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

Abstract

Introduction: An outbreak of a respiratory illness caused by 2009 H1N1 influenza virus proved to be an important cause of morbidity and mortality.
Aim: To analyze clinical presentation, complications and treatment of hospitalized patients with 2009 H1N1 influenza.
Methods: case records of 68 adult patients admitted with clinical and epidemiological suspicion for H1N1 influenza to a temporary constituted A (H1N1) unit of Sfanta Treime Hospital of Chisinau from December 1, 2009 trough February 10, 2010 were reviewed. Infection with H1N1/09 flu was confirmed by Real-time RT-PCR of nasopharyngeal and oropharyngeal tissue swab.
Results: 24 patients (35.3%) were positive for H1N1/09 flu, their mean age was 50.2±17.1 years and 70.8% were female, in 14 cases (58.3%) two and more comorbidities were found. The disease began with barking-like cough and fever less than 39ºC in 20 cases (83.3%), mean duration of symptoms before hospitalization was 3.1±1.9 days. The patients were diagnosed with tracheobronchitis in 54.2% and pneumonia in 45.85% (11/24). On chest X-ray there was an interstitial pattern in 7 cases and blood analysis revealed lymphopenia in 13 cases (54.4%). Initial treatment included oseltamivir (mean duration 4.9±1.2 days), antibiotics and symptomatic therapy. Rapid deterioration within 24 hours and development of ARDS required immediate admission to the intensive care unit in 7 patients (29.2%). The mortality rate was 20.8% (5/24).
Conclusions: Our data indicate a variety of H1N1 flu presentation ranging from mild cases to fulminant disease course. The delayed start of treatment and presence of multiple comorbidities contributed to fatal outcome. ARDS was the leading complication in all lethal cases.

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T. Dumitras, S. Matcovschi, I. Nikolenko, M. Lupan, N. Draguta, N. Capros, S. Svet, E. Terna, E. Ignatiuc (Chisinau, Republic Of Moldova). Hospitalized patients with 2009 H1N1 influenza in a Chisinau Municipal Hospital. Eur Respir J 2010; 36: Suppl. 54, 2978

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