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阿根廷圣达菲 2009 年大流行性流感 A(H1N1)住院患者的临床特征。

Clinical features of the hospitalized patients with 2009 pandemic influenza A (H1N1) in Santa Fe, Argentina.

机构信息

Instituto Nacional de Respiratorias Dr. Emilio Coni, Santa Fe, Argentina.

出版信息

Influenza Other Respir Viruses. 2013 May;7(3):410-7. doi: 10.1111/j.1750-2659.2012.00405.x. Epub 2012 Jul 23.

Abstract

BACKGROUND

During 2009 occurred the emergence and global spread of a novel influenza A (H1N1) virus. We describe the clinical and epidemiologic features of hospitalized patients who survived and patients who died because of pandemic 2009 influenza A (H1N1) infection reported in Santa Fe, Argentina, from May to July 2009.

METHODS

Using medical charts, we collected data on 242 patients who were hospitalized with confirmed laboratory results (defined as positive by specific PCR for pandemic 2009 influenza A H1N1).

RESULTS

During the study period, there were 242 cases of hospitalization or death. Of the 242, 46% were admitted to an intensive care unit (ICU) and 33·5% died. The mean age was 27·8 years for surviving and 39·6 for those who died. Twenty-eight percent of hospitalizations involved persons under the age of 15 years; 33% of the patients were between the age of 15 and 44 years; and only 3·3% were 65 years of age or older. Sixty-seven percent had an underlying medical conditions, including diabetes, obesity, heart and lung diseases, and pregnancy. Of the 242 patients, 68% had findings consistent with pneumonia. Treatment with oseltamivir was administered to 227 (93·8%) patients from which 38 received oseltamivir within 48 hours after the onset of symptoms.

CONCLUSIONS

The pandemic strain caused severe illness, including pneumonia and acute respiratory distress syndrome, and resulted in ICU admissions in 46% of patients and death in 33·5%. The mean age of hospitalized infected cases was lower than is common with seasonal influenza. Underlying medical conditions were common in the 67% the evaluated patients. Patients who died had a higher prevalence of comorbidities (86·4%) than those who survived (57%), suggesting that the presence of chronic illness may increase the likelihood of death. However, the severe illness was also identified among young, healthy persons.

摘要

背景

2009 年期间出现了一种新型甲型流感(H1N1)病毒,并在全球范围内传播。我们描述了 2009 年在阿根廷圣达菲因大流行性甲型 H1N1 流感住院的存活患者和死亡患者的临床和流行病学特征,报告时间为 2009 年 5 月至 7 月。

方法

我们使用病历收集了经实验室确诊的 242 例住院患者的数据(通过针对大流行性 2009 年甲型 H1N1 的特定 PCR 检测呈阳性定义)。

结果

在研究期间,有 242 例住院或死亡。在这 242 例患者中,46%被收入重症监护病房(ICU),33.5%死亡。存活患者的平均年龄为 27.8 岁,死亡患者的平均年龄为 39.6 岁。28%的住院患者年龄在 15 岁以下,33%的患者年龄在 15 至 44 岁之间,仅有 3.3%的患者年龄在 65 岁或以上。67%的患者有基础疾病,包括糖尿病、肥胖症、心肺疾病和妊娠。在 242 例患者中,68%有肺炎的表现。227 例(93.8%)患者接受了奥司他韦治疗,其中 38 例患者在症状出现后 48 小时内接受了奥司他韦治疗。

结论

大流行株引起了严重疾病,包括肺炎和急性呼吸窘迫综合征,导致 46%的患者入住 ICU 和 33.5%的患者死亡。住院感染患者的平均年龄低于季节性流感。在评估的 67%患者中,基础疾病很常见。死亡患者的合并症患病率(86.4%)高于存活患者(57%),这表明慢性疾病的存在可能增加死亡的可能性。但是,在年轻健康人群中也发现了严重疾病。

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