaluation period in Shenyang, China, 2009 H1N1 influenza caused severe illness requiring hospitalization in 68 patients, 10 (14.7%) of which died. Many of these patients were considered healthy adults and few were elderly (65 years or older). Obesity and lymphopenia, which was not restored after five days of treatment, were factors associated with poor outcomes of 2009 H1N1 influenza infection.

【 授权许可】

Unknown   
© Cui; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.