Clinical aspects of 2009 pandemic influenza A (H1N1) virus infection in Austria

Poeppl, Wolfgang; Hell, Markus; Herkner, Harald; Stoiser, Brigitte; Fritsche, György Bèla; Schurz-Bamieh, N.; Poeppl, G.; Gattringer, Rainer; Jones, Nicholas F.; Maass, Matthias; Egle, Alexander; Burgmann, Heinz

doi:10.1007/s15010-011-0121-9

Cited by 43 publications

(62 citation statements)

References 35 publications

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“…In the current study, 60.9% of cases had an accompanying risk factor, which is a similar finding in previously mentioned studies. In addition to chronic disease and immunosuppression, the risk of H1N1 influenza infection increases during pregnancy 2,5,[18][19][20][21] . In a study of pregnant women with serious influenza infection conducted in Australia, the relative risks of hospitalisation, admittance to ICU, and death were determined to be 5.2, 6.5, and 1.4, respectively 23 .…”

Section: Discussionmentioning

confidence: 99%

“…In 2009, millions of people worldwide were affected by the rapid person-to-person spread of the H1N1 influenza A virus 1,2 . In June 2009, the World Health Organisation (WHO) declared a level 6 warning for this new influenza pandemic th of November 2009 as the first critically ill patient with respiratory failure due to H1N1 infection.…”

Section: Introductionmentioning

confidence: 99%

“…As the first pandemic of the 21st century, this infection primarily affected those with underlying respiratory and cardiac disease, children, young adults, and pregnant women 2,5,6 . Although early symptoms similar to seasonal influenza were observed, cases of H1N1 infection progressed to viral pneumonia, respiratory failure, hypoxia, and organ failure resulting in death [6][7][8] .…”

Section: Introductionmentioning

confidence: 99%

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A retrospective evaluation of critically ill patients infected with H1N1 influenza A virus in Bursa, Turkey, during the 2009–2010 pandemic

Nermin¹,

İşçimen²,

Zeynep³

et al. 2015

Afr H. Sci.

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Background: H1N1 influenza A virus infections were first reported in April 2009 and spread rapidly, resulting in mortality worldwide. The aim of this study was to evaluate patients with H1N1 infection treated in the intensive care unit (ICU) in Bursa, Turkey. Methods: Demographic characteristics, clinical features, and outcome relating to H1N1 infection were retrospectively analysed in patients treated in the ICU. Results: Twenty-three cases of H1N1 infection were treated in the ICU. The mean age of patients was 37 years range: (17-82). Fifteen patients were female (65.2%). The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 19 range: (5-39). The most common symptoms were dyspnea (73.9%), fever (69.6%), and cough (60.9%). Mechanical ventilation was required for all patients. Oseltamivir and antibiotics were administered to all patients. Six (26.1%) patients died. APACHE II scores were higher in the deceased 28.5 range: vs. 14 range: in survivors; p = 0.013). Conclusion: When compared to the literature, the demographic, epidemiological, and clinical characteristics were similar in the cases we encountered. The mortality rate was high despite the use of appropriate treatment. We believe that the high mortality is related to higher APACHE II scores. The H1N1 virus should be considered in community acquired pneumonia, especially in younger patients presenting with severe pneumonia.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A retrospective evaluation of critically ill patients infected with H1N1 influenza A virus in Bursa, Turkey, during the 2009–2010 pandemic

Nermin¹,

İşçimen²,

Zeynep³

et al. 2015

Afr H. Sci.

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“…The percentages of missing data were smaller for the deaths than the survivors (0.4% vs. 36% for time to death/discharge for example), suggesting that data collection was more thorough for patients who died. 210 Poeppl 2011 198 Blumental 2011 202 Yung 2011 195 Altmann 2011 185 Enstone 2011 192 del Rosal 2011 205 Nguyen-Van-Tam 2010 186 Thompson 2011 188 Miranda-Choque 2011 197 Yokota 2011 200 Moretti 2011 208 Yang 2010 191 Mickienė 2011 Results show that when the time-dependent nature of treatment is taken into account appropriately the treatment effects change direction, although none of the results is statistically significant. Adjusting for potential confounders and imputing missing data made little difference to the results.…”

Section: Meta-analysis Of Individual Patient Datamentioning

confidence: 99%

Neuraminidase inhibitors for influenza: a systematic review and meta-analysis of regulatory and mortality data

