Retrospective review of epidemic viral pneumonia cases in Turkey: A multicenter study

Abstract

Influenza A (H1N1) caused its first pandemic in 2009 in USA and Mexico. Since then, clinicians have exercised great care in order to make an early diagnosis of viral pneumonias. This is due in part to pandemic influenza A infection having greater impact on populations <65 years old than other viral strains, including seasonal influenza. Chest radiographies of those affected displayed a rapid progression of patchy infiltrates, and a large proportion of individuals required admission to intensive care units (ICU). Despite efforts, patients infected with the virus had a high mortality rate. The present multicenter study aimed to retrospectively evaluate the clinical, demographic and prognostic characteristics of patients diagnosed with epidemic viral pneumonia in Turkey. A total of 92 patients were included in the study. The Student's t-test and Chi-square tests were performed to analyze quantitative data, assuming a normal distribution, and to analyze qualitative data, respectively. Stepwise logistic regression was used to evaluate the effects of demographic variables and laboratory values on the virus mortality rate. The male/female ratio was 42/50 and the mean age was 48.74±16.65 years. A total of 69 (75%) patients were unvaccinated against influenza. The most common symptoms were cough (87%) and fever (63%). Chest computed tomography showed peripheral patchy areas of the lungs of ground glass density in 38 patients (41.3%). A total of 22 (59.4%) patients had H1N1, 5 (12.5%) patients had influenza B, and 38 (41.3%) patients met the criteria for admission to the ICU. Of these patients, 20 (52.63%) were monitored with a mechanical ventilator, with a noninvasive ventilator being adequate for 10 (26.32%) of patients. The length of stay in the ICU was 6.45±5.97 days and the duration of mechanical ventilation was 5.06±4.69 days. A total of 12 (13.04%) patients in the ICU succumbed. Logistic regression analysis revealed that among the parameters possibly associated with mortality, being an active smoker increased the risk of mortality 7.08-fold compared to other groups (P=0.005). In conclusion, viral pneumonia remains a significant health problem during the winter period. Considering the high number of ICU admissions and high rate of mortality for patients in the present study, earlier initiation of antiviral therapy is necessary. Active smoking increased mortality in viral pneumonia.

Evaluation of clinical and laboratory parameters in patients with influenza pneumonia

“…In our study, 70% of influenza cases were type A and 30% type B. Previously done studies showed that influenza A cases were more frequent than influenza B cases that is similar to our results [16,19,20]. Most of the patients in our study group expressed complaints of fever, cough, and malaise.…”

“…The mean age of patients hospitalized with the diagnosis of influenza A was 49.7±18.7 in the study of Gürgün et al, and 48.6±19.1 in the study of Özlü et al [17,18]. In our study, 53.3% of the patients in whom influenza was identified in lower respiratory tract samples were females and 46.7% were males that is similar to the study of Çörtük et al [16]. When compared according to the distribution of types, female/male ratio was similar in influenza A cases (42.8% females/57.1% males), whereas the female ratio was higher in influenza type B (77.7% females/22.2% males).…”

“…In this study of ours that evaluated the clinical and laboratory characteristics of adult patients with confirmed influenza-related lower respiratory tract infections, 50% of the patients were determined to be over 65 years of age. In the study of Çörtük et al, the mean age of influenza cases was 48.74±16.65, whereas it was 58.06±19.08 in our study [16]. The mean age of influenza A and B patients were found as 56.9 and 62.6 in our study.…”

“…Most of the patients in our study group expressed complaints of fever, cough, and malaise. In the study published by Çörtük et al, the most frequently recorded symptoms were a cough (87%), fever (63%), and dyspnea (58.7%) [16]. When the symptom distribution according to the type was analyzed, symptoms were found to be similar in types A and B.…”

Smoking and female sex as key risk factors associated with severe arthralgia in acute and chronic phases of Chikungunya virus infection

“…There are no previous reports associating smoking habits with the severity of symptoms during CHIKV infection, but it is logical to assume that smoking can influence the severity of a viral infection that affects the lungs, since they could already be compromised by the chemical components of cigarette smoke. This premise has previously been demonstrated in association with influenza infection (25). Smoking has also been demonstrated to influence the severity of viral infections in other organs.…”