Clinical Features and Factors Associated with Outcomes of Patients Infected with a Novel Influenza A (H7N9) Virus: A Preliminary Study

Abstract

ObjectiveThe present study aimed to analyze clinical features and factors associated with treatment outcomes of H7N9 influenza A virus infection.MethodsThe clinical progress in 18 H7N9-infected patients was monitored and recorded. The clinical features of H7N9 infection were noted and factors associated with treatment outcomes were analyzed by univariate analyses.ResultsThe average ages of patients in recovered and critical conditions were 67.0±10.83 years and 72.75±12.0 years, respectively. Renal insufficiency developed more frequently in critically ill patients (P = 0.023). The duration of traditional Chinese medicine (TCM) therapy was longer in recovered patients than in critically ill patients (P = 0.01). Laboratory tests showed that levels of C-reactive protein, serum creatinine, and myoglobin were significantly higher in critically ill patients than in recovered patients (P = 0.011, 0.04, and 0.016, respectively). Meanwhile, levels of all T cell subsets examined including total CD3+, CD4+, CD8+, and CD45+ T cells were lower in critically ill patients than in recovered patients (P = 0.033, 0.059, 0.015, and 0.039, respectively). Logistic regression analysis demonstrated that C-reactive protein level, myoglobin level and TCM therapy duration were likely associated with treatment outcomes of H7N9 infection (P = 0.032, 0.041 and 0.017, respectively).ConclusionElderly people may have increased risk for H7N9 virus infection. T cell-mediated responses play an important role in defense against the H7N9 virus. C-reactive protein level, myoglobin level and TCM duration may be associated with treatment outcomes of H7N9 infection.

Predictors for fatal human infections with avian H7N9 influenza, evidence from four epidemic waves in Jiangsu Province, Eastern China, 2013‐2016

“…We found in this study that clinical complications such as ARDS, heart failure and septic shock could pose an elevated risk of death from H7N9 infection. This finding is consistent with previous studies and case reports . A longer disease duration was found to be associated with a reduced risk of death in our study.…”

“…The virus has raised severe concerns due to its ability of binding to receptors in the upper respiratory tract and the high death rate in human infections. Several published studies have presented preliminary analyses of the risk factors or predictors for fatal human infections with H7N9 . However, statistical analyses, especially multivariate analyses, were underpowered in most studies due to small sample size (≤40 cases) or patients' limited epidemiological/clinical information.…”

Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study

“…In our study, the predisposing conditions for COVID19 pneumonia tended to be old age and medical comor bidities (such as chronic pulmonary disease, diabetes, and other chronic diseases), similar to previous viral infections such as influenza H7N9. 18,19 There was no obvious predilection for males or females in our cohort. However, another study reported that 30 (73%) of 41 infected patients were men.…”

A pilot study on primary cultures of human respiratory tract epithelial cells to predict patients’ responses to H7N9 infection

“…Notably, old age (≥ 65 years), male sex, medical comorbidities, and obesity have been previously identified as risk factors for the development of severe disease [2,[11][12][13][14][15]]. An age-and sex-based analysis of 63 patients infected by the H7N9 virus showed that elderly men are most commonly affected, whereas no deaths were observed in elderly women.…”