Reducing occurrence and severity of pneumonia due to pandemic H1N1 2009 by early oseltamivir administration: a retrospective study in Mexico.
Reducing occurrence and severity of pneumonia due to pandemic H1N1 2009 by early oseltamivir administration: a retrospective study in Mexico.
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DOI：
10.1371/journal.pone.0021838
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发表时间：
2011
期刊：
影响因子：
3.7
通讯作者：
Perez Padilla JR
中科院分区：
文献类型：
--
作者：
Higuera Iglesias AL;Kudo K;Manabe T;Corcho Berdugo AE;Corrales Baeza A;Alfaro Ramos L;Guevara Gutiérrez R;Manjarrez Zavala ME;Takasaki J;Izumi S;Bautista E;Perez Padilla JR
抗病毒治疗已用于治疗2009年甲型H1N1流感大流行引起的严重或进展性疾病。2009年甲型H1N1流感大流行的严重疾病的一个主要原因是病毒性肺炎；然而，尚不清楚在症状出现48小时后给予抗病毒治疗对肺炎有多有效。因此，我们的目标是确定从症状出现到抗病毒治疗的时间如何影响2009年H1N1大流行所致肺炎的抗病毒治疗的有效性。墨西哥一家医院对442名患者进行了回顾性病历回顾。受试者已经通过实时reverse-transcriptase-polymerase-chain-reaction检测出2009年大流行H1N1病毒呈阳性，并接受了奥司他韦治疗。从出现症状到使用奥司他韦的中位时间为5.0天(0-43天)。其中重症肺炎71例(16.1%)，轻、中度肺炎191例(43.2%)，无肺炎180例(40%)。受试者根据服用奥司他韦的时间分为四组：≤2天、3-7天、8-14天和14天。呼吸特征的严重程度与治疗时间相关，多变量分析表明，奥司他韦给药时间与呼吸特征的严重程度相关。比例优势模型显示，在症状出现后大约3.4天和21天，任何严重程度的肺炎和重症肺炎的发生概率分别达到50%。服用奥司他韦时间较短的患者较早出院。由于2009年甲型H1N1流感大流行，症状出现后尽早开始使用奥司他韦可显著降低肺炎的发生率和严重程度，并缩短住院时间。即使在症状出现48小时后服用奥司他韦，奥司他韦仍显示出相当大的潜力来减少肺炎。这些结果的应用将使受未来流感大流行影响的患者受益。
Anti-viral treatment has been used to treat severe or progressive illness due to pandemic H1N1 2009. A main cause of severe illness in pandemic H1N1 2009 is viral pneumonia; however, it is unclear how effective antiviral treatment is against pneumonia when administered >48 hours after symptom onset. Therefore, we aimed to determine how time from symptom onset to antiviral administration affected the effectiveness of antiviral treatment against pneumonia due to pandemic (H1N1) 2009. A retrospective medical chart review of 442 patients was conducted in a hospital in Mexico. Subjects had tested positive for pandemic H1N1 2009 virus by real-time reverse-transcriptase-polymerase-chain-reaction and were administered oseltamivir. Median time from symptom onset to oseltamivir administration was 5.0 days (range, 0–43). 442 subjects, 71 (16.1%) had severe pneumonia which required mechanical ventilation, 191 (43.2%) had mild to moderate pneumonia, and 180 (40%) did not have pneumonia. Subjects were divided into four groups based on time to oseltamivir administration: ≤2, 3–7, 8–14, and >14 days. Severity of respiratory features was associated with time to treatment, and multivariate analysis indicated that time to oseltamivir administration was associated with severity of respiratory features. A proportional odds model indicated that 50% probability for occurrence of pneumonia of any severity and that of severe pneumonia in patients who would develop pneumonia reached at approximately 3.4 and 21 days, respectively, after symptom onset. Patients with a shorter time to oseltamivir administration were discharged earlier from the hospital. Earlier initiation of oseltamivir administration after symptom onset significantly reduced occurrence and severity of pneumonia and shortened hospitalization due to pandemic H1N1 2009. Even when administered >48 hours after symptom onset, oseltamivir showed considerable potential for reducing pneumonia. Application of these results would benefit patients affected by future influenza pandemics.
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DOI：
10.2353/ajpath.2010.100115
发表时间：
2010-07
期刊：
The American journal of pathology
影响因子：
--
作者：
Shieh WJ;Blau DM;Denison AM;Deleon-Carnes M;Adem P;Bhatnagar J;Sumner J;Liu L;Patel M;Batten B;Greer P;Jones T;Smith C;Bartlett J;Montague J;White E;Rollin D;Gao R;Seales C;Jost H;Metcalfe M;Goldsmith CS;Humphrey C;Schmitz A;Drew C;Paddock C;Uyeki TM;Zaki SR
通讯作者：
Zaki SR
影响因子：
11.8
作者：
To, Kelvin K. W.;Hung, Ivan F. N.;Yuen, Kwok-Yung
通讯作者：
Yuen, Kwok-Yung
影响因子：
158.5
作者：
Webb, Steven A. R.;Pettila, Ville;Yung, Michael
通讯作者：
Yung, Michael
影响因子：
5.4
作者：
Matrosovich, MN;Matrosovich, TY;Klenk, HD
通讯作者：
Klenk, HD
影响因子：
120.7
作者：
Dominguez-Cherit, Guillermo;Lapinsky, Stephen E.;Fowler, Robert A.
通讯作者：
Fowler, Robert A.