Corticosteroid therapy in patients with primary viral pneumonia due to pandemic (H1N1) 2009 influenza

Dı́az, Emili; Martín‐Loeches, Ignacio; Canadell, Laura; Vidaur, Loreto; Suarez, David L.; Socías, Lorenzo; Estella, Ángel; Rueda, Bernardo Gil; Guerrero, José Eugenio; Valverdú-Vidal, Montserrat; Vergara, Juan Carlos; López-Pueyo, María Jesús; Magret, Mónica; Recio, Teresa; López, Diego Pérez; Rello, Jordi; Rodríguez, Alejandro

doi:10.1016/j.jinf.2011.12.010

Cited by 59 publications

(57 citation statements)

References 33 publications

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“…Brun-Buisson et al [74] analyzed 208 acute respiratory failure patients who had no other indication for corticosteroids other than acute respiratory failure and showed that the administration of a corticosteroid increased the mortality and the risk of hospital-acquired pneumonia, and particularly, early administration within 3 days after mechanical ventilation was correlated with increased mortality. Similar to the results of other studies, a study on viral pneumonia did not show a therapeutic effect for a steroid [76].…”

Section: Steroids Key Question 7: Should a Corticosteroid Be Administsupporting

confidence: 88%

Severe Influenza Treatment Guideline

et al. 2014

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Section: Steroids Key Question 7: Should a Corticosteroid Be Administsupporting

confidence: 88%

Severe Influenza Treatment Guideline

et al. 2014

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“…In a retrospective cohort study of hospitalized patients with A (H1N1)pdm09 influenza virus infection in China, the early use of glucocorticoids for fever reduction and pneumonia prevention was associated with the subsequent development of critical illnesses, even after adjusting for the presence of underlying diseases or risk factors 25, 26. Corticosteroids may also prolong influenza viral shedding in the respiratory tract 27.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and factors associated with severe acute respiratory infection and influenza among children in Jingzhou, China

Yang¹,

Guan

Liu

et al. 2016

Influenza Resp Viruses

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BackgroundInfluenza is an important cause of respiratory illness in children, but data are limited on hospitalized children with laboratory‐confirmed influenza in China.MethodsWe conducted active surveillance for severe acute respiratory infection (SARI; fever and at least one sign or symptom of acute respiratory illness) among hospitalized pediatric patients in Jingzhou, Hubei Province, from April 2010 to April 2012. Data were collected from enrolled SARI patients on demographics, underlying health conditions, clinical course of illness, and outcomes. Nasal swabs were collected and tested for influenza viruses by reverse transcription polymerase chain reaction. We described the clinical and epidemiological characteristics of children with influenza and analyzed the association between potential risk factors and SARI patients with influenza.ResultsDuring the study period, 15 354 children aged <15 years with signs and symptoms of SARI were enrolled at hospital admission. severe acute respiratory infection patients aged 5–15 years with confirmed influenza (H3N2) infection were more likely than children without influenza to have radiographic diagnosis of pneumonia (11/31, 36% vs 15/105, 14%. P<.05). Only 16% (1116/7145) of enrolled patients had received seasonal trivalent influenza vaccination within 12 months of hospital admission. Non‐vaccinated influenza cases were more likely than vaccinated influenza cases to have pneumonia (31/133, 23% vs 37/256, 15%, P<.05). severe acute respiratory infection cases aged 5–15 years diagnosed with influenza were also more likely to have a household member who smoked cigarettes compared with SARI cases without a smoking household member (54/208, 26% vs 158/960, 16%, P<.05).ConclusionsInfluenza A (H3N2) virus infection was an important contributor to pneumonia requiring hospitalization. Our results highlight the importance of surveillance in identifying factors for influenza hospitalization, monitoring adherence to influenza prevention and treatment strategies, and evaluating the disease burden among hospitalized pediatric SARI patients. Influenza vaccination promotion should target children.

