Hospitalized Patients with 2009 H1N1 Influenza in the United States, April-June 2009.
Hospitalized Patients with 2009 H1N1 Influenza in the United States, April-June 2009.
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DOI：
10.1056/nejmoa0906695
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发表时间：
2009-11-12
影响因子：
158.5
通讯作者：
Finelli, Lyn
中科院分区：
文献类型：
--
作者：
Jain, Seema;Kamimoto, Laurie;Finelli, Lyn
背景：2009年春季，甲型H1N1流感大流行病毒出现并在全球传播。我们描述了2009年4月至2009年6月中旬在美国住院的2009H1N1流感患者的临床特征。方法：使用病历收集272例因流感样疾病住院至少24小时且2009年H1N1病毒检测为阳性的患者的数据，采用实时reverse-transcriptase-polymerase-chain-reaction检测。45%的患者是18岁以下的儿童，5%的患者年龄在65岁或以上。73%的患者至少有一种潜在的健康状况；这些状况包括哮喘；糖尿病；心脏、肺和神经疾病；以及怀孕。在入院时接受胸部X光检查的249名患者中，100名(40%)的发现与肺炎相符。在可获得抗病毒药物使用数据的268名患者中，有200名患者(75%)在发病后3天的中位数开始进行此类治疗。数据表明，住院患者使用抗病毒药物是有益的，特别是在早期开始抗病毒治疗的情况下。结论：在评估期内，2009年甲型H1N1流感导致了包括肺炎和死亡在内的需要住院的严重疾病。近四分之三的患者有一种或多种潜在的健康状况。65岁或65岁以上的人中几乎没有严重疾病的报告。患者似乎从抗病毒治疗中受益。N Engl J Med 2009；361：1935-44。
Background: During the spring of 2009, a pandemic influenza A (H1N1) virus emerged and spread globally. We describe the clinical characteristics of patients who were hospitalized with 2009 H1N1 influenza in the United States from April 2009 to mid-June 2009.Methods: Using medical charts, we collected data on 272 patients who were hospitalized for at least 24 hours for influenza-like illness and who tested positive for the 2009 H1N1 virus with the use of a real-time reverse-transcriptase-polymerase-chain-reaction assay.Results: Of the 272 patients we studied, 25% were admitted to an intensive care unit and 7% died. Forty-five percent of the patients were children under the age of 18 years, and 5% were 65 years of age or older. Seventy-three percent of the patients had at least one underlying medical condition; these conditions included asthma; diabetes; heart, lung, and neurologic diseases; and pregnancy. Of the 249 patients who underwent chest radiography on admission, 100 (40%) had findings consistent with pneumonia. Of the 268 patients for whom data were available regarding the use of antiviral drugs, such therapy was initiated in 200 patients (75%) at a median of 3 days after the onset of illness. Data suggest that the use of antiviral drugs was beneficial in hospitalized patients, especially when such therapy was initiated early.Conclusions: During the evaluation period, 2009 H1N1 influenza caused severe illness requiring hospitalization, including pneumonia and death. Nearly three quarters of the patients had one or more underlying medical conditions. Few severe illnesses were reported among persons 65 years of age or older. Patients seemed to benefit from antiviral therapy.N Engl J Med 2009;361:1935-44.