tetano
Editor, Senior Moderator
J Clin Virol. 2013 Jul 2. pii: S1386-6532(13)00205-9. doi: 10.1016/j.jcv.2013.05.025. [Epub ahead of print]
Complications and factors associated with severity of influenza in hospitalized children and adults during the pandemic wave of A(H1N1)pdm2009 infections-The Fluco French cohort.
Ploin D, Chidiac C, Carrat F, Cohen B, Javouhey E, Mayaud C, Desenclos JC, Lina B, Leport C; the Fluco study group.
Source
Urgences et R?animation P?diatrique, H?pital Femme M?re Enfant, Hospices Civils de Lyon, 59 Bd Pinel, 69677 Bron Cedex, France.
Abstract
BACKGROUND:
The emergence of novel A(H1N1)pdm2009 virus threatened to lead to frequent severe manifestations.
OBJECTIVES:
To describe the clinical, virological, and biological characteristics of the disease and identify the factors associated with severe presentations.
STUDY DESIGN:
This prospective multicenter study recruited consecutive hospitalized patients with confirmed A(H1N1)pdm2009 disease. Clinical, virological and biological assessments were carried out at inclusion and 30 days post-inclusion. Disease manifestations were assessed by an adjudication committee using pre-identified definitions of complications and severity scores.
RESULTS:
The study analyzed from November 30th, 2009 to February 8th, 2010, 40 hospitalized patients, 21 children and 19 adults. Eighteen (45%) were considered to have severe presentations. Except age, main characteristics in children and adults did not differ. The majority (18/21) of children and all adults had a respiratory presentation; extra-respiratory manifestations tended to be more frequent in children (12 vs. 6, P=0.10). Two children against 5 adults presented acute respiratory distress syndrome (ARDS, P=0.23), but more children suffered respiratory failure (7 vs. 1, P=0.046) without ARDS. At day 30, one death had occurred in each group. The main factor associated with non-severe presentation was an early (<48h) implementation of oseltamivir treatment (P=0.038).
CONCLUSIONS:
Although the study failed to achieve its main objective, due mainly to the difficulty of carrying a study of this nature in the midst of a pandemic, it allowed the description of a panel of unusual and complicated forms and confirmed the added value of early oseltamivir treatment in limiting severity in hospitalized children and adults.
Copyright ? 2013. Published by Elsevier B.V.
KEYWORDS:
A(H1N1)pdm2009 virus, Complication, Influenza, Pandemic, Severity
PMID:
23829965
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/23829965
Complications and factors associated with severity of influenza in hospitalized children and adults during the pandemic wave of A(H1N1)pdm2009 infections-The Fluco French cohort.
Ploin D, Chidiac C, Carrat F, Cohen B, Javouhey E, Mayaud C, Desenclos JC, Lina B, Leport C; the Fluco study group.
Source
Urgences et R?animation P?diatrique, H?pital Femme M?re Enfant, Hospices Civils de Lyon, 59 Bd Pinel, 69677 Bron Cedex, France.
Abstract
BACKGROUND:
The emergence of novel A(H1N1)pdm2009 virus threatened to lead to frequent severe manifestations.
OBJECTIVES:
To describe the clinical, virological, and biological characteristics of the disease and identify the factors associated with severe presentations.
STUDY DESIGN:
This prospective multicenter study recruited consecutive hospitalized patients with confirmed A(H1N1)pdm2009 disease. Clinical, virological and biological assessments were carried out at inclusion and 30 days post-inclusion. Disease manifestations were assessed by an adjudication committee using pre-identified definitions of complications and severity scores.
RESULTS:
The study analyzed from November 30th, 2009 to February 8th, 2010, 40 hospitalized patients, 21 children and 19 adults. Eighteen (45%) were considered to have severe presentations. Except age, main characteristics in children and adults did not differ. The majority (18/21) of children and all adults had a respiratory presentation; extra-respiratory manifestations tended to be more frequent in children (12 vs. 6, P=0.10). Two children against 5 adults presented acute respiratory distress syndrome (ARDS, P=0.23), but more children suffered respiratory failure (7 vs. 1, P=0.046) without ARDS. At day 30, one death had occurred in each group. The main factor associated with non-severe presentation was an early (<48h) implementation of oseltamivir treatment (P=0.038).
CONCLUSIONS:
Although the study failed to achieve its main objective, due mainly to the difficulty of carrying a study of this nature in the midst of a pandemic, it allowed the description of a panel of unusual and complicated forms and confirmed the added value of early oseltamivir treatment in limiting severity in hospitalized children and adults.
Copyright ? 2013. Published by Elsevier B.V.
KEYWORDS:
A(H1N1)pdm2009 virus, Complication, Influenza, Pandemic, Severity
PMID:
23829965
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/23829965