Excess mortality is associated with influenza A (H1N1) in patients with severe acute respiratory illness

Lobo, Suzana Margareth; Watanabe, Aripuanã Sakurada Aranha; Salomão, Maria Lúcia Machado; Queiroz, Flávia; Gandolfi, Joelma Vilafanha; Oliveira, Neymar Elias de; Covello, Luís Henrique Simões; Sacillotto, Guilherme Hirassawa; Godoy, Livia Gonçalez de; Simões, Estela Silva; Frini, Inara Cristina Marciano; Teixeira, Rayane Estefani Ribas Da Silva; Furlan, Nathália Pimentel; Dutra, Karina Rocha; Nogueira, Maurício Lacerda

doi:10.1016/j.jcv.2019.05.003

Cited by 28 publications

(25 citation statements)

References 24 publications

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“…We found a significant higher incidence of reduced SPO 2 in patients with more severe COVID-19 infection (35.5%) when compared to the patients with the mild infection (9.9%), suggesting that early decline of SPO 2 could be an indicator for severe infection. As a marker for systemic inflammatory response, CK has been reported to be associated with higher risk of disease progressing in patients with influenza A (H1N1) viral pneumonia [ 42 ], and in patients with severe COVID-19 infection [ 7 , 9 , 12 ]. Recent studies have reported that elevated CK was commonly seen in patients with COVID-19, indicating possible damage to skeletal muscle and cardiac muscle [ [7] , [8] , [9] , [10] , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Myosteatosis predicting risk of transition to severe COVID-19 infection

Liu

Zhu

et al. 2022

Clinical Nutrition

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Background About 10–20% of patients with Coronavirus disease 2019 (COVID-19) infection progressed to severe illness within a week or so after initially diagnosed as mild infection. Identification of this subgroup of patients was crucial for early aggressive intervention to improve survival. The purpose of this study was to evaluate whether computer tomography (CT) - derived measurements of body composition such as myosteatosis indicating fat deposition inside the muscles could be used to predict the risk of transition to severe illness in patients with initial diagnosis of mild COVID-19 infection. Methods Patients with laboratory-confirmed COVID-19 infection presenting initially as having the mild common-subtype illness were retrospectively recruited between January 21, 2020 and February 19, 2020. CT-derived body composition measurements were obtained from the initial chest CT images at the level of the twelfth thoracic vertebra (T12) and were used to build models to predict the risk of transition. A myosteatosis nomogram was constructed using multivariate logistic regression incorporating both clinical variables and myosteatosis measurements. The performance of the prediction models was assessed by receiver operating characteristic (ROC) curve including the area under the curve (AUC). The performance of the nomogram was evaluated by discrimination, calibration curve, and decision curve. Results A total of 234 patients were included in this study. Thirty-one of the enrolled patients transitioned to severe illness. Myosteatosis measurements including SM-RA (skeletal muscle radiation attenuation) and SMFI (skeletal muscle fat index) score fitted with SMFI, age and gender, were significantly associated with risk of transition for both the training and validation cohorts (P < 0.01). The nomogram combining the SM-RA, SMFI score and clinical model improved prediction for the transition risk with an AUC of 0.85 [95% CI, 0.75 to 0.95] for the training cohort and 0.84 [95% CI, 0.71 to 0.97] for the validation cohort, as compared to the nomogram of the clinical model with AUC of 0.75 and 0.74 for the training and validation cohorts respectively. Favorable clinical utility was observed using decision curve analysis. Conclusion We found CT-derived measurements of thoracic myosteatosis to be associated with higher risk of transition to severe illness in patients affected by COVID-19 who presented initially as having the mild common-subtype infection. Our study showed the relevance of skeletal muscle examination in the overall assessment of disease progression and prognosis of patients with COVID-19 infection.

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Section: Discussionmentioning

confidence: 99%

Myosteatosis predicting risk of transition to severe COVID-19 infection

Liu

Zhu

et al. 2022

Clinical Nutrition

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“…The pathogenic influenza A virus (H1N1) causes respiratory tract infection that develops into severe influenza pneumonia, leading to acute pulmonary injury (ALI) 37,38 and acute respiratory distress syndrome (ARDS) 39,40 , even to death. In this study, we successfully established a mouse model of IAV pneumonia and death in which mice were infected with influenza virus A/FM1/47.…”

Section: Discussionmentioning

confidence: 99%

Antiviral activity of iridoid glycosides extracted from Fructus Gardeniae against influenza A virus by PACT-dependent suppression of viral RNA replication

