BACKGROUND: Novel influenza A (H1N1) virus infection has persisted mainly through person-to-person transmission in schools. However, data on critically ill patients infected with H1N1 are currently limited. This study was conducted to investigate the epidemiological characteristics, clinical features, treatment modalities, and clinical outcomes of pediatric patients critically ill with H1N1 infection. METHODS: Subjects included 30 critically ill pediatric patients reported to the Korea Centers for Disease Control and Prevention (KCDC) between June and November 2009. Data were obtained by medical record review and interviews with primary treating physician. RESULTS: Of the 30 patients, 14 died and 16 were discharged from the hospital with complete recovery. The median patient age was 7 years (range, 2 months to 18 years). Nineteen patients belonged to the high-risk group. Cough was the most common initial symptom, followed by fever. In most patients, serum levels of C-reactive protein and lactate dehydrogenase were elevated. Oseltamivir, an antiviral agent, was administered to 29 patients. The most common causes of death were encephalopathy and myocarditis, with a higher mortality rate in the high-risk group. Platelet counts were significantly lower than normal and serum aspartate aminotransferase levels significantly higher in the non-survivors. CONCLUSIONS: The results of this study suggest that Korean high-risk pediatric patients have an elevated mortality rate following infection with novel influenza A (H1N1) virus. Further studies involving high-risk pediatric patients classified using consistent criteria are needed to confirm our results.
BACKGROUND: Novel influenza A (H1N1) virus infection has persisted mainly through person-to-person transmission in schools. However, data on critically ill patients infected with H1N1 are currently limited. This study was conducted to investigate the epidemiological characteristics, clinical features, treatment modalities, and clinical outcomes of pediatric patients critically ill with H1N1infection. METHODS: Subjects included 30 critically ill pediatric patients reported to the Korea Centers for Disease Control and Prevention (KCDC) between June and November 2009. Data were obtained by medical record review and interviews with primary treating physician. RESULTS: Of the 30 patients, 14 died and 16 were discharged from the hospital with complete recovery. The median patient age was 7 years (range, 2 months to 18 years). Nineteen patients belonged to the high-risk group. Cough was the most common initial symptom, followed by fever. In most patients, serum levels of C-reactive protein and lactate dehydrogenase were elevated. Oseltamivir, an antiviral agent, was administered to 29 patients. The most common causes of death were encephalopathy and myocarditis, with a higher mortality rate in the high-risk group. Platelet counts were significantly lower than normal and serum aspartate aminotransferase levels significantly higher in the non-survivors. CONCLUSIONS: The results of this study suggest that Korean high-risk pediatric patients have an elevated mortality rate following infection with novel influenza A (H1N1) virus. Further studies involving high-risk pediatric patients classified using consistent criteria are needed to confirm our results.
Authors: Adrienne G Randolph; Frances Vaughn; Ryan Sullivan; Lewis Rubinson; B Taylor Thompson; Grace Yoon; Elizabeth Smoot; Todd W Rice; Laura L Loftis; Mark Helfaer; Allan Doctor; Matthew Paden; Heidi Flori; Christopher Babbitt; Ana Lia Graciano; Rainer Gedeit; Ronald C Sanders; John S Giuliano; Jerry Zimmerman; Timothy M Uyeki Journal: Pediatrics Date: 2011-11-07 Impact factor: 7.124
Authors: Seok Jeong Kang; Jae Min Lee; Jeong Ok Hah; Ye Jee Shim; Kun Soo Lee; Hyun Jung Shin; Heung Sik Kim; Eun Jin Choi; So Eun Jeon; Young Tak Lim; Ji Kyeong Park; Eun Sil Park Journal: Korean J Pediatr Date: 2011-03-31
Authors: S B Hong; E Y Choi; S H Kim; G Y Suh; M S Park; M G Lee; J Lim; H K Lee; S C Kim; S J Kim; K U Kim; S H Kwak; Y Koh Journal: Epidemiol Infect Date: 2012-08-01 Impact factor: 4.434
Authors: D Braunschweig; P Krakowiak; P Duncanson; R Boyce; R L Hansen; P Ashwood; I Hertz-Picciotto; I N Pessah; J Van de Water Journal: Transl Psychiatry Date: 2013-07-09 Impact factor: 6.222