Long-term clinical prognosis of human infections with avian influenza A(H7N9) viruses in China after hospitalization

[tetano]

EClinicalMedicine. 2020 Feb 19;20:100282. doi: 10.1016/j.eclinm.2020.100282. eCollection 2020 Mar.
Long-term clinical prognosis of human infections with avian influenza A(H7N9) viruses in China after hospitalization.


Wang Q¹, Jiang H^2,3,4, Xie Y⁵, Zhang T⁵, Liu S⁶, Wu S⁷, Sun Q⁸, Song S⁹, Wang W¹, Deng X¹, Ren L¹, Qin T¹⁰, Horby P¹¹, Uyeki T¹², Yu H¹.

Author information




Abstract

Background:

Mainland China has experienced five epidemics of human cases of avian influenza A(H7N9) virus infection since 2013. We conducted a prospective study to assess long-term clinical, pulmonary function testing, and chest computed tomography (CT) imaging findings after patients were discharged from hospital.
Methods:

A(H7N9) survivors in five provinces and one municipality underwent follow-up visits from August 2013 to September 2018, at three, six, and 12 months after illness onset, and a subset was also assessed at 18 and 64 months after onset. Thirteen patients were enrolled from the first A(H7N9) epidemic in 2013, 36 from the 2013-2014 second epidemic, and 12 from the 2016-2017 fifth epidemic. At each visit, A(H7N9) survivors received a medical examination, including the mMRC (modified Medical Research Council) dyspnea scale assessment, chest auscultation, pulmonary function testing and chest CT scans.
Findings:

The median age of 61 A(H7N9) survivors was 50 years. The cumulative rate of pulmonary dysfunction was 38?5% and 78?2% for chest CT scan abnormalities at the end of follow-up. Restrictive ventilation dysfunction was common during follow-up. Mild dyspnea was documented at three to 12-month follow-up visits.
Interpretation:

Patients who survived severe illness from A(H7N9) virus infection had evidence of persistent lung damage and long-term pulmonary dysfunction.
Funding:

National Science Fund for Distinguished Young Scholars (grant number 81525023); Program of Shanghai Academic/Technology Research Leader (grant number 18XD1400300); National Science and Technology Major Project of China (grant numbers 2017ZX10103009-005, 2018ZX10201001-010).
? 2020 Published by Elsevier Ltd.



KEYWORDS:

CT scan; CT, computed tomography; DLCO, diffusion capacity of carbon monoxide; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; Follow-up; GGO, ground-glass opacity; H7N9 subtype; ICU, intensive care unit; IQR, interquartile range; Prognosis; RT-PCR, reverse transcriptase polymerase chain reaction; Respiratory function tests; SD, standard deviation; SPSS, Statistical Package for Social Sciences; WHO, World Health Organization; mMRC, modified Medical Research Council


PMID:32300739PMCID:PMC7152818DOI:10.1016/j.eclinm.2020.100282
Free PMC Article