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Intern Med J. 2019 Nov 10. doi: 10.1111/imj.14685. [Epub ahead of print] Characteristics of H7N9 avian influenza pneumonia: a retrospective analysis of 17 cases.
Yu WQ1,2, Ji NF1, Ding MD2, Gu CJ3, Ma Y1, Wu ZZ1, Wang YL1, Wu CJ1, Dai GH4, Chen Y4, Jin RR4, Tan YB5, Yang Z6, Zhou DM2, Xian JC2, Xu HT2, Huang M1.
Author information
1 Department of Respiratory & Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China. 2 Department of Infectious Diseases, Taizhou People's hospital, Taizhou, 225300, China. 3 Department of Pharmacy, Taizhou People's hospital, Taizhou, 225300, China. 4 Department of Pathology, Taizhou People's hospital, Taizhou, 225300, China. 5 Department of Nuclear Medicine, Taizhou People's hospital, Taizhou, 225300, China. 6 Department of Medical Microbiology and Immunology, Wannan Medical College, No. 22, Wenchang West Road, Yijiang District, Wuhu, Anhui, 241002, China.
Abstract
BACKGROUND:
H7N9 avian influenza is an infection of public health concern, in part because of its high mortality rate and pandemic potential.
OBJECTIVES:
We aimed to describe the clinical features of H7N9 avian influenza and the response to treatment.
METHODS:
Clinical, radiological, and histopathological data, and treatment-related of H7N9-infected patients hospitalized during 2014-2017 were extracted and analyzed.
RESULTS:
A total of 17 H7N9 patients (three females; mean age, 58.4 ? 13.7 years) were identified; of these six died. All patients presented with fever and productive cough; four patients had hemoptysis and 13 had chest distress and/or shortness of breath. Early subnormal white blood cell count and elevation of serum liver enzymes were common. Multilobar patchy shadows, rapid progression to ground-glass opacities, air bronchograms, and consolidation were the most common imaging findings. Histopathological examination of lung tissue of three patients who died showed severe alveolar epithelial cell damage, with inflammatory exudation into the alveolar space and hyaline membrane formation; widened alveolar septae, prominent inflammatory cell infiltration; and hyperplasia of pneumocytes. Viral inclusions were found in the lung tissue of two patients. All patients received antiviral drugs (oseltamivir ? peramivir). Four patients carried the rs12252-C/C IFN-induced transmembrane protein-3 (IFITM3) genotype, while the others had the C/T genotype.
CONCLUSIONS:
H7N9 virus infection causes human influenza-like symptoms, but may rapidly progress to severe pneumonia and even death. Clinicians should be alert to the possibility of H7N9 infection in high-risk patients. The presence of the IFITM3 rs12252-C genotype may predict severe illness. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
PMID: 31707755 DOI: 10.1111/imj.14685