Clinical analysis of the lethal outcomes at influenza, including A (H1N1) pdm09, in pandemic and post-pandemic period (2009–2016)
DOI:
https://doi.org/10.15587/2313-8416.2016.65103Keywords:
А(H1N1) influenza, acute respiratory distress-syndrome, lethal outcome, clinical analysisAbstract
Substantiation. There is a risk of global spread of the A (H1N1) influenza with the probability of high lethality.
Aim. Analysis of the clinical data of patients who died from influenza including А(H1N1)pdm and its complications in 2009/2010 years and in post-pandemic period in the comparative aspect.
Results. Among 32 died patients of the main group were 16 men and 16 women. The group of comparison included 24 patients: 17men and 7 women. At virological examination of all patients RNA of virus of the А(Н1Н1)pdm influenza in nasopharyngeal samples was detected in lifetime by the PCR method in 29 cases (51,7 %), in pulmonary tissue after autopsy – in 25 cases (44,6 %) in nasopharyngeal samples and pulmonary tissue in the same patients in– 12 (21,4 %). Among the main risk factors in patients of the main group the most often observed were obesity – 18 (56,2 %), diabetes in 9 (28,1 % ) patients, pregnancy in 2 trimester – 1 (3,1 % ), pregnancy in 3 trimester – 2 (6,3 %). In the group of comparison obesity was observed in 10 (41,6 %) patients, diabetes mellitus in 1(4,2 %). Streptococcus pneumoniae and Candida albicans were most often isolated from the pulmonary tissue at autopsy by bacteriological method.
Conclusions. In the main group and in the group of comparison prevailed patients of the young and middle age 22 (68,7 %) and 14 (58,3 %) respectively. According to the results of pathomorphologic examination the ARDS was detected in 13 (23,2 %) of all patients included into examination. In the rest 43 died patients influenza was complicated with viral and viral-bacteriological pneumonias. The duration of disease to the lethal outcome development among patients of the main group was 9,67±0,65 days and 9±0,66 days in the group of comparison at absence of the statistically significant difference. In most patients at admission to hospital was decreased the SpO2 level (less than 90 %), and in 14 (25 %) SpO2 was less than 60. The increase of respiratory movements number more than 30 per 1 minute was observed in 39 (69,6 %)patients. No one patient from the control group was vaccinated against influenza
References
Palese, P., Kingsbury, D. W. (Eds.) (1983). Genetic of Influenza Viruses. New York. doi: 10.1007/978-3-7091-8706-7
Taubenberger, J. K., Morens, D. M. (2013). Influenza Viruses: Breaking All the Rules. mBio, 4 (4), e00365–13–e00365–13. doi: 10.1128/mbio.00365-13
Altmann, M., Fiebig, L., Buda, S., von Kries, R., Dehnert, M., Haas, W. (2012). Unchanged Severity of Influenza A(H1N1)pdm09 Infection in Children during First Postpandemic Season. Emerging Infectious Diseases, 18 (11). doi: 10.3201/eid1811.120719
Gradil, G. I., Gubinа-Vakulik, G. I., Tereshin, V. A. et. al (2015). Clinical analysis of lethal cases of the flu A (H1N1) pdm, complicated by pneumonia caused by Klebsiella pneumoniae in the post-pandemic period, against the background of extracorporeal membrane oxygenation. International Journal of Medicine, 21 (4), 72–77.
Gill, J. R., Sheng, Z.-M., Ely, S. F. et. al (2010). Pulmonary Pathologic Findings of Fatal 2009 Pandemic Influenza A/H1N1 Viral Infections. Arch. Pathol. Lab. Med., 134 (2), 235.
