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Characteristics and outcomes of critically ill patients with influenza A (H1N1) in the Western Balkans during the 2019 post-pandemic season
Indian Journal of Medical Microbiology ( IF 1.4 ) Pub Date : 2020-07-01 , DOI: 10.4103/ijmm.ijmm_20_169 Pedja Kovacevic 1 , Jovan Matijasevic 2 , Sasa Dragic 3 , Biljana Zlojutro 3 , Srdjan Gavrilovic 2 , Milka Jandric 3 , Ana Andrijevic 2 , Tijana Kovacevic 4 , Vladimir Carapic 2 , Maja Travar 5 , Ljubisa Preradovic 6 , Danica Momcicevic 3
Background: This study looked at the characteristics and outcomes of critically ill patients with confirmed influenza A (H1N1) pdm09 infection in the Western Balkans in the post-pandemic period. Materials and Methods: This retrospective observational study of medical records and associated data collected during the post-pandemic period included all mechanically ventilated adult patients of two university-affiliated hospitals of the Western Balkans between 1 January and 31 March 2019 who had influenza A (H1N1) pdm09 infection confirmed by real-time reverse transcriptase-polymerase chain reaction from nasopharyngeal swab specimens and respiratory secretions. Results: The study included 89 patients, 49 males (55.1%), aged 56.09 ± 12.64 years. The median time from shift from hospital time to intensive care unit was 1 day (range: 1–2). In the post-pandemic period, cases observed in this study were found to have the following comorbidities: cardiovascular diseases in 44 (49.4%) patients and diabetes in 21 (23.6%) patients. Thirty-one patients (34.8%) in this study were obese. All 89 patients (100%) experienced some degree of acute respiratory distress syndrome, and 39 (44%) had multiorgan failure. Eighty-three patients (93%) were intubated and mechanically ventilated, 6 (7%) received non-invasive mechanical ventilation, 12 (13%) were treated with vvECMO and 36 (40%) received renal replacement therapy. Vasoactive support was needed by 56 (63%) patients. The median duration of mechanical ventilation was 9 (6–15.5) days. The hospital mortality rate was 44%. Conclusion: Critically ill patients with confirmed influenza A (H1N1) pdm09 infection in the post-pandemic season were older, required vasoactive drugs more often, and there was a trend of higher survival compared to H1N1 infection patients in the previous pandemic seasons.
中文翻译：
2019年大流行后季节西巴尔干地区甲型H1N1流感危重患者的特征和结果
背景：本研究调查了大流行后时期西巴尔干地区确诊感染甲型 H1N1 pdm09 流感的危重患者的特征和结果。材）通过鼻咽拭子标本和呼吸道分泌物的实时逆转录酶-聚合酶链反应证实pdm09感染。结果：该研究包括 89 名患者，其中 49 名男性（55.1%），年龄 56.09 ± 12.64 岁。从住院转入重症监护室的中位时间为 1 天（范围：1-2）。在大流行后时期，本研究中观察到的病例发现有以下合并症：44 例（49.4%）患者患有心血管疾病，21 例（23.6%）患者患有糖尿病。本研究中有 31 名患者 (34.8%) 肥胖。所有 89 名患者（100%）都经历了某种程度的急性呼吸窘迫综合征，其中 39 名患者（44%）患有多器官衰竭。 83 名患者 (93%) 接受插管和机械通气，6 名患者 (7%) 接受无创机械通气，12 名患者 (13%) 接受 vvECMO 治疗，36 名患者 (40%) 接受肾脏替代治疗。 56 名 (63%) 患者需要血管活性支持。机械通气的中位持续时间为 9 (6–15.5) 天。医院死亡率为44%。 结论：与前一个流行季节的H1N1感染患者相比，后流行季节确诊的甲型H1N1流感pdm09感染的危重患者年龄较大，需要更多的血管活性药物，且生存率有更高的趋势。
更新日期：2020-07-01
Indian Journal of Medical Microbiology ( IF 1.4 ) Pub Date : 2020-07-01 , DOI: 10.4103/ijmm.ijmm_20_169 Pedja Kovacevic 1 , Jovan Matijasevic 2 , Sasa Dragic 3 , Biljana Zlojutro 3 , Srdjan Gavrilovic 2 , Milka Jandric 3 , Ana Andrijevic 2 , Tijana Kovacevic 4 , Vladimir Carapic 2 , Maja Travar 5 , Ljubisa Preradovic 6 , Danica Momcicevic 3
Affiliation
Background: This study looked at the characteristics and outcomes of critically ill patients with confirmed influenza A (H1N1) pdm09 infection in the Western Balkans in the post-pandemic period. Materials and Methods: This retrospective observational study of medical records and associated data collected during the post-pandemic period included all mechanically ventilated adult patients of two university-affiliated hospitals of the Western Balkans between 1 January and 31 March 2019 who had influenza A (H1N1) pdm09 infection confirmed by real-time reverse transcriptase-polymerase chain reaction from nasopharyngeal swab specimens and respiratory secretions. Results: The study included 89 patients, 49 males (55.1%), aged 56.09 ± 12.64 years. The median time from shift from hospital time to intensive care unit was 1 day (range: 1–2). In the post-pandemic period, cases observed in this study were found to have the following comorbidities: cardiovascular diseases in 44 (49.4%) patients and diabetes in 21 (23.6%) patients. Thirty-one patients (34.8%) in this study were obese. All 89 patients (100%) experienced some degree of acute respiratory distress syndrome, and 39 (44%) had multiorgan failure. Eighty-three patients (93%) were intubated and mechanically ventilated, 6 (7%) received non-invasive mechanical ventilation, 12 (13%) were treated with vvECMO and 36 (40%) received renal replacement therapy. Vasoactive support was needed by 56 (63%) patients. The median duration of mechanical ventilation was 9 (6–15.5) days. The hospital mortality rate was 44%. Conclusion: Critically ill patients with confirmed influenza A (H1N1) pdm09 infection in the post-pandemic season were older, required vasoactive drugs more often, and there was a trend of higher survival compared to H1N1 infection patients in the previous pandemic seasons.
中文翻译：
2019年大流行后季节西巴尔干地区甲型H1N1流感危重患者的特征和结果
背景：本研究调查了大流行后时期西巴尔干地区确诊感染甲型 H1N1 pdm09 流感的危重患者的特征和结果。材）通过鼻咽拭子标本和呼吸道分泌物的实时逆转录酶-聚合酶链反应证实pdm09感染。结果：该研究包括 89 名患者，其中 49 名男性（55.1%），年龄 56.09 ± 12.64 岁。从住院转入重症监护室的中位时间为 1 天（范围：1-2）。在大流行后时期，本研究中观察到的病例发现有以下合并症：44 例（49.4%）患者患有心血管疾病，21 例（23.6%）患者患有糖尿病。本研究中有 31 名患者 (34.8%) 肥胖。所有 89 名患者（100%）都经历了某种程度的急性呼吸窘迫综合征，其中 39 名患者（44%）患有多器官衰竭。 83 名患者 (93%) 接受插管和机械通气，6 名患者 (7%) 接受无创机械通气，12 名患者 (13%) 接受 vvECMO 治疗，36 名患者 (40%) 接受肾脏替代治疗。 56 名 (63%) 患者需要血管活性支持。机械通气的中位持续时间为 9 (6–15.5) 天。医院死亡率为44%。 结论：与前一个流行季节的H1N1感染患者相比，后流行季节确诊的甲型H1N1流感pdm09感染的危重患者年龄较大，需要更多的血管活性药物，且生存率有更高的趋势。
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