Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, People's Republic of China.
Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.
Int J Infect Dis. 2017 Dec;65:148-155. doi: 10.1016/j.ijid.2017.07.021. Epub 2017 Nov 8.
To describe the demographics and clinical characteristics of patients with A (H7N9) infection, to test the differences in the distribution of demographics and clinical characteristics by clinical severity, and to explore potential factors associated with clinical severity.
This retrospective study was conducted to collect epidemiological and clinical information regarding the confirmed cases in Guangdong through field investigation and review of medical records.
Of the 256 cases, 100 (39.0%) patients died, and 168 (65.6%) patients were admitted to ICUs. The male-to-female ratio was approximately 2.0:1, and the median age was 56 years (range, 1 to 88). Among the 215 patients accepting oseltamivir treatment, the median time from the onset of illness to oseltamivir treatment was 5days (range, 0 to 16); 35 patients received zanamivir treatment after a median of 8days (range, 0 to 23). The univariable logistic regression models demonstrated that time from the onset of illness to oseltamivir treatment (OR=1.10, 95% CI=1.01-1.10) and zanamivir treatment (OR=1.05, 95% CI=1.02-1.07) were associated with the death of patients.
Preventive measures should focus on high-risk populations, such as the elderly and the groups with high frequency exposure to live poultry. Earlier oseltamivir and zanamivir treatment were recommended.
描述 A（H7N9）感染患者的人口统计学和临床特征，检验临床严重程度分布的人口统计学和临床特征差异，并探讨与临床严重程度相关的潜在因素。
本回顾性研究通过现场调查和病历回顾，收集了广东确诊病例的流行病学和临床信息。
在 256 例病例中，100 例（39.0%）患者死亡，168 例（65.6%）患者入住 ICU。男女比例约为 2.0:1，中位年龄为 56 岁（范围 1-88 岁）。在接受奥司他韦治疗的 215 例患者中，从发病到接受奥司他韦治疗的中位时间为 5 天（范围 0-16 天）；35 例患者在中位时间 8 天后（范围 0-23 天）接受了扎那米韦治疗。单变量逻辑回归模型表明，从发病到奥司他韦治疗（OR=1.10，95%CI=1.01-1.10）和扎那米韦治疗（OR=1.05，95%CI=1.02-1.07）的时间与患者死亡相关。
预防措施应针对高危人群，如老年人和高频接触活禽的人群。建议尽早使用奥司他韦和扎那米韦治疗。
