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

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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antiviral Agents / therapeutic use
  • Argentina / epidemiology
  • Child
  • Child, Preschool
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Infant
  • Influenza A Virus, H1N1 Subtype / genetics
  • Influenza A Virus, H1N1 Subtype / isolation & purification*
  • Influenza A Virus, H1N1 Subtype / physiology
  • Influenza, Human / drug therapy
  • Influenza, Human / epidemiology*
  • Influenza, Human / mortality
  • Influenza, Human / virology
  • Intensive Care Units / statistics & numerical data
  • Male
  • Middle Aged
  • Pandemics
  • Risk Factors
  • Young Adult

Substances

  • Antiviral Agents