Coordinating Centre for Health Alerts and Emergencies (CCAES), Ministry of Health and Social Policy Paseo del Prado 18-20, 28071 Madrid, Spain.
J Infect. 2012 Feb;64(2):218-24. doi: 10.1016/j.jinf.2011.11.022. Epub 2011 Nov 25.
To describe demographic and clinical data and outcomes of severe cases of 2009 pandemic influenza A H1N1 (pH1N1) infections for persons with diabetes.
We selected all person with diabetes (N = 252) among severe laboratory confirmed cases reported to the Spanish Surveillance System for detection of pH1N1 from June through December, 2009. One patient without diabetes matched by age and sex was selected. Collected variables included demographic characteristics, underlying medical conditions, outcome, clinical course and treatment.
Among those suffering diabetes only 15.9% did not report any other underlying condition. 38% of diabetic patients and 27.4% of non diabetic patients were admitted to ICU (p = 0.008). Thirty subjects suffering diabetes and fifteen without the disease died (11.9% vs. 6%[p = 0.019]). Multivariable analysis showed that the independent risk factors for ICU admission or death were suffering cardiovascular disease (OR = 2.28), morbid obesity (OR = 2.08) and antiviral treatment started after 48 h of onset of symptoms (OR = 1.89). Suffering diabetes was not independent risk factors for ICU admission or death after adjusting for covariates.
The worse outcome among diabetes sufferers could be a consequence of the higher prevalence of comorbid underlying medical conditions but not diabetes itself. Further prospective studies are needed to verify these results.
描述 2009 年甲型 H1N1 流感（pH1N1）重症感染患者的人口统计学和临床数据及结局，这些患者患有糖尿病。
我们从 2009 年 6 月至 12 月选择了在西班牙 pH1N1 检测监测系统报告的所有重症实验室确诊病例中的 252 名糖尿病患者。按年龄和性别匹配了 1 名无糖尿病患者。收集的变量包括人口统计学特征、基础医学状况、结局、临床病程和治疗情况。
在患有糖尿病的患者中，仅有 15.9%的患者没有报告任何其他基础疾病。38%的糖尿病患者和 27.4%的非糖尿病患者被收入 ICU（p=0.008）。30 名患有糖尿病的患者和 15 名没有糖尿病的患者死亡（11.9% vs. 6%[p=0.019]）。多变量分析显示，入住 ICU 或死亡的独立危险因素为患有心血管疾病（OR=2.28）、病态肥胖（OR=2.08）和在症状出现后 48 小时开始抗病毒治疗（OR=1.89）。调整协变量后，糖尿病并不是入住 ICU 或死亡的独立危险因素。
糖尿病患者的预后较差可能是合并基础疾病发病率较高的结果，而不是糖尿病本身。需要进一步的前瞻性研究来验证这些结果。
