State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, China.
Biomedicine Discovery Institute & Department of Microbiology, Monash University, Melbourne, VIC, 3800, Australia.
BMC Infect Dis. 2019 Jul 29;19(1):668. doi: 10.1186/s12879-019-4181-2.
A severe seasonal influenza epidemic was observed during 2017-2018 in China, prompting questions on clinical characteristics and outcomes of severe cases with influenza.
We retrospectively collected clinical data and outcomes of laboratory-confirmed hospitalized patients (severe to critical) during Jan-2011 to Feb-2018 from five hospitals, followed by a systematic analysis of cases from 2017 to 2018 (n = 289) and all previous epidemics during 2011-2017 (n = 169).
In-hospital fatality was over 5-folds higher during the 2017-2018 (p < 0.01) in which 19 patients died (6.6%), whereas only 2 mortalities (1.2%) were observed during 2011-2017. Of the 289 hospitalized in 2017-2018, 153 were confirmed with influenza B virus, 110 with A/H1N1pdm09, and 26 A/H3N2, whereas A/H1N1pdm09 was the predominant cause of hospitalization in previous seasons combined (45%). Fatal cases in 2017-2018 were exclusively associated with either influenza B or A/H1N1pdm09. Our results show that a significant lower proportion of patients aged 14 or greater were treated with oseltamivir, during the 2017-2018 epidemic, and exhibited higher levels of clinical severity.
In-hospital fatality rate might be significantly higher in the 2017-2018 season in China. A sufficient supply of oseltamivir and antiviral therapy within 48 h from onset could reduce fatality rates.
2017-2018 年中国发生了严重的季节性流感疫情，促使人们对流感重症病例的临床特征和结局提出了疑问。
我们回顾性收集了 2011 年 1 月至 2018 年 2 月期间 5 家医院住院（重症至危重症）确诊患者的临床数据和结局，并对 2017-2018 年（n=289）和 2011-2017 年所有以往流行季（n=169）的病例进行了系统分析。
2017-2018 年住院病死率高出 5 倍以上（p<0.01），其中 19 例死亡（6.6%），而 2011-2017 年仅有 2 例死亡（1.2%）。2017-2018 年住院的 289 例患者中，153 例确诊为乙型流感病毒，110 例确诊为 A/H1N1pdm09，26 例确诊为 A/H3N2，而 A/H1N1pdm09是以往所有流行季住院的主要原因（45%）。2017-2018 年死亡病例均仅与乙型流感或 A/H1N1pdm09有关。我们的研究结果表明，在 2017-2018 年流行期间，年龄在 14 岁及以上的患者接受奥司他韦治疗的比例显著降低，且表现出更高的临床严重程度。
2017-2018 年中国季节性流感住院病死率可能显著升高。发病后 48 小时内足量供应奥司他韦和抗病毒治疗可能降低病死率。
