OBJECTIVE: Pandemic flu has changed the epidemiology of pneumonia, thus challenging the prediction of etiology and outcome. We analyze the risk factors to predict influenza A/H1N1 infection in patients with pneumonia, and the impact of this etiology on mortality during a pandemic period. Differences between pneumonia with or without A/H1N1 coinfection are described. METHODS: Retrospective observational study in 364 consecutive patients hospitalized with pneumonia during the A/H1N1 pandemic flu, April-December 2009. RESULTS: 294 patients (80.5%) had A/H1N1(-) pneumonia, 47 (13.2%) A/H1N1(+) pneumonia, and 23 (6.3%) coinfection. Mortality during hospitalization was 24/294 (8.2%), 8/47 (16.7%), 2/23 (8.7%) respectively. A regression logistic analysis (Area under curve, AUC 0.81) to predict A/H1N1(+) pneumonia identified four independent variables: age < 60 years (Odds ratio, OR 5.9), multilobar infiltrates (OR 7.7), C-reactive protein (CRP) < 10 mg/dL (OR 2.8), and leukopenia < 5000/mm(3) (OR 3.4). Risk factors for in-hospital mortality in the whole group were A/H1N1 (+) etiology and LDH > 600 IU/L (OR 4.1) when adjusting for PSI, and hypoxemia (OR 4.2) when adjusting for CURB 65 (AUC 0.81). Heart disease (OR 27.4) and LDH > 600 IU/L (OR 10.5) were risk factors for in-hospital mortality in A/H1N1(+) patients (AUC 0.81) CONCLUSION: Leukopenia, multilobar infiltrates, CRP<10 mg/dl and age < 60 years were independently associated with A/H1N1(+) etiology. Pandemic A/H1N1(+) increased mortality pneumonia. Heart disease and LDH > 600 were independently associated with mortality in A/H1N1(+) pneumonia.
OBJECTIVE: Pandemic flu has changed the epidemiology of pneumonia, thus challenging the prediction of etiology and outcome. We analyze the risk factors to predict influenza A/H1N1infection in patients with pneumonia, and the impact of this etiology on mortality during a pandemic period. Differences between pneumonia with or without A/H1N1 coinfection are described. METHODS: Retrospective observational study in 364 consecutive patients hospitalized with pneumonia during the A/H1N1 pandemic flu, April-December 2009. RESULTS: 294 patients (80.5%) had A/H1N1(-) pneumonia, 47 (13.2%) A/H1N1(+) pneumonia, and 23 (6.3%) coinfection. Mortality during hospitalization was 24/294 (8.2%), 8/47 (16.7%), 2/23 (8.7%) respectively. A regression logistic analysis (Area under curve, AUC 0.81) to predict A/H1N1(+) pneumonia identified four independent variables: age < 60 years (Odds ratio, OR 5.9), multilobar infiltrates (OR 7.7), C-reactive protein (CRP) < 10 mg/dL (OR 2.8), and leukopenia < 5000/mm(3) (OR 3.4). Risk factors for in-hospital mortality in the whole group were A/H1N1 (+) etiology and LDH > 600 IU/L (OR 4.1) when adjusting for PSI, and hypoxemia (OR 4.2) when adjusting for CURB 65 (AUC 0.81). Heart disease (OR 27.4) and LDH > 600 IU/L (OR 10.5) were risk factors for in-hospital mortality in A/H1N1(+) patients (AUC 0.81) CONCLUSION:Leukopenia, multilobar infiltrates, CRP<10 mg/dl and age < 60 years were independently associated with A/H1N1(+) etiology. Pandemic A/H1N1(+) increased mortality pneumonia. Heart disease and LDH > 600 were independently associated with mortality in A/H1N1(+) pneumonia.
Authors: Romina Abelleira; Alberto Ruano-Ravina; Adriana Lama; Gema Barbeito; María E Toubes; Cristina Domínguez-Antelo; Francisco J González-Barcala; Nuria Rodríguez-Núñez; Pedro J Marcos; María L Pérez Del Molino; Luis Valdés Journal: Can Respir J Date: 2019-03-17 Impact factor: 2.409
Authors: Stella G Muthuri; Sudhir Venkatesan; Puja R Myles; Jo Leonardi-Bee; Wei Shen Lim; Abdullah Al Mamun; Ashish P Anovadiya; Wildo N Araújo; Eduardo Azziz-Baumgartner; Clarisa Báez; Carlos Bantar; Mazen M Barhoush; Matteo Bassetti; Bojana Beovic; Roland Bingisser; Isabelle Bonmarin; Victor H Borja-Aburto; Bin Cao; Jordi Carratala; María R Cuezzo; Justin T Denholm; Samuel R Dominguez; Pericles A D Duarte; Gal Dubnov-Raz; Marcela Echavarria; Sergio Fanella; James Fraser; Zhancheng Gao; Patrick Gérardin; Maddalena Giannella; Sophie Gubbels; Jethro Herberg; Anjarath L Higuera Iglesias; Peter H Hoeger; Matthias Hoffmann; Xiaoyun Hu; Quazi T Islam; Mirela F Jiménez; Amr Kandeel; Gerben Keijzers; Hossein Khalili; Gulam Khandaker; Marian Knight; Gabriela Kusznierz; Ilija Kuzman; Arthur M C Kwan; Idriss Lahlou Amine; Eduard Langenegger; Kamran B Lankarani; Yee-Sin Leo; Rita Linko; Pei Liu; Faris Madanat; Toshie Manabe; Elga Mayo-Montero; Allison McGeer; Ziad A Memish; Gokhan Metan; Dragan Mikić; Kristin G I Mohn; Ahmadreza Moradi; Pagbajabyn Nymadawa; Bulent Ozbay; Mehpare Ozkan; Dhruv Parekh; Mical Paul; Wolfgang Poeppl; Fernando P Polack; Barbara A Rath; Alejandro H Rodríguez; Marilda M Siqueira; Joanna Skręt-Magierło; Ewa Talarek; Julian W Tang; Antoni Torres; Selda H Törün; Dat Tran; Timothy M Uyeki; Annelies van Zwol; Wendy Vaudry; Daiva Velyvyte; Tjasa Vidmar; Paul Zarogoulidis; Jonathan S Nguyen-Van-Tam Journal: Influenza Other Respir Viruses Date: 2016-02-01 Impact factor: 4.380