Risk factors and outcomes among children admitted to hospital with pandemic H1N1 influenza
Risk factors and outcomes among children admitted to hospital with pandemic H1N1 influenza
复制标题
DOI：
10.1503/cmaj.091724
复制
发表时间：
2010-01-12
影响因子：
14.6
通讯作者：
Tran, Dat
中科院分区：
文献类型：
--
作者：
O'Riordan, Sean;Barton, Michelle;Tran, Dat
背景：关于需要住院治疗的 2009 年大流行甲型 H1N1 流感病毒感染（大流行 H1N1 流感）儿童的疾病特征和结果的数据有限。方法：我们回顾了 2009 年 5 月 8 日至 7 月 22 日期间在加拿大安大略省一家大型儿科医院收治的 58 名大流行 H1N1 流感儿童的图表。我们将这些儿童的危险因素、严重程度指标和结果与 200 名季节性甲型流感入院的儿童进行了比较。过去 5 年（2004/05 至 2008/09）。结果：患有大流行性 H1N1 流感的儿童明显比患有季节性流感的儿童年龄大（中位年龄 6.4 岁 vs. 3.3 岁）。 46 名 (79%) 感染 H1N1 流感的儿童有基础疾病；另外 12 名之前健康的人中，42% 年龄在 2 岁以下。因大流行性 H1N1 流感入院的儿童比因季节性流感入院的儿童患哮喘的可能性明显更高（22% 对 6%）。两名儿童的哮喘控制不佳，其中 6 名儿童仅间歇性使用吸入药物。两组儿童的平均住院时间均为 4 天。需要入住重症监护病房（大流行性 H1N1 流感儿童为 21%，季节性流感儿童为 14%）和机械通气（分别为 12% 和 10%）的儿童比例相似。因大流行性 H1N1 流感入院的儿童中，没有一人死亡，而因季节性流感入院的儿童中有 1 人死亡（0.4%）。解释：大流行性 H1N1 流感似乎并未导致比季节性甲型流感更严重的疾病。哮喘似乎是严重疾病的重要危险因素，与哮喘的严重程度没有明确关系。这一发现应该会影响疫苗接种和先发性抗病毒治疗的策略。
Background: Limited data are available on disease characteristics and outcomes of children with 2009 pandemic influenza A(H1N1) virus infection (pandemic H1N1 influenza) who have required hospital admission.Methods: We reviewed the charts of 58 children with pandemic H1N1 influenza admitted to a large pediatric hospital in Ontario, Canada, between May 8 and July 22, 2009. We compared risk factors, severity indicators and outcomes of these children with those of 200 children admitted with seasonal influenza A during the previous 5 years (2004/05 to 2008/09).Results: Children with pandemic H1N1 influenza were significantly older than those with seasonal influenza (median age 6.4 years v. 3.3 years). Forty-six (79%) of the children with pandemic H1N1 influenza had underlying medical conditions; of the other 12 who were previously healthy, 42% were under 2 years of age. Children admitted with pandemic H1N1 influenza were significantly more likely to have asthma than those with seasonal influenza (22% v. 6%). Two children had poorly controlled asthma, and 6 used inhaled medications only intermittently. The median length of stay in hospital was 4 days in both groups of children. Similar proportions of children required admission to the intensive care unit (21% of those with pandemic H1N1 influenza and 14% of those with seasonal influenza) and mechanical ventilation (12% and 10% respectively). None of the children admitted with pandemic H1N1 influenza died, as compared with 1 (0.4%) of those admitted with seasonal influenza.Interpretation: Pandemic H1N1 influenza did not appear to cause more severe disease than seasonal influenza A. Asthma appears to be a significant risk factor for severe disease, with no clear relation to severity of asthma. This finding should influence strategies for vaccination and pre- emptive anti viral therapy.