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Indian J Med Microbiol . Characteristics and Outcomes of Critically ill Patients with Influenza A (H1N1) in the Western Balkans during the 2019 Post-Pandemic Season

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  • Indian J Med Microbiol . Characteristics and Outcomes of Critically ill Patients with Influenza A (H1N1) in the Western Balkans during the 2019 Post-Pandemic Season


    Indian J Med Microbiol


    . Jul-Dec 2020;38(3-4):415-420.
    doi: 10.4103/ijmm.IJMM_20_169. Epub 2020 Dec 2.
    Characteristics and Outcomes of Critically ill Patients with Influenza A (H1N1) in the Western Balkans during the 2019 Post-Pandemic Season


    Pedja Kovacevic 1 , Jovan Matijasevic 2 , Sasa Dragic 3 , Biljana Zlojutro 3 , Srdjan Gavrilovic 2 , Milka Jandric 3 , Ana Andrijevic 2 , Tijana Kovacevic 4 , Vladimir Carapic 2 , Maja Travar 5 , Ljubisa Preradovic 6 , Danica Momcicevic 3



    Affiliations

    Abstract

    Background: This study looked at the characteristics and outcomes of critically ill patients with confirmed influenza A (H1N1) pdm09 infection in the Western Balkans in the post-pandemic period.
    Materials and methods: This retrospective observational study of medical records and associated data collected during the post-pandemic period included all mechanically ventilated adult patients of two university-affiliated hospitals of the Western Balkans between 1 January and 31 March 2019 who had influenza A (H1N1) pdm09 infection confirmed by real-time reverse transcriptase-polymerase chain reaction from nasopharyngeal swab specimens and respiratory secretions.
    Results: The study included 89 patients, 49 males (55.1%), aged 56.09 ? 12.64 years. The median time from shift from hospital time to intensive care unit was 1 day (range: 1-2). In the post-pandemic period, cases observed in this study were found to have the following comorbidities: cardiovascular diseases in 44 (49.4%) patients and diabetes in 21 (23.6%) patients. Thirty-one patients (34.8%) in this study were obese. All 89 patients (100%) experienced some degree of acute respiratory distress syndrome, and 39 (44%) had multiorgan failure. Eighty-three patients (93%) were intubated and mechanically ventilated, 6 (7%) received non-invasive mechanical ventilation, 12 (13%) were treated with vvECMO and 36 (40%) received renal replacement therapy. Vasoactive support was needed by 56 (63%) patients. The median duration of mechanical ventilation was 9 (6-15.5) days. The hospital mortality rate was 44%.
    Conclusion: Critically ill patients with confirmed influenza A (H1N1) pdm09 infection in the post-pandemic season were older, required vasoactive drugs more often, and there was a trend of higher survival compared to H1N1 infection patients in the previous pandemic seasons.

    Keywords: Acute respiratory distress syndrome; influenza A (H1N1) pdm09; mechanical ventilation; outcome.

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