Clinical and prognostic features of patients with pandemic 2009 influenza A (H1N1) virus in the intensive care unit

B Sertogullarindan, B Ozbay, H Gunini, A Sunnetcioglu, A Arisoy, HM Bilgin, CB Mermit, M Duran, H Yildiz, S Ekin, AI Baran

Abstract

Objective: To investigate the clinical and prognostic features of patients admitted to intensive care unit (ICU) with pandemic 2009 influenza A (H1N1) virus.

Methods: Patients admitted to the intensive care unit for severe pneumonia associated with pandemic 2009 influenza A (H1N1) virus were evaluated.

Results: The study included 20 patients with the mean age of 36±13. Of the 20 subjects, 17 (85%) had underlying conditions. Of the 20 patients, 11(55%) were discharged and 9 (45%) died. Cardinal symptoms were fever, myalgia, and hemoptysis with the rates of 85 %, 75 % and 45 %, respectively. All patients had pneumonic infiltrations in their chest roentgenograms. Main laboratory findings were lymphopenia, high creatin phosphokinase (CPK) and Lactate dehydrogenase (LDH) levels. All patients had positivity on real time reverse transcription–polymerase chain reaction (RT-PCR). None of the patients had pandemic 2009 influenza A (H1N1) virus vaccination. None of them had taken oseltamivir within 48 hours. Main reasons for mortality were cardiovascular complications and ventilatory associated pneumonia due to Acynetobacter baumannii.

Conclusion: Early diagnosis and antiviral treatment in these cases seem to be the best approach to avoid serious illness. Special attention should be given to patients having underlying conditions such as cardiovascular and pulmonary diseases and pregnancy.