Heneghan

Onakpoya

Jones

et al. 2016

Health Technol Assess

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BackgroundNeuraminidase inhibitors (NIs) are stockpiled and recommended by public health agencies for treating and preventing seasonal and pandemic influenza. They are used clinically worldwide.ObjectivesTo (1) describe the potential benefits and harms of NIs for influenza in all age groups by reviewing all clinical study reports (CSRs) of published and unpublished randomised, placebo-controlled trials and regulatory comments; and (2) determine the effect of oseltamivir (Tamiflu®, Roche) treatment on mortality in patients with 2009A/H1N1 influenza.MethodsWe searched trial registries, electronic databases and corresponded with regulators and sponsors to identify randomised trials of NIs. We requested full CSRs and accessed regulators’ comments. We included only those trials for which we had CSRs. To examine the effects of oseltamivir on 2009A/H1N1 influenza mortality, we requested individual patient data (IPD) from corresponding authors of all included observational studies.ResultsEffect of oseltamivir and zanamivir (Relenza®, GlaxoSmithKline) in the prevention and treatment of influenza: Oseltamivir reduced the time to first alleviation of symptoms in adults by 16.8 hours [95% confidence interval (CI) 8.4 to 25.1 hours]. Zanamivir reduced the time to first alleviation of symptoms in adults by 0.60 days (95% CI 0.39 to 0.81 days). Oseltamivir reduced unverified pneumonia in adult treatment [risk difference (RD) 1.00%, 95% CI 0.22% to 1.49%]; similar findings were observed with zanamivir prophylaxis in adults (RD 0.32%, 95% CI 0.09% to 0.41%). Oseltamivir treatment of adults increased the risk of nausea (RD 3.66%, 95% CI 0.90% to 7.39%) and vomiting (RD 4.56%, 95% CI 2.39% to 7.58%). In the treatment of children, oseltamivir induced vomiting (RD 5.34%, 95% CI 1.75% to 10.29%). Both oseltamivir and zanamivir prophylaxis reduced the risk of symptomatic influenza in individuals (oseltamivir RD 3.05%, 95% CI 1.83% to 3.88%; zanamivir RD 1.98%, 95% CI 0.98% to 2.54%) and in households (oseltamivir RD 13.6%, 95% CI 9.52% to 15.47%; zanamivir RD 14.84%, 95% CI 12.18% to 16.55%). Oseltamivir increased psychiatric adverse events in the combined on- and off-treatment periods (RD 1.06%, 95% CI 0.07% to 2.76%) and the risk of headaches while on treatment (RD 3.15%, 95% CI 0.88% to 5.78%).Effect of oseltamivir on mortality in patients with 2009A/H1N1 influenza: Analysis of summary data of 30 studies as well as IPD of four studies showed evidence of time-dependent bias. After adjusting for time-dependent bias and potential confounding variables, competing risks analysis of the IPD showed insufficient evidence that oseltamivir reduced the risk of mortality (hazard ratio 1.03, 95% CI 0.64 to 1.65).ConclusionsOseltamivir and zanamivir cause small reductions in the time to first alleviation of influenza symptoms in adults. The use of oseltamivir increases the risk of nausea, vomiting, psychiatric events in adults and vomiting in children. Oseltamivir has no protective effect on mortality among patients with 2009A/H1N1 influenza. Prophylaxis with either NI may reduce symptomatic influenza in individuals and in households. The balance between benefits and harms should be considered when making decisions about use of NIs for either prophylaxis or treatment of influenza.Study registrationThis study is registered as PROSPERO CRD42012002245.FundingThe National Institute for Health Research Health Technology Assessment programme.

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“…Data regarding the use of oseltamivir, an inhibitor of the infl uenza enzyme neuraminidase, 5 have been confl icting with some studies showing shortened duration and severity of seasonal infl uenza infection in adults and children including patients with high-risk conditions. [6][7][8][9][10][11][12][13][14][15][16] However, 2 recent meta-analyses have suggested that although oseltamivir decreases the duration of symptoms or the time to fi rst alleviation of symptoms, it did not decrease the rate of provider-diagnosed pneumonia or hospitalization. 17,18 These new fi ndings arise in part from the fact that 9 randomized controlled trials sponsored by manufacturers had not previously been published in full even though patients agreed to be subjects in a study of what was an experimental medication.…”

Section: Hospital Readmissions Among Children With H1n1 Infl Uenza Inmentioning

confidence: 99%

Hospital Readmissions Among Children With H1N1 Influenza Infection

Brogan

Hall

Sills

et al. 2014

Hospital Pediatrics

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Objectives: To describe readmissions among children hospitalized with H1N1 (influenza subtype, hemagglutinin1, neuraminidase 1) pandemic influenza and secondarily to determine the association of oseltamivir during index hospitalization with readmission. Methods: We reviewed data from 42 freestanding children’s hospitals contributing to the Pediatric Health Information System from May through December 2009 when H1N1 was the predominant influenza strain. Children were divided into 2 groups by whether they experienced complications of influenza during index hospitalization. Primary outcome was readmission at 3, 7, and 30 days among both patient groups. Secondary outcome was the association of oseltamivir treatment with readmission. Results: The study included 8899 children; 6162 patients had uncomplicated index hospitalization, of whom 3808 (61.8%) received oseltamivir during hospitalization, and 2737 children had complicated influenza, of whom 1055 (38.5%) received oseltamivir. Median 3-, 7-, and 30-day readmission rates were 1.6%, 2.5%, and 4.7% for patients with uncomplicated index hospitalizations and 4.3%, 5.8%, and 10.3% among patients with complicated influenza. The 30-day readmission rates did not differ by treatment group among patients with uncomplicated influenza; however, patients with complicated index hospitalizations who received oseltamivir had lower all-cause 30-day readmissions than untreated patients. The most common causes of readmission were pneumonia and asthma exacerbations. Conclusions: Oseltamivir use for hospitalized children did not decrease 30-day readmission rates in children after uncomplicated index hospitalization but was associated with a lower 30-day readmission rate among children with complicated infections during the 2009 H1N1 pandemic. Readmission rates for children who had complicated influenza infection during index hospitalizations are high.

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Clinical aspects of 2009 pandemic influenza A (H1N1) virus infection in Austria

Cited by 43 publications

References 35 publications

A retrospective evaluation of critically ill patients infected with H1N1 influenza A virus in Bursa, Turkey, during the 2009–2010 pandemic

A retrospective evaluation of critically ill patients infected with H1N1 influenza A virus in Bursa, Turkey, during the 2009–2010 pandemic

Neuraminidase inhibitors for influenza: a systematic review and meta-analysis of regulatory and mortality data

Hospital Readmissions Among Children With H1N1 Influenza Infection

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