Factors associated with severe disease in hospitalised adults with pandemic (H1N1) 2009 in Spain.
Clin Microbiol Infect. 2010 Sep 3;
Authors: Viasus D, PaÃ±o-Pardo JR, PachÃ³n J, Campins A, LÃ³pez-Medrano F, Villoslada A, Carmen FariÃ±as M, Moreno A, RodrÃguez-BaÃ±o J, Oteo JA, MartÃnez-Montauti J, Torre-Cisneros J, Segura F, Gudiol F, CarratalÃ J,
Abstract The risk factors for complications in patients with influenza A (H1N1)v virus infection have not been fully elucidated. We performed an observational analysis of a prospective cohort of hospitalised adults with confirmed pandemic influenza A (H1N1)v virus infection at 13 hospitals in Spain, between June 12 and November 10, 2009, to identify factors associated with severe disease. Severe disease was defined as the composite outcome of intensive care unit (ICU) admission or in-hospital mortality. During the study period, 585 adult patients (median age 40 years) required hospitalisation due to pandemic (H1N1) 2009. At least one comorbid condition was present in 318 (54.4%) patients. Pneumonia was diagnosed in 234 (43.2%) patients and bacterial coinfection in 45 (7.6%). Severe disease occurred in 75 (12.8%) patients, of whom 71 required ICU admission and 13 (2.2%) died. Independent factors for severe disease were age < 50 years (odds ratio [OR], 2.39; 95% confidence interval [CI], 1.05-5.47), chronic comorbid conditions (OR, 2.93; 95% CI, 1.41-6.09), morbid obesity (OR, 6.7; 95% CI, 2.25-20.19), concomitant and/or secondary bacterial coinfection (OR, 2.78; 95% CI, 1.11-7) and early oseltamivir therapy (OR, 0.32; 95% CI 0.16-0.63). In conclusion, although adults hospitalised for pandemic (H1N1) 2009 suffer from significant morbidity, mortality is lower than that reported in the earliest studies. Younger age, chronic comorbid conditions, morbid obesity and bacterial coinfection are independent risk factors for severe disease, whereas early oseltamivir therapy is a protective factor.
PMID: 20825436 [PubMed - as supplied by publisher]