Morens, D. M., Taubenberger, J. K., Fauci, A. S. (2008). Predominant Role of Bacterial Pneumonia as a Cause of Death in Pandemic Influenza: Implications for Pandemic Influenza Preparedness. The Journal of Infectious Diseases, 198 (7), 962–970. doi: 10.1086/591708
Cheng, V. C. C., To, K. K. W., Tse, H., Hung, I. F. N., Yuen, K.-Y. (2012). Two Years after Pandemic Influenza A/2009/H1N1: What Have We Learned? Clinical Microbiology Reviews, 25 (2), 223–263. doi: 10.1128/cmr.05012-11
Skalova, H., Povysil, C., Hofmanova, J., Goldova, B., Jaksa, R., Jandova, K., Galko, J. (2012). Histopathological autoptic findings in 8 patients with pandemic influenza A (H1N1) pneumonia. Cesk Patol., 48 (3), 161–164.
Nakajima, N., Sato, Y., Katano, H., Hasegawa, H., Kumasaka, T., Hata, S. et. al (2011). Histopathological and immunohistochemical findings of 20 autopsy cases with 2009 H1N1 virus infection. Modern Pathology, 25 (1), 1–13. doi: 10.1038/modpathol.2011.125
Chernjev, A. L., Zayratyants, O. V., Polyanko, N. I. et. al (2010). Pathological anatomy of influenza A /H1N1/. Arch. pathol., 72 (3), 3–6.
Morens, D. M., Taubenberger, J. K., Fauci, A. S. (2008). Predominant Role of Bacterial Pneumonia as a Cause of Death in Pandemic Influenza: Implications for Pandemic Influenza Preparedness. The Journal of Infectious Diseases, 198 (7), 962–970. doi: 10.1086/591708
Sarmiento, X., Guardiola, J. J., Almirall, J., Mesalles, E., Mate, J. L., Soler, M., Klamburg, J. (2011). Discrepancy between clinical criteria for diagnosing acute respiratory distress syndrome secondary to community acquired pneumonia with autopsy findings of diffuse alveolar damage. Respiratory Medicine, 105 (8), 1170–1175. doi: 10.1016/j.rmed.2011.04.001
Shieh, W.-J., Blau, D. M., Denison, A. M., DeLeon-Carnes, M., Adem, P., Bhatnagar, J. et. al (2010). 2009 Pandemic Influenza A (H1N1). The American Journal of Pathology, 177 (1), 166–175. doi: 10.2353/ajpath.2010.100115
Lee, E. H., Wu, C., Lee, E. U., Stoute, A., Hanson, H., Cook, H. A. et. al (2010). Fatalities Associated with the 2009 H1N1 Influenza A Virus in New York City. Clinical Infectious Diseases, 50 (11), 1498–1504. doi: 10.1086/652446
Centers for Disease Control and Prevention. CDC estimates of 2009 H1N1 influenza cases, hospitalizations and deaths in the United States, April 2009-March 13, 2010 (2010). Centers for Disease Control and Prevention. Available at: http://www.cdc.gov/h1n1flu/estimates/April_March_13.htm
Harper, S. A., Bradley, J. S., Englund, J. A., File, T. M., Gravenstein, S., Hayden, F. G. et. al (2009). Seasonal Influenza in Adults and Children—Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management: Clinical Practice Guidelines of the Infectious Diseases Society of America. Clinical Infectious Diseases, 48 (8), 1003–1032. doi: 10.1086/598513
Acute Respiratory Distress Syndrome (2012). JAMA, 307 (23). doi: 10.1001/jama.2012.5669
Bernard, G. R., Artigas, A., Brigham, K. L., Carlet, J., Falke, K., Hudson, L. et. al (1994). The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. American Journal of Respiratory and Critical Care Medicine, 149 (3), 818–824. doi: 10.1164/ajrccm.149.3.7509706
Jaber, S., Conseil, M., Coisel, Y., Jung, B., Chanques, G. (2010). Grippe A (H1N1) et SDRA: caractéristiques des patients admis en réanimation et prise en charge. Revue de la littérature. Annales Françaises d’Anesthésie et de Réanimation, 29 (2), 117–125. doi: 10.1016/j.annfar.2009.12.026
Standiford, T. J., Ward, P. A. (2016). Therapeutic targeting of acute lung injury and acute respiratory distress syndrome. Translational Research, 167 (1), 183–191. doi: 10.1016/j.trsl.2015.04.015
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