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Article: Comparison of Patients Hospitalized With Influenza A Subtypes H7N9, H5N1, and 2009 Pandemic H1N1

TitleComparison of Patients Hospitalized With Influenza A Subtypes H7N9, H5N1, and 2009 Pandemic H1N1
Authors
Issue Date2014
PublisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/
Citation
Clinical Infectious Diseases, 2014, v. 58 n. 8, p. 1095-1103 How to Cite?
AbstractBackground. Influenza A(H7N9) viruses isolated from humans show features suggesting partial adaptation to mammals. To provide insights into the pathogenesis of H7N9 virus infection, we compared risk factors, clinical presentation, and progression of patients hospitalized with H7N9, H5N1, and influenza A (H1N1)pdm09 (pH1N1) virus infections. Methods. We compared individual-level data from patients hospitalized with infection by H7N9 (n=123), H5N1 (n= 119; 43 China, 76 Vietnam), and pH1N1 (n=3486) viruses. We assessed risk factors for hospitalization after adjustment for age and gender specific prevalence of risk factors in the general Chinese population. Results. The median age of patients with H7N9 virus infection was older than other patient groups (63 years; P <0.001) and a higher proportion was male (71%; P <0.02). After adjustment for age and gender, chronic heart disease was associated with an increased risk of hospitalization with H7N9 (relative risk 9.68; 95% CI 5.24-17.90). H7N9 patients had similar patterns of leukopenia, thrombocytopenia, and elevated alanine aminotransferase, creatinine kinase, C-reactive protein, and lactate dehydrogenase to those seen in H5N1 patients, which were all significantly different from pH1N1 patients (P<0.005). H7N9 patients had a longer duration of hospitalization than either H5N1 or pH1N1 patients (P<0.001), and the median time from onset to death was 18 days for H7N9 (P=0.002) versus 11 days for H5N1 and 15 days for pH1N1 (P=0.154). Conclusions. The identification of known risk factors for severe seasonal influenza and the more protracted clinical course compared to H5N1 suggests that host factors are an important contributor to H7N9 severity.
Persistent Identifierhttp://hdl.handle.net/10722/195727
ISSN
2015 Impact Factor: 8.736
2015 SCImago Journal Rankings: 4.742
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWang, Cen_US
dc.contributor.authorYu, HJen_US
dc.contributor.authorHorby, PWen_US
dc.contributor.authorCao, Ben_US
dc.contributor.authorWu, Pen_US
dc.contributor.authorYang, Sen_US
dc.contributor.authorGao, Hen_US
dc.contributor.authorLi, Hen_US
dc.contributor.authorTsang, KLen_US
dc.contributor.authorLiao, QHen_US
dc.contributor.authorGao, ZCen_US
dc.contributor.authorIp, DKMen_US
dc.contributor.authorJia, HYen_US
dc.contributor.authorJiang, Hen_US
dc.contributor.authorLiu, Ben_US
dc.contributor.authorNi, MYen_US
dc.contributor.authorDai, ZHen_US
dc.contributor.authorLiu, FFen_US
dc.contributor.authorKinh, NVen_US
dc.contributor.authorLiem, NTen_US
dc.contributor.authorHien, TTen_US
dc.contributor.authorLi, Yen_US
dc.contributor.authorYang, Jen_US
dc.contributor.authorWu, JTKen_US
dc.contributor.authorZheng, YMen_US
dc.contributor.authorLeung, GMen_US
dc.contributor.authorFarrar, JJen_US
dc.contributor.authorCowling, BJen_US
dc.contributor.authorUyeki, TMen_US
dc.contributor.authorLi, LJen_US
dc.date.accessioned2014-03-07T04:35:03Z-
dc.date.available2014-03-07T04:35:03Z-
dc.date.issued2014en_US
dc.identifier.citationClinical Infectious Diseases, 2014, v. 58 n. 8, p. 1095-1103en_US
dc.identifier.issn1058-4838-
dc.identifier.urihttp://hdl.handle.net/10722/195727-
dc.description.abstractBackground. Influenza A(H7N9) viruses isolated from humans show features suggesting partial adaptation to mammals. To provide insights into the pathogenesis of H7N9 virus infection, we compared risk factors, clinical presentation, and progression of patients hospitalized with H7N9, H5N1, and influenza A (H1N1)pdm09 (pH1N1) virus infections. Methods. We compared individual-level data from patients hospitalized with infection by H7N9 (n=123), H5N1 (n= 119; 43 China, 76 Vietnam), and pH1N1 (n=3486) viruses. We assessed risk factors for hospitalization after adjustment for age and gender specific prevalence of risk factors in the general Chinese population. Results. The median age of patients with H7N9 virus infection was older than other patient groups (63 years; P <0.001) and a higher proportion was male (71%; P <0.02). After adjustment for age and gender, chronic heart disease was associated with an increased risk of hospitalization with H7N9 (relative risk 9.68; 95% CI 5.24-17.90). H7N9 patients had similar patterns of leukopenia, thrombocytopenia, and elevated alanine aminotransferase, creatinine kinase, C-reactive protein, and lactate dehydrogenase to those seen in H5N1 patients, which were all significantly different from pH1N1 patients (P<0.005). H7N9 patients had a longer duration of hospitalization than either H5N1 or pH1N1 patients (P<0.001), and the median time from onset to death was 18 days for H7N9 (P=0.002) versus 11 days for H5N1 and 15 days for pH1N1 (P=0.154). Conclusions. The identification of known risk factors for severe seasonal influenza and the more protracted clinical course compared to H5N1 suggests that host factors are an important contributor to H7N9 severity.-
dc.languageengen_US
dc.publisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/-
dc.relation.ispartofClinical Infectious Diseasesen_US
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleComparison of Patients Hospitalized With Influenza A Subtypes H7N9, H5N1, and 2009 Pandemic H1N1en_US
dc.typeArticleen_US
dc.identifier.emailWu, P: pengwu@hku.hken_US
dc.identifier.emailIp, DKM: dkmip@hku.hken_US
dc.identifier.emailNi, MY: nimy@hku.hken_US
dc.identifier.emailWu, JTK: joewu@hku.hken_US
dc.identifier.emailLeung, GM: gmleung@hku.hken_US
dc.identifier.emailCowling, BJ: bcowling@hku.hken_US
dc.identifier.authorityIp, DKM=rp00256en_US
dc.identifier.authorityNi, MY=rp01639en_US
dc.identifier.authorityWu, JTK=rp00517en_US
dc.identifier.authorityLeung, GM=rp00460en_US
dc.identifier.authorityCowling, BJ=rp01326en_US
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1093/cid/ciu053-
dc.identifier.pmid24488975-
dc.identifier.scopuseid_2-s2.0-84897462238-
dc.identifier.hkuros228114en_US
dc.identifier.volume58-
dc.identifier.issue8-
dc.identifier.spage1095-
dc.identifier.epage1103-
dc.identifier.isiWOS:000334113700015-
dc.publisher.placeUnited States-

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