Complications and factors associated with severity of influenza in hospitalized children and adults during the pandemic wave of A(H1N1)pdm2009 infections—The Fluco French cohort

Abstract Background The emergence of novel A(H1N1)pdm2009 virus threatened to lead to frequent severe manifestations. Objectives To describe the clinical, virological, and biological characteristics of the disease and identify the factors associated with severe presentations. Study design This prosp...

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Bibliographic Details
Published in:Journal of clinical virology 2013-09, Vol.58 (1), p.114-119
Main Authors: Ploin, D, Chidiac, C, Carrat, F, Cohen, B, Javouhey, E, Mayaud, C, Desenclos, J.-C, Lina, B, Leport, C
Format: Article
Language:English
Subjects:
A(H1N1)pdm2009 virus
Adolescent
Adult
Aged
Allergy and Immunology
Antiviral Agents - therapeutic use
Child
Child, Preschool
Complication
Female
France
Hospitalization
Humans
Infant
Infant, Newborn
Infectious Disease
Influenza
Influenza A Virus, H1N1 Subtype - isolation & purification
Influenza, Human - complications
Influenza, Human - epidemiology
Influenza, Human - pathology
Influenza, Human - virology
Male
Middle Aged
Oseltamivir - therapeutic use
Pandemic
Prospective Studies
Risk Factors
Severity
Severity of Illness Index
Young Adult
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Summary:Abstract Background The emergence of novel A(H1N1)pdm2009 virus threatened to lead to frequent severe manifestations. Objectives To describe the clinical, virological, and biological characteristics of the disease and identify the factors associated with severe presentations. Study design This prospective multicenter study recruited consecutive hospitalized patients with confirmed A(H1N1)pdm2009 disease. Clinical, virological and biological assessments were carried out at inclusion and 30 days post-inclusion. Disease manifestations were assessed by an adjudication committee using pre-identified definitions of complications and severity scores. Results The study analyzed from November 30th, 2009 to February 8th, 2010, 40 hospitalized patients, 21 children and 19 adults. Eighteen (45%) were considered to have severe presentations. Except age, main characteristics in children and adults did not differ. The majority (18/21) of children and all adults had a respiratory presentation; extra-respiratory manifestations tended to be more frequent in children (12 vs. 6, P = 0.10). Two children against 5 adults presented acute respiratory distress syndrome (ARDS, P = 0.23), but more children suffered respiratory failure (7 vs. 1, P = 0.046) without ARDS. At day 30, one death had occurred in each group. The main factor associated with non-severe presentation was an early (
ISSN:1386-6532
1873-5967
DOI:10.1016/j.jcv.2013.05.025