Clinical Features, Risk Factors, and Complications Among Pediatric Patients With Pandemic Influenza A (H1N1)

Plessa, Eleni; Diakakis, Panagiotis; Gardelis, John; Thirios, Athanasios; Koletsi, Patra; Falagas, Matthew E.

doi:10.1177/0009922810368558

Cited by 52 publications

(33 citation statements)

References 15 publications

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“…Among the 6 patients admitted to the ICU, 3 had lymphopenia similar to studies from India, California and Mexico [18,19,20,21,22]. In Mexico, the analysis of 18 deaths caused by H1N1 infection in previously healthy subjects revealed lymphopenia in 16% of them; apparently lymphopenia is an important risk factor and patients should be closely observed, especially those with underlying medical conditions.…”

Section: Discussionsupporting

confidence: 55%

Epidemiology and Clinical Presentation of Pandemic Influenza A (H1N1) among Hospitalized Children in Kuwait

et al. 2011

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Objective: To describe the epidemiological and clinical characteristics of children hospitalized for the 2009 influenza A H1N1 infection in Kuwait. Materials and Methods: A retrospective chart review of hospitalized children with laboratory-confirmed influenza A H1N1 infection in two hospitals in Kuwait was conducted. Epidemiological characteristics, clinical features, risk factors for severe disease, complications and mortality were analyzed. Results: The medical records of 197 children hospitalized for the 2009 pandemic H1N1 infection from August 2009 to January 2010 were reviewed. The majority of the children (104; 52.8%) were admitted during the month of October. The median age was 2 years. Most of the admitted children were in two age categories: 64 infants ≤1 year (32%) and 62 schoolchildren >5 years (31%). The most frequent presentations were fever in 193 (98%), cough in 155 (79%) and runny nose in 105 (53%) cases. The majority of the admitted children (109; 55%) had been previously healthy. All children received an antiviral agent (oseltamivir), and antibiotics were administered to 147 (75%). Bacterial co-infections occurred in 3 (1.5%) of all hospitalized children. Six (3%) children were admitted to the intensive care unit, of whom 4 (66%) required artificial ventilation. There was only 1 mortality. Conclusions: The pandemic H1N1 infection was associated with a wide spectrum of clinical manifestations. The majority of hospitalized children had previously been healthy. Most of the admitted children had an uncomplicated clinical course.

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Section: Discussionsupporting

confidence: 55%

Epidemiology and Clinical Presentation of Pandemic Influenza A (H1N1) among Hospitalized Children in Kuwait

et al. 2011

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“…Underlying medical conditions including asthma and obesity have been reported in pediatric studies to be risk factors for morbidity or mortality 1,6 . In the present study, underlying medical conditions showed no statistical significance on either univariate or multivariate analysis.…”

Section: Discussioncontrasting

confidence: 74%

“…Basic demographic and clinical data including age, sex, length of hospitalization, fever duration, and underlying medical conditions, as well as vital signs (heart rate and respiratory rate at admission) were obtained from patient charts. Data such as underlying medical conditions, 1,6 and interval from symptom onset to oseltamivir treatment, 7 obtained from previous studies with important factors of morbidity of pH1N1 were also recorded. The underlying medical conditions considered to be established risk factors for severe influenza included chronic pulmonary disease including asthma, hemodynamically significant cardiac disease, hemoglobinopathy, immunosuppressive treatment, chronic renal dysfunction, chronic metabolic disorder, and neuromuscular disorder.…”

Section: Methodsmentioning

confidence: 99%

Factors associated with hypoxemia in children infected with pandemic H1N1 2009 influenza virus

Yeom¹,

Park²,

Seo³

et al. 2011

Pediatrics International

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“…9,10 Several cross-sectional and cohort studies have suggested that obesity may contribute to respiratory complications in children. 11–13 These findings provide important rationale for investigations of pediatric obesity outcomes. However, the findings may not be generalizable to acutely ill children, especially because unique short-term consequences may result from pediatric obesity.…”

mentioning

confidence: 93%

Influence of Obesity on Clinical Outcomes in Hospitalized Children

Bechard¹,

Rothpletz‐Puglia²,

Touger‐Decker³

et al. 2013

JAMA Pediatr

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Importance Obesity is prevalent among hospitalized children. Knowledge of the relationship between obesity and outcomes in hospitalized children will enhance nutrition assessment and provide opportunities for interventions. Objective To systematically review the existing literature concerning the impact of obesity on clinical outcomes in hospitalized children. Evidence Acquisition PubMed, Web of Science, and EMBASE databases were searched for studies of hospitalized children aged 2 to 18 years with identified obesity and at least 1 of the following clinical outcomes: all-cause mortality, incidence of infections, and length of hospital stay. Cohort and case-control studies were included. Cross-sectional studies, studies of healthy children, and those without defined criteria for classifying weight status were excluded. The Newcastle-Ottawa Scale was used to assess study quality. Results Twenty-eight studies (26 retrospective; 24 cohort and 4 case-control) were included. Of the 21 studies that included mortality as an outcome, 10 reported a significant positive relationship between obesity and mortality. The incidence of infections was assessed in 8 of the 28 studies; 2 reported significantly more infections in obese compared with nonobese patients. Of the 11 studies that examined length of stay, 5 reported significantly longer lengths of hospital stay for obese children. Fifteen studies (53%) had a high quality score. Larger studies observed significant relationships between obesity and outcomes. Studies of critically ill, oncologic or stem cell transplant, and solid organ transplant patients showed a relationship between obesity and mortality. Conclusions and Relevance The available literature on the relationship between obesity and clinical outcomes is limited by subject heterogeneity, variations in criteria for defining obesity, and outcomes examined. Childhood obesity may be a risk factor for higher mortality in hospitalized children with critical illness, oncologic diagnoses, or transplants. Further examination of the relationship between obesity and clinical outcomes in this subgroup of hospitalized children is needed.

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Clinical Features, Risk Factors, and Complications Among Pediatric Patients With Pandemic Influenza A (H1N1)

Abstract: In this cohort, most children with confirmed H1N1 infection experience an uncomplicated viral illness. Nevertheless, underlying asthma and obesity may aggravate their clinical course.

Cited by 52 publications

References 15 publications

Epidemiology and Clinical Presentation of Pandemic Influenza A (H1N1) among Hospitalized Children in Kuwait

Epidemiology and Clinical Presentation of Pandemic Influenza A (H1N1) among Hospitalized Children in Kuwait

Factors associated with hypoxemia in children infected with pandemic H1N1 2009 influenza virus

Influence of Obesity on Clinical Outcomes in Hospitalized Children

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