Source: Annual Congress 2010 - Influenza A (H1N1) and other viral infections: therapeutic aspects
Disease area: Respiratory critical care, Respiratory infections

Abstract

The 2009 H1N1 Influenza pandemics was associated with severe viral pneumonia and respiratory failure. There is no strong evidence to date on oseltamivir efficacy in preventing respiratory failure during this pandemics.
Methods: A prospective cohort study of 233 adult inpatients with acute flu syndrome during 2009 Influenza H1N1 pandemics, evaluating early use of oseltamivir and necessity of mechanical ventilation. All patients admitted to a tertiary care hospital with an acute respiratory illness suspected of Influenza were included. Oseltamivir use was considered early if initiated up to 48h from onset of symptoms and late if thereafter. Obesity, age, chronic respiratory and cardiovascular disease, imunossupression and pregnancy were defined as risk factors to severe forms. The main outcome was respiratory failure, addressed by necessity of mechanical ventilation.
Results: Respiratory failure requiring invasive mechanical ventilation occurred in 21 patients (9.4%). Acute renal failure necessitating hemodialysis arised in 9 (4%) and we observed 8 deaths (3.5%). Early oseltamivir use was associated with a 77% relative risk reduction (95% CI, 0.18 to 0.94;P<0.024) for invasive mechanical ventilation in multivariate model. Acute renal failure was significantly more common among patients starting oseltamivir late (P<0.005). An increased risk for death was observed when oseltamivir was initiated after 72 hours from symptom onset (RR 1.96; 95% CI 1.27 to 3.04).
Conclusion: Early use of oseltamivir improved outcomes among patients with flu syndrome during Influenza A H1N1 pandemics.

Rating:

Share or cite this content

Citations should be made in the following way:
R. Seligman, G. Geib, G. Faulhaber, T. Dutra, M. Alves, R. Seewald, L. Pinheiro, L. Ramos-Lima, V. Oliveira, C. Sanvicente, E. Pacheco, M. Fernandes, Jr., R. Kuchenbecker, S. Pinto Ribeiro, T. Furlanetto (Porto Alegre, Brazil). Early use of oseltamivir protected from respiratory failure in patients with acute flu syndrome during 2009 Brazilian influenza H1N1 pandemics. Eur Respir J 2010; 36: Suppl. 54, 2976

Member's Comments

No comment yet.

Related content which might interest you: Characteristics and outcome of pneumonia in patients with 2009 pandemic influenza A/H1N1. Source: Annual Congress 2010 - Influenza A (H1N1): characteristics, risk factors and prognosis Year: 2010 Hospitalizations from pandemic influenza (pH1N1) infections among patients with asthma in Spain Source: Annual Congress 2012 - Epidemiology of various respiratory diseases Year: 2012 Hospitalizations from pandemic influenza (pH1N1) infections among patients with COPD in Spain Source: Annual Congress 2012 - Epidemiology of various respiratory diseases Year: 2012 Early clinical abnormalities after H1N1 influenza pneumonia Source: Annual Congress 2011 - Influenza A (H1N1): lessons after the epidemic Year: 2011 Characteristics of hospitalised patients with 2009 H1N1 influenza in Chile Source: Eur Respir J 2010; 36: 864-869 Year: 2010 Early diagnosis and causal treatment of pneumonia associated with pandemic influenza A (H1N1) virus Source: Annual Congress 2012 - Respiratory infections: a clinical point of view Year: 2012 The severity of pandemic H1N1 influenza in Albania Source: Annual Congress 2010 - Pulmonary infections and sepsis Year: 2010 Evaluation of pneumonia cases due to pandemic influenza A (H1N1) Source: Annual Congress 2010 - Influenza A (H1N1): epidemiology Year: 2010 Cytokine response in pediatric patients with pandemic H1N1 influenza virus infection and pneumonia: Comparison with pediatric pneumonia without H1N1 infection Source: Annual Congress 2011 - Innate and exogenous factors in childhood respiratory infection Year: 2011 Clinical presentations of complicated pandemic 2009 A H1N1 flu disease in a general hospital in Bulgaria Source: Annual Congress 2010 - Influenza A (H1N1): epidemiology Year: 2010 Clinical relevance of mixed respiratory viral infections in adults with influenza A H1N1 Source: Eur Respir J 2011; 38: 739-742 Year: 2011 Predictors of H1N1 severe infection Source: Annual Congress 2010 - Influenza A (H1N1): characteristics, risk factors and prognosis Year: 2010 Community-acquired pneumonia during the influenza pandemic A(H1N1)pdm09 and post-pandemic period in hospitalized patients, Russia Source: Annual Congress 2012 - Viral infections and rare respiratory infections Year: 2012 Influenza pneumonia: a comparison between seasonal influenza virus and the H1N1 pandemic Source: Eur Respir J 2011; 37: 106-111 Year: 2011 ARDS in patients with 2009 H1N1 influenza: Preliminary data Source: Annual Congress 2010 - Pulmonary infections and sepsis Year: 2010 Characteristics of critically ill patients with 2009 pandemic influenza A (H1N1) Source: Annual Congress 2010 - Pulmonary infections and sepsis Year: 2010 Long-term outcomes after viral pneumonia caused by influenza A (H1N1) Source: Annual Congress 2011 - Influenza A (H1N1): lessons after the epidemic Year: 2011 The influenza pandemic: 1918 compared to 2005 Source: Annual Congress 2005 - New developments in infectious disease Year: 2005 Preventing the next influenza pandemic Source: International Congress 2015 – PG11 Emerging infectious diseases and pandemic planning Year: 2015 Pandemic 2009 influenza A (H1N1) patients who followed-up in department of chest diseases without requiring mechanical ventilation Source: Annual Congress 2010 - Influenza A (H1N1) and other viral infections: therapeutic aspects Year: 2010