Tweet
Respirology. 2010 Oct 14. doi: 10.1111/j.1440-1843.2010.01874.x. [Epub ahead of print]
Severe pandemic (H1N1)v influenza A infection: Report on the first deaths in Spain.
Martin-Loeches I, Rodriguez A, Bonastre J, Zaragoza R, Sierra R, Marques A, Juli?-Narvaez J, Diaz E, Rello J; the H1N1 SEMICYUC working group.
Critical Care Department, Joan XXIII University Hospital, University Rovira i Virgili, IISPV, CIBER Enfermedades Respiratorias (CIBERes) Tarragona, Critical Care Department, La Fe University Hospital, Valencia, Critical Care Department, Dr Peset University Hospital, Valencia, Critical Care Department, Puerta del Mar University Hospital, C?diz, Critical Care Department, La Ribera University Hospital, Valencia, Critical Care Department, Infanta Cristina University Hospital, Badajoz, Critical Care Department, Vall d'Hebron University Hospital, Institut de Recerca Vall d'Hebron, CIBER Enfermedades Respiratorias (CIBERes), Universitat Aut?noma de Barcelona, Barcelona, Spain and the H1N1 SEMICYUC working group, whose names are listed at the end of the manuscript*
Abstract
SUMMARY AT A GLANCE: The impact of pandemic (H1N1)v influenza A infection is still unknown but it is associated with a high case-fatality rate. This prospective, observational, multi-centre study conducted in 144 Spanish intensive care units, summarizes the clinical characteristics of the first 131 patients who died during the initial wave of infection. ABSTRACT: Background and objective: The impact of pandemic influenza A (H1N1)v infection is still unknown but it is associated with a high case-fatality rate. Methods: This was a prospective, observational, multi-centre study conducted in 144 Spanish intensive care units (ICU). Demographic and clinical data were reviewed for all cases of pandemic influenza A (H1N1)v infection reported from June 23, 2009 through February 11, 2010 and confirmed by reverse transcriptase PCR assay. Results: Out of 872 cases reported by statewide surveillance, data for the first 131 deceased patients were analyzed. Thirty-seven patients (28.2%) died within the first 14 days. The median age of these patients was 46 years (interquartile range 35-58) and 60.3% were males. Twenty-eight patients (21.4%) did not present with any comorbidities on admission. Forty-six percent of patients were reported to be obese and 22 (16.8%) had COPD. The vast majority of the patients (72.5%) had viral pneumonia; 95.4% of these had bilateral patchy alveolar opacities (predominantly basal), affecting three or four quadrants. One hundred and fifteen patients (87.8%) developed multiple organ dysfunction syndrome. Ninety-seven patients (74%) required vasopressor drugs, 37 (27.2%) received renal replacement therapy and 47 (35.1%) received intravenous corticosteroids on admission to the ICU. Only 68 patients (51.9%) received empirical antiviral treatment. Conclusions: One third of patients with pandemic influenza A (H1N1)v infection died within the first two weeks and these were young patients, with rapidly progressive viral pneumonia as the primary cause of admission. Obese patients were at high risk but one in four patients did not present with any risk factors on admission. Only half the patients received empirical antiviral therapy and this was administered late.
? 2010 The Authors. Respirology ? 2010 Asian Pacific Society of Respirology.
PMID: 20946335 [PubMed - as supplied by publisher]
Severe pandemic (H1N1)v influenza A infection: Report on the first deaths in Spain.
Martin-Loeches I, Rodriguez A, Bonastre J, Zaragoza R, Sierra R, Marques A, Juli?-Narvaez J, Diaz E, Rello J; the H1N1 SEMICYUC working group.
Critical Care Department, Joan XXIII University Hospital, University Rovira i Virgili, IISPV, CIBER Enfermedades Respiratorias (CIBERes) Tarragona, Critical Care Department, La Fe University Hospital, Valencia, Critical Care Department, Dr Peset University Hospital, Valencia, Critical Care Department, Puerta del Mar University Hospital, C?diz, Critical Care Department, La Ribera University Hospital, Valencia, Critical Care Department, Infanta Cristina University Hospital, Badajoz, Critical Care Department, Vall d'Hebron University Hospital, Institut de Recerca Vall d'Hebron, CIBER Enfermedades Respiratorias (CIBERes), Universitat Aut?noma de Barcelona, Barcelona, Spain and the H1N1 SEMICYUC working group, whose names are listed at the end of the manuscript*
Abstract
SUMMARY AT A GLANCE: The impact of pandemic (H1N1)v influenza A infection is still unknown but it is associated with a high case-fatality rate. This prospective, observational, multi-centre study conducted in 144 Spanish intensive care units, summarizes the clinical characteristics of the first 131 patients who died during the initial wave of infection. ABSTRACT: Background and objective: The impact of pandemic influenza A (H1N1)v infection is still unknown but it is associated with a high case-fatality rate. Methods: This was a prospective, observational, multi-centre study conducted in 144 Spanish intensive care units (ICU). Demographic and clinical data were reviewed for all cases of pandemic influenza A (H1N1)v infection reported from June 23, 2009 through February 11, 2010 and confirmed by reverse transcriptase PCR assay. Results: Out of 872 cases reported by statewide surveillance, data for the first 131 deceased patients were analyzed. Thirty-seven patients (28.2%) died within the first 14 days. The median age of these patients was 46 years (interquartile range 35-58) and 60.3% were males. Twenty-eight patients (21.4%) did not present with any comorbidities on admission. Forty-six percent of patients were reported to be obese and 22 (16.8%) had COPD. The vast majority of the patients (72.5%) had viral pneumonia; 95.4% of these had bilateral patchy alveolar opacities (predominantly basal), affecting three or four quadrants. One hundred and fifteen patients (87.8%) developed multiple organ dysfunction syndrome. Ninety-seven patients (74%) required vasopressor drugs, 37 (27.2%) received renal replacement therapy and 47 (35.1%) received intravenous corticosteroids on admission to the ICU. Only 68 patients (51.9%) received empirical antiviral treatment. Conclusions: One third of patients with pandemic influenza A (H1N1)v infection died within the first two weeks and these were young patients, with rapidly progressive viral pneumonia as the primary cause of admission. Obese patients were at high risk but one in four patients did not present with any risk factors on admission. Only half the patients received empirical antiviral therapy and this was administered late.
? 2010 The Authors. Respirology ? 2010 Asian Pacific Society of Respirology.
PMID: 20946335 [PubMed - as supplied by publisher]
