tetano
Editor, Senior Moderator
Chest. 2010 Sep 23. [Epub ahead of print]
Clinical Features of Pneumonia Caused by Influenza A (H1N1) Virus in Beijing, China.
Bai L, Gu L, Cao B, Zhai XL, Lu M, Lu Y, Liang LR, Zhang L, Gao ZF, Huang KW, Liu YM, Song SF, Wu L, Yin YD, Wang C.
1Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Capital Medical University.
Abstract
Abstract
BACKGROUND: Data on symptoms and radiographic changes in patients with 2009 pandemic influenza A (H1N1) pneumonia during convalescence have not been reported.
METHODS: During October 26, 2009 and January 23, 2010, adult pneumonia patients with laboratory-confirmed or clinically suspected 2009 pandemic influenza A (H1N1) infections were observed for clinical characteristics, high-resolution chest CT and lung function tests changes during acute and 3-month convalescent phases.
RESULTS: Of the 65 cases, the median age was 41 (IQR 28 to 57) years, 60.0% were male and 55.4% had at least one underlying medical condition. Sixty two patients started oseltamivir therapy within a median of 5 days (IQR 4 to 6) from the onset of illness and 31 received intravenous corticosteroids. Acute respiratory distress syndrome developed in 33 patients and 24 were initially treated with noninvasive positive pressure ventilation (NPPV). In this group, NPPV succeeded in 13 (54.2%). Nine patients died at a median of 16 (IQR 10 to 24) days after onset of illness. Multivariate Cox regression identified two independent risk factors for death: progressive dyspnea after resolution of fever (relative risk, 5.852; 95%CI, 1.395 to 24.541; P=0.016) and a higher APACHE II score on presentation (relative risk for each point, 1.312; 95%CI, 1.140 to 1.511; P<0.001). At 3-month follow-up of H1N1 pneumonia survivors, ground-glass opacities were still present although diminished in 85.7% and carbon monoxide diffusing capacity was mildly reduced in 61.5%.
CONCLUSIONS: Ground-glass opacities and decreased diffusing capacity were the main abnormalities observed at 3-month follow-up of H1N1 pneumonia survivors.
PMID: 20864615 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/20864615
Clinical Features of Pneumonia Caused by Influenza A (H1N1) Virus in Beijing, China.
Bai L, Gu L, Cao B, Zhai XL, Lu M, Lu Y, Liang LR, Zhang L, Gao ZF, Huang KW, Liu YM, Song SF, Wu L, Yin YD, Wang C.
1Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Capital Medical University.
Abstract
Abstract
BACKGROUND: Data on symptoms and radiographic changes in patients with 2009 pandemic influenza A (H1N1) pneumonia during convalescence have not been reported.
METHODS: During October 26, 2009 and January 23, 2010, adult pneumonia patients with laboratory-confirmed or clinically suspected 2009 pandemic influenza A (H1N1) infections were observed for clinical characteristics, high-resolution chest CT and lung function tests changes during acute and 3-month convalescent phases.
RESULTS: Of the 65 cases, the median age was 41 (IQR 28 to 57) years, 60.0% were male and 55.4% had at least one underlying medical condition. Sixty two patients started oseltamivir therapy within a median of 5 days (IQR 4 to 6) from the onset of illness and 31 received intravenous corticosteroids. Acute respiratory distress syndrome developed in 33 patients and 24 were initially treated with noninvasive positive pressure ventilation (NPPV). In this group, NPPV succeeded in 13 (54.2%). Nine patients died at a median of 16 (IQR 10 to 24) days after onset of illness. Multivariate Cox regression identified two independent risk factors for death: progressive dyspnea after resolution of fever (relative risk, 5.852; 95%CI, 1.395 to 24.541; P=0.016) and a higher APACHE II score on presentation (relative risk for each point, 1.312; 95%CI, 1.140 to 1.511; P<0.001). At 3-month follow-up of H1N1 pneumonia survivors, ground-glass opacities were still present although diminished in 85.7% and carbon monoxide diffusing capacity was mildly reduced in 61.5%.
CONCLUSIONS: Ground-glass opacities and decreased diffusing capacity were the main abnormalities observed at 3-month follow-up of H1N1 pneumonia survivors.
PMID: 20864615 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/20864615