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“…Likewise, antiviral drugs are expensive (80), often induce resistance (81), and are generally less effective late in infection (82). Corticosteroids and ␤-adrenergic agonists generally have very limited beneficial effects on lung function in patients with severe viral ALI (83). Hence, treatment is limited to nonspecific supportive care in intensive care units (84).…”

Section: Fig 7 Lung Compliance and Airway Resistance Were Not Alteredmentioning

confidence: 99%

Activation of A ₁ -Adenosine Receptors Promotes Leukocyte Recruitment to the Lung and Attenuates Acute Lung Injury in Mice Infected with Influenza A/WSN/33 (H1N1) Virus

Aeffner

Woods

Davis

2014

J Virol

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We have shown that bronchoalveolar epithelial A 1 -adenosine receptors (A 1 -AdoR) are activated in influenza A virus-infected mice. Alveolar macrophages and neutrophils also express A 1 -AdoRs, and we hypothesized that activation of A 1 -AdoRs on these cells will promote macrophage and neutrophil chemotaxis and activation and thereby play a role in the pathogenesis of influenza virus-induced acute lung injury. Wild-type (WT) C57BL/6 mice, congenic A 1 -AdoR knockout (A 1 -KO) mice, and mice that had undergone reciprocal bone marrow transfer were inoculated intranasally with 10,000 PFU/mouse influenza A/WSN/33 (H1N1) virus. Alternatively, WT mice underwent daily treatment with the A 1 -AdoR antagonist 8-cyclopentyl-1,3-dipropylxanthine (DPCPX) from 1 day prior to inoculation. Infection increased bronchoalveolar lining fluid (BALF) adenosine comparably in WT and A 1 -KO mice. Infection of WT mice resulted in reduced carotid arterial O 2 saturation (hypoxemia), lung pathology, pulmonary edema, reduced lung compliance, increased basal airway resistance, and hyperresponsiveness to methacholine. These effects were absent or significantly attenuated in A 1 -KO mice. Levels of BALF leukocytes, gamma interferon (IFN-␥), and interleukin 10 (IL-10) were significantly reduced in infected A 1 -KO mice, but levels of KC, IP-10, and MCP-1 were increased. Reciprocal bone marrow transfer resulted in WT-like lung injury severity, but BALF leukocyte levels increased only in WT and A 1 -KO mice with WT bone barrow. Hypoxemia, pulmonary edema, and levels of BALF alveolar macrophages, neutrophils, IFN-␥, and IL-10 were reduced in DPCPX-treated WT mice. Levels of viral replication did not differ between mouse strains or treatment groups. These findings indicate that adenosine activation of leukocyte A 1 -AdoRs plays a significant role in their recruitment to the infected lung and contributes to influenza pathogenesis. A 1 -AdoR inhibitor therapy may therefore be beneficial in patients with influenza virus-induced lung injury. IMPORTANCEBecause antiviral drugs are of limited efficacy in patients hospitalized for influenza virus-induced respiratory failure, there is an urgent need for new therapeutics that can limit the progression of lung injury and reduce influenza death rates. We show that influenza A virus infection results in increased production of the nucleoside adenosine in the mouse lung and that activation of A 1 -subtype adenosine receptors by adenosine contributes significantly to both recruitment of innate immune cells to the lung and development of acute lung injury following influenza virus infection. We also show that treatment with an A 1 -adenosine receptor antagonist reduces the severity of lung injury in influenza virus-infected mice. Our findings indicate that adenosine plays an important and previously unrecognized role in the innate immune response to influenza virus infection and suggest that drugs which can inhibit either generation of adenosine or activation of A 1 -adenosine receptors may be beneficia...

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Corticosteroid therapy in patients with primary viral pneumonia due to pandemic (H1N1) 2009 influenza

Cited by 59 publications

References 33 publications

Severe Influenza Treatment Guideline

Severe Influenza Treatment Guideline

Clinical characteristics and factors associated with severe acute respiratory infection and influenza among children in Jingzhou, China

Activation of A ₁ -Adenosine Receptors Promotes Leukocyte Recruitment to the Lung and Attenuates Acute Lung Injury in Mice Infected with Influenza A/WSN/33 (H1N1) Virus

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Corticosteroid therapy in patients with primary viral pneumonia due to pandemic (H1N1) 2009 influenza

Cited by 59 publications

References 33 publications

Severe Influenza Treatment Guideline

Severe Influenza Treatment Guideline

Clinical characteristics and factors associated with severe acute respiratory infection and influenza among children in Jingzhou, China

Activation of A 1 -Adenosine Receptors Promotes Leukocyte Recruitment to the Lung and Attenuates Acute Lung Injury in Mice Infected with Influenza A/WSN/33 (H1N1) Virus

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Product

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Activation of A ₁ -Adenosine Receptors Promotes Leukocyte Recruitment to the Lung and Attenuates Acute Lung Injury in Mice Infected with Influenza A/WSN/33 (H1N1) Virus