Leonardo Martinez1,2, Wei Cheng3, Xiaoxiao Wang3, Feng Ling3, Lan Mu4, Changwei Li1, Xiang Huo5, Mark H Ebell1, Haodi Huang5, Limei Zhu5, Chao Li1, Enfu Chen3, Andreas Handel1, Ye Shen1. 1. Department of Epidemiology and Biostatistics, College of Public Health, Athens. 2. Division of Infectious Diseases and Geographic Medicine, School of Medicine, Stanford University, California. 3. Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China. 4. Department of Geography, University of Georgia, Athens. 5. Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
Abstract
BACKGROUND: Avian influenza A H7N9 (A/H7N9) is characterized by rapid progressive pneumonia and respiratory failure. Mortality among laboratory-confirmed cases is above 30%; however, the clinical course of disease is variable and patients at high risk for death are not well characterized. METHODS: We obtained demographic, clinical, and laboratory information on all A/H7N9 patients in Zhejiang province from China Centers for Disease Control and Prevention electronic databases. Risk factors for death were identified using logistic regression and a risk score was created using regression coefficients from multivariable models. We externally validated this score in an independent cohort from Jiangsu province. RESULTS: Among 305 A/H7N9 patients, 115 (37.7%) died. Four independent predictors of death were identified: older age, diabetes, bilateral lung infection, and neutrophil percentage. We constructed a score with 0-13 points. Mortality rates in low- (0-3), medium- (4-6), and high-risk (7-13) groups were 4.6%, 32.1%, and 62.7% (Ptrend < .0001). In a validation cohort of 111 A/H7N9 patients, 61 (55%) died. Mortality rates in low-, medium-, and high-risk groups were 35.5%, 55.8, and 67.4% (Ptrend = .0063). CONCLUSIONS: We developed and validated a simple-to-use, predictive risk score for clinical use, identifying patients at high mortality risk.
BACKGROUND: Avian influenza A H7N9 (A/H7N9) is characterized by rapid progressive pneumonia and respiratory failure. Mortality among laboratory-confirmed cases is above 30%; however, the clinical course of disease is variable and patients at high risk for death are not well characterized. METHODS: We obtained demographic, clinical, and laboratory information on all A/H7N9patients in Zhejiang province from China Centers for Disease Control and Prevention electronic databases. Risk factors for death were identified using logistic regression and a risk score was created using regression coefficients from multivariable models. We externally validated this score in an independent cohort from Jiangsu province. RESULTS: Among 305 A/H7N9patients, 115 (37.7%) died. Four independent predictors of death were identified: older age, diabetes, bilateral lung infection, and neutrophil percentage. We constructed a score with 0-13 points. Mortality rates in low- (0-3), medium- (4-6), and high-risk (7-13) groups were 4.6%, 32.1%, and 62.7% (Ptrend < .0001). In a validation cohort of 111 A/H7N9patients, 61 (55%) died. Mortality rates in low-, medium-, and high-risk groups were 35.5%, 55.8, and 67.4% (Ptrend = .0063). CONCLUSIONS: We developed and validated a simple-to-use, predictive risk score for clinical use, identifying patients at high mortality risk.
Authors: Mickael Gette; Sara Fernandes; Marion Marlinge; Marine Duranjou; Wijayanto Adi; Maelle Dambo; Pierre Simeone; Pierre Michelet; Nicolas Bruder; Regis Guieu; Julien Fromonot Journal: Biomedicines Date: 2021-05-18
Authors: N Habibi; S Uddin; F Al-Salameen; S Al-Amad; V Kumar; M Al-Otaibi; N Abdul Razzack; A Shajan; F Shirshikar Journal: Indoor Air Date: 2021-06-14 Impact factor: 6.554
Authors: Fabio Tagliabue; Daniele Schena; Luca Galassi; Matteo Magni; Guglielmo Guerrazzi; Andrea Acerbis; Christina Rinallo; Daniel Longhi; Alberto Ronzani; Pierpaolo Mariani Journal: SN Compr Clin Med Date: 2021-06-18