Abstract
BackgroundThe aim of this study was to evaluate the correlation between clinical and imaging findings with a worse clinical outcome in patients with a confirmed diagnosis of H1N1 influenza A virus.MethodsPatients with a positive viral test for influenza A H1N1 in 2016 and chest radiography (CR) and/or computed tomography (CT) results had clinical and imaging data reviewed. Hospitalization, admission to the intensive care unit or death were defined as worse clinical outcomes. The association between clinical and imaging features and the worse outcome was calculated in a logistical regression model.ResultsEighty of 160 (50%) patients were men, with a mean age of 43 ± 19 years. The most common symptoms were as follows: flu-like symptoms 141/160 (88%), dyspnea (25/160, 17%), and thoracic pain (7/160, 5%). Abnormalities on CR were detected in 8/110 (7%) patients, and 43/59 (73%) patients had an abnormal CT. The following variables were associated with worse clinical outcomes: the presence of diabetes mellitus (DM), hypertension, dyspnea, thoracic pain, abnormal CR or CT regardless of the type of finding, CT with consolidation or ground glass opacity.ConclusionsThe presence of DM, hypertension, dyspnea, thoracic pain, or an abnormal CR or CT on admission were associated with worse clinical outcomes in patients with H1N1 influenza A virus infection. Thus, the use of readily accessible clinical and imaging features on admission may have a role in the evaluation of patients with H1N1 infection.
Highlights
The aim of this study was to evaluate the correlation between clinical and imaging findings with a worse clinical outcome in patients with a confirmed diagnosis of H1N1 influenza A virus
Influenza A H1N1 virus is the subtype of influenza virus that typically leads to a more severe infection than the usual seasonal influenza virus, and its viral strains were historically responsible for the major outbreaks worldwide, similar to the Spanish flu in the twentieth century
The identification of clinical and radiographic findings in patients with H1N1 infection that correlate with the Schoen et al BMC Infectious Diseases (2019) 19:964 clinical severity is of key importance in the management of these patients
Summary
The aim of this study was to evaluate the correlation between clinical and imaging findings with a worse clinical outcome in patients with a confirmed diagnosis of H1N1 influenza A virus. Influenza A H1N1 virus is the subtype of influenza virus that typically leads to a more severe infection than the usual seasonal influenza virus, and its viral strains were historically responsible for the major outbreaks worldwide, similar to the Spanish flu in the twentieth century. It was the cause of the last influenza pandemic in 2009, which resulted in thousands of deaths worldwide, principally among young individuals and pregnant woman. There is a relative lack of studies in the literature that have evaluated predictive tools in the evaluation of patients with H1N1 [7, 8]
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