H1N1 2009 influenza virus infection during pregnancy in the USA

Jamieson, Denise J.; Honein, Margaret A.; Rasmussen, Sonja A.; Williams, Jennifer L.; Swerdlow, David L.; Biggerstaff, Matthew; Lindstrom, Stephen; Louie, Janice K.; Christ, Cara; Bohm, Susan; Fonseca, Vincent P.; Ritger, Kathleen A.; Kuhles, Daniel; Eggers, Paula; Bruce, Hollianne; Davidson, Heidi; Lutterloh, Emily; Harris, Meghan L.; Burke, C.; Cocoros, Noelle M; Finelli, Lyn; MacFarlane, Kitty; Shu, Bo; Olsen, Sonja J.

doi:10.1016/s0140-6736(09)61304-0

Cited by 1,216 publications

(978 citation statements)

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“…Novel influenza A H1N1 testing was performed in each institution, or centralized in a reference laboratory when not available. A confirmed case was defined as an acute respiratory illness with laboratory-confirmed pandemic H1N1 virus infection identified by RT-PCR or viral culture [10]. Only confirmed cases were included in the current study.…”

Section: Methodsmentioning

confidence: 99%

Acute kidney injury in critical ill patients affected by influenza A (H1N1) virus infection

et al. 2011

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IntroductionLittle information exists about the impact of acute kidney injury (AKI) in critically ill patients with the pandemic 2009 influenza A (H1N1) virus infection.MethodsWe conducted a prospective, observational, multicenter study in 148 Spanish intensive care units (ICUs). Patients with chronic renal failure were excluded. AKI was defined according to Acute Kidney Injury Network (AKIN) criteria.ResultsA total of 661 patients were analyzed. One hundred eighteen (17.7%) patients developed AKI; of these, 37 (31.4%) of the patients with AKI were classified as AKI I, 15 (12.7%) were classified as AKI II and 66 (55.9%) were classified as AKI III, among the latter of whom 50 (75.7%) required continuous renal replacement therapy. Patients with AKI had a higher Acute Physiology and Chronic Health Evaluation II score (19.2 ± 8.3 versus 12.6 ± 5.9; P < 0.001), a higher Sequential Organ Failure Assessment score (8.7 ± 4.2 versus 4.8 ± 2.9; P < 0.001), more need for mechanical ventilation (MV) (87.3% versus 56.2%; P < 0.01, odds ratio (OR) 5.3, 95% confidence interval (CI) 3.0 to 9.4), a greater incidence of shock (75.4% versus 38.3%; P < 0.01, OR 4.9, 95% CI, 3.1 to 7.7), a greater incidence of multiorgan dysfunction syndrome (92.4% versus 54.7%; P < 0.01, OR 10.0, 95% CI, 4.9 to 20.21) and a greater incidence of coinfection (23.7% versus 14.4%; P < 0.01, OR 1.8, 95% CI, 1.1 to 3.0). In survivors, patients with AKI remained on MV longer and ICU and hospital length of stay were longer than in patients without AKI. The overall mortality was 18.8% and was significantly higher for AKI patients (44.1% versus 13.3%; P < 0.01, OR 5.1, 95% CI, 3.3 to 7.9). Logistic regression analysis was performed with AKIN criteria, and it demonstrated that among patients with AKI, only AKI III was independently associated with higher ICU mortality (P < 0.001, OR 4.81, 95% CI 2.17 to 10.62).ConclusionsIn our cohort of patients with H1N1 virus infection, only those cases in the AKI III category were independently associated with mortality.

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Section: Methodsmentioning

confidence: 99%

Acute kidney injury in critical ill patients affected by influenza A (H1N1) virus infection

et al. 2011

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“…Our data sources are refs [5, 6, 8, 25] (MIDAS High Risk Segmentation Group, D. Wagener, private communication, 2009). The estimates below are crude and based on limited available data.…”

Section: Relative Risks For Certain High‐risk Groupsmentioning

confidence: 99%

“…An estimate in ref. [8] suggests that they are about four times more likely to be hospitalized as a result of H1N1 infection compared with general public. The percentages of pregnant women among hospitalized patients in refs [5] and [6] are 6·6% and 9·6% correspondingly.…”

Section: Relative Risks For Certain High‐risk Groupsmentioning

confidence: 99%

“…These groups include pregnant women, 5 , 6 , 8 , 28 children and adults with neurological conditions, 5 , 6 , 29 persons with immunosuppression and certain chronic diseases, 5 , 6 , 13 morbidly obese individuals (BMI ≥ 40), 5 , 6 and some of the other high‐risk groups 5 , 6 , 13 . We believe it is also plausible to expect that pre‐dispensed antivirals are more likely to be life‐saving (or to prevent hospitalizations or other severe outcomes) than those that are not pre‐dispensed ( B > 1), because wastage is relatively unlikely given the short time frame between when pre‐dispensing and usage could occur, and because early treatment is likely to have benefits in preventing progression to more severe condition 4 , 5 , 6 …”

Section: Implications For Decision‐makingmentioning

confidence: 99%

“…Several recent studies suggest that most severe outcomes for H1N1pdm infection occur in individuals with pre‐existing medical conditions, 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 although the exact percentages vary between the studies. This has been recognized in several countries, where prompt antiviral prescription to symptomatic high‐risk individuals is recommended 13 , 14 , 15 , 16 , 17 .…”

Section: Introductionmentioning

confidence: 99%

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Pre‐dispensing of antivirals to high‐risk individuals in an influenza pandemic

Goldstein

Miller

O’Hagan

et al. 2010

Influenza Resp Viruses

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Please cite this paper as: Goldstein et al. (2010) Pre‐dispensing of antivirals to high‐risk individuals in an influenza pandemic. Influenza and other Respiratory Viruses 4(2), 101‐112.We consider the net benefits of pre‐dispensing antivirals to high‐risk individuals during an influenza pandemic, where the measure of the benefit is the number of severe outcomes (such as deaths or hospitalizations) prevented by antivirals in the whole population. One potential benefit of pre‐dispensing is that individuals to whom antivirals have been pre‐dispensed may be able to initiate treatment earlier than if they had to wait to obtain and fill a prescription, reducing their risk of progression to severe disease. If this benefit exceeds the side effects of misuse for the category of individuals to whom antivirals were pre‐dispensed, and if antiviral supply exceeds overall population demand (which appears relevant for several countries including US in the 2009 H1N1 pandemic), pre‐dispensing a quantity of antivirals not exceeding the difference between supply and demand is always beneficial. In this study, we consider the net benefits of pre‐dispensing antivirals under various scenarios, including demand exceeding supply, and derive mathematical conditions under which antiviral pre‐dispensing is advantageous on balance. For individuals whose relative risk of severe outcome is high enough, such as immunosuppressed individuals (particularly children) and possibly individuals with neurological disorders, pre‐dispensing is always beneficial at a given level of antiviral stockpile with modest assumptions on the relative benefit of early treatment by a pre‐dispensed course, regardless of the overall population demand for antivirals during the course of an epidemic. Making additional assumptions on either the overall population demand for antivirals (which appear relevant for the 2009 H1N1 pandemic) or on the relative benefit of pre‐dispensing would make pre‐dispensing net beneficial with inclusion of a larger number of persons such as pregnant women and morbidly obese adults.

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