tetano
Editor, Senior Moderator
Front Cell Infect Microbiol
. 2024 Mar 28:14:1378379.
doi: 10.3389/fcimb.2024.1378379. eCollection 2024. Long-term outcomes of survivors with influenza A H1N1 virus-induced severe pneumonia and ARDS: a single-center prospective cohort study
Xiao Tang[SUP] #[/SUP][SUP] 1 [/SUP], Xiao-Li Xu[SUP] #[/SUP][SUP] 2 [/SUP], Na Wan[SUP] 1 [/SUP], Yu Zhao[SUP] 1 [/SUP], Rui Wang[SUP] 1 [/SUP], Xu-Yan Li[SUP] 1 [/SUP], Ying Li[SUP] 1 [/SUP], Li Wang[SUP] 1 [/SUP], Hai-Chao Li[SUP] 1 [/SUP], Yue Gu[SUP] 1 [/SUP], Chun-Yan Zhang[SUP] 1 [/SUP], Qi Yang[SUP] 2 [/SUP], Zhao-Hui Tong[SUP] 1 [/SUP], Bing Sun[SUP] 1 [/SUP]
Affiliations
Introduction: Systematic evaluation of long-term outcomes in survivors of H1N1 is still lacking. This study aimed to characterize long-term outcomes of severe H1N1-induced pneumonia and acute respiratory distress syndrome (ARDS).
Method: This was a single-center, prospective, cohort study. Survivors were followed up for four times after discharge from intensive care unit (ICU) by lung high-resolution computed tomography (HRCT), pulmonary function assessment, 6-minute walk test (6MWT), and SF-36 instrument.
Result: A total of 60 survivors of H1N1-induced pneumonia and ARDS were followed up for four times. The carbon monoxide at single breath (D[SUB]LCO[/SUB]) of predicted values and the 6MWT results didn't continue improving after 3 months. Health-related quality of life didn't change during the 12 months after ICU discharge. Reticulation or interlobular septal thickening on HRCT did not begin to improve significantly until the 12-month follow-up. The D[SUB]LCO[/SUB] of predicted values showed negative correlation with the severity degree of primary disease and reticulation or interlobular septal thickening, and a positive correlation with physical functioning. The D[SUB]LCO[/SUB] of predicted values and reticulation or interlobular septal thickening both correlated with the highest tidal volume during mechanical ventilation. Levels of fibrogenic cytokines had a positive correlation with reticulation or interlobular septal thickening.
Conclusion: The improvements in pulmonary function and exercise capacity, imaging, and health-related quality of life had different time phase and impact on each other during 12 months of follow-up. Long-term outcomes of pulmonary fibrosis might be related to the lung injury and excessive lung fibroproliferation at the early stage during ICU admission.
Keywords: acute respiratory distress syndrome (ARDS); influenza A (H1N1) virus; pulmonary fibrosis; pulmonary function; severe community-acquired pneumonia (SCAP).
. 2024 Mar 28:14:1378379.
doi: 10.3389/fcimb.2024.1378379. eCollection 2024. Long-term outcomes of survivors with influenza A H1N1 virus-induced severe pneumonia and ARDS: a single-center prospective cohort study
Xiao Tang[SUP] #[/SUP][SUP] 1 [/SUP], Xiao-Li Xu[SUP] #[/SUP][SUP] 2 [/SUP], Na Wan[SUP] 1 [/SUP], Yu Zhao[SUP] 1 [/SUP], Rui Wang[SUP] 1 [/SUP], Xu-Yan Li[SUP] 1 [/SUP], Ying Li[SUP] 1 [/SUP], Li Wang[SUP] 1 [/SUP], Hai-Chao Li[SUP] 1 [/SUP], Yue Gu[SUP] 1 [/SUP], Chun-Yan Zhang[SUP] 1 [/SUP], Qi Yang[SUP] 2 [/SUP], Zhao-Hui Tong[SUP] 1 [/SUP], Bing Sun[SUP] 1 [/SUP]
Affiliations
- PMID: 38606295
- PMCID: PMC11007161
- DOI: 10.3389/fcimb.2024.1378379
Introduction: Systematic evaluation of long-term outcomes in survivors of H1N1 is still lacking. This study aimed to characterize long-term outcomes of severe H1N1-induced pneumonia and acute respiratory distress syndrome (ARDS).
Method: This was a single-center, prospective, cohort study. Survivors were followed up for four times after discharge from intensive care unit (ICU) by lung high-resolution computed tomography (HRCT), pulmonary function assessment, 6-minute walk test (6MWT), and SF-36 instrument.
Result: A total of 60 survivors of H1N1-induced pneumonia and ARDS were followed up for four times. The carbon monoxide at single breath (D[SUB]LCO[/SUB]) of predicted values and the 6MWT results didn't continue improving after 3 months. Health-related quality of life didn't change during the 12 months after ICU discharge. Reticulation or interlobular septal thickening on HRCT did not begin to improve significantly until the 12-month follow-up. The D[SUB]LCO[/SUB] of predicted values showed negative correlation with the severity degree of primary disease and reticulation or interlobular septal thickening, and a positive correlation with physical functioning. The D[SUB]LCO[/SUB] of predicted values and reticulation or interlobular septal thickening both correlated with the highest tidal volume during mechanical ventilation. Levels of fibrogenic cytokines had a positive correlation with reticulation or interlobular septal thickening.
Conclusion: The improvements in pulmonary function and exercise capacity, imaging, and health-related quality of life had different time phase and impact on each other during 12 months of follow-up. Long-term outcomes of pulmonary fibrosis might be related to the lung injury and excessive lung fibroproliferation at the early stage during ICU admission.
Keywords: acute respiratory distress syndrome (ARDS); influenza A (H1N1) virus; pulmonary fibrosis; pulmonary function; severe community-acquired pneumonia (SCAP).