Korea Centers for Disease Control and Prevention (KCDC), Division of Epidemic Intelligence Service, Seoul, Korea.
Pediatr Pulmonol. 2010 Oct;45(10):1014-20. doi: 10.1002/ppul.21288.
Novel influenza A (H1N1) virus infection has persisted mainly through person-to-person transmission in schools. However, data on critically ill patients infected with H1N1 are currently limited. This study was conducted to investigate the epidemiological characteristics, clinical features, treatment modalities, and clinical outcomes of pediatric patients critically ill with H1N1 infection.
Subjects included 30 critically ill pediatric patients reported to the Korea Centers for Disease Control and Prevention (KCDC) between June and November 2009. Data were obtained by medical record review and interviews with primary treating physician.
Of the 30 patients, 14 died and 16 were discharged from the hospital with complete recovery. The median patient age was 7 years (range, 2 months to 18 years). Nineteen patients belonged to the high-risk group. Cough was the most common initial symptom, followed by fever. In most patients, serum levels of C-reactive protein and lactate dehydrogenase were elevated. Oseltamivir, an antiviral agent, was administered to 29 patients. The most common causes of death were encephalopathy and myocarditis, with a higher mortality rate in the high-risk group. Platelet counts were significantly lower than normal and serum aspartate aminotransferase levels significantly higher in the non-survivors.
The results of this study suggest that Korean high-risk pediatric patients have an elevated mortality rate following infection with novel influenza A (H1N1) virus. Further studies involving high-risk pediatric patients classified using consistent criteria are needed to confirm our results.
新型甲型 H1N1 流感病毒主要通过人际传播在学校中持续传播。然而，目前关于感染 H1N1 的重症患者的数据有限。本研究旨在调查感染 H1N1 的儿科重症患者的流行病学特征、临床特征、治疗方式和临床结局。
本研究纳入了韩国疾病控制与预防中心（KCDC）在 2009 年 6 月至 11 月报告的 30 例重症儿科患者。通过病历回顾和对主要治疗医生的访谈获取数据。
30 例患者中，14 例死亡，16 例治愈出院。患者的中位年龄为 7 岁（2 个月至 18 岁）。19 例属于高危组。最常见的初始症状是咳嗽，其次是发热。大多数患者的血清 C-反应蛋白和乳酸脱氢酶水平升高。29 例患者接受了抗病毒药物奥司他韦治疗。最常见的死亡原因为脑病和心肌炎，高危组的死亡率较高。血小板计数明显低于正常值，且非幸存者的血清天门冬氨酸氨基转移酶水平明显升高。
本研究结果表明，韩国的高危儿科患者感染新型甲型 H1N1 流感病毒后的死亡率较高。需要进一步研究使用一致标准分类的高危儿科患者，以验证我们的结果。