Guo

Bao

et al. 2020

Sci Rep

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Epidemic and pandemic influenza A virus (IAV) poses a significant threat to human populations worldwide. Iridoid glycosides are principal bioactive components from the Gardenia jasminoides J. Ellis fruit that exhibit antiviral activity against several strains of IAV. In the present study, we evaluated the protective effect of Fructus Gardeniae iridoid glycoside extracts (IGEs) against IAV by cytopathogenic effect(CPE), MTT and a plaque formation assay in vitro and examined the reduction in the pulmonary index (PI), restoration of body weight, reduction in mortality and increases in survival time in vivo.As a host factor, PACT provides protection against the pathogenic influenza A virus by interacting with IAV polymerase and activating the IFN-I response. To verify the whether IGEs suppress IAV replication in a PACT-dependent manner, IAV RNA replication, expression of PACT and the phosphorylation of eIF2α in A549 cells were detected; the levels of IFNβ, PACT and PKR in mouse lung tissues were determined; and the activity of IAV polymerase was evaluated in PACT-compromised cells. The results indicated that IGEs sufficiently alleviated cell damage and suppressed IAV replication in vitro, protecting mice from IAV-induced injury and lethal IAV infection. These anti-IAV effects might be related to disrupted interplay between IVA polymerase and PACT and/or prevention of a PACT-dependent overactivated IFN-I antiviral response. Taken together, our findings reveal a new facet of the mechanisms by which IGEs fight the influenza A virus in a PACT-dependent manner.

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“…In COVID-19 patients complicated with ARDS, the subpleural ground-glass opacities developed rapidly into bilateral diffuse in ltration or massive consolidation, often accompanied by the pleural parallel sign (100%) and vascular thickening sign (71.4%). Although the imaging manifestations of ARDS were similar, patients with H1N1 initially showed patchy ground-glass opacities, which were mainly distributed in the bronchovascular bundle (19,20), and were accompanied by bronchiectasis (100%), pleural effusion (60%), and increased heart shadow (60%). Therefore, the combination of the distribution of ground glass opacities and the accompanying pleural parallel sign, enlarged heart shadows, and pleural effUsion sign would be of great value for the differential diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Clinical Characteristics of 2019 Novel Coronavirus Disease and Avian Influenza A (H1N1) Complicated with Acute Respiratory Distress Syndrome1

Zuo¹,

Yang³

et al. 2021

Preprint

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Objective: Both 2019 novel coronavirus disease (COVID-19) and avian influenza A (H1N1) are serious acute respiratory diseases with a predisposition to acute respiratory distress syndrome (ARDS). Our aim was to compare the clinical characteristics of patients with COVID-19 and H1N1 influenza complicated with ARDS.Methods: We retrospectively studied data of 12 patients with ARDS (7 with COVID-19; 5 with H1N1 influenza) who were managed at The Second Affiliated Hospital of Xiamen Medical College and Xinglin Branch of the First Affiliated Hospital of Xiamen University between December 20, 2019 and February 29, 2020. We extracted the clinical information and outcomes from the hospital medical charts.Results: Patients with COVID-19 were older and were more likely to have underlying diseases. Low-to-moderate fever was more frequent and upper respiratory tract symptoms were less common in COVID-19 patients. Chest computed tomography of patients with COVID-19 more frequently revealed bilateral nodular patchy ground-glass opacities in the subpleural and central lobular regions. Heart disorders and pleural effusion were less frequent, and coagulopathy was more common in patients with COVID-19. The average duration of stay in the respiratory intensive care unit was longer in patients with COVID-19. The disease severity and clinical outcomes did not differ significantly between the two groups.Conclusion: Older age, higher comorbidity frequency, abnormal coagulation responses, longer hypoxemia duration, pulmonary fibrosis, and poorer clinical outcomes are the main characteristics in patients with COVID-19 who have ARDS. This calls for closer dynamic monitoring and more rigorous follow-up.

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Excess mortality is associated with influenza A (H1N1) in patients with severe acute respiratory illness

Cited by 28 publications

References 24 publications

Myosteatosis predicting risk of transition to severe COVID-19 infection

Myosteatosis predicting risk of transition to severe COVID-19 infection

Antiviral activity of iridoid glycosides extracted from Fructus Gardeniae against influenza A virus by PACT-dependent suppression of viral RNA replication

Comparison of the Clinical Characteristics of 2019 Novel Coronavirus Disease and Avian Influenza A (H1N1) Complicated with Acute Respiratory Distress Syndrome1

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