Epidemiological and Clinical Characteristics and Risk Factors for Death of Patients with Avian Influenza A H7N9 Virus Infection from Jiangsu Province, Eastern ChinaReportar como inadecuado




Epidemiological and Clinical Characteristics and Risk Factors for Death of Patients with Avian Influenza A H7N9 Virus Infection from Jiangsu Province, Eastern China - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Background

A novel avian influenza A H7N9 virus has caused great morbidity as well as mortality since its emergence in Eastern China in February 2013. However, the possible risk factors for death are not yet fully known.

Methods and Findings

Patients with H7N9 virus infection between March 1 and August 14, 2013 in Jiangsu province were enrolled. Data were collected with a standard form. Mean or percentage was used to describe the features, and Fisher-s exact test or t-test test was used to compare the differences between fatal and nonfatal cases with H7N9 virus infection. A total of 28 patients with H7N9 virus infection were identified among whom, nine 32.1% died. The median age of fatal cases was significant higher than nonfatal cases P<0.05. Patients with older age were more strongly associated with increased odds of death OR = 30.0; 95% CI, 2.85–315.62. Co-morbidity with chronic lung disease and hypertension were risk factors for mortality OR = 14.40; 95% CI, 1.30–159.52, OR = 6.67; 95% CI, 1.09–40.43, respectively. Moreover, the presence of either bilateral lung inflammation or pulmonary consolidation on chest imaging on admission was related with fatal outcome OR = 7.00; 95%CI, 1.10–44.61. Finally, dynamic monitoring showed that lymphopenia was more significant in fatal group than in nonfatal group from day 11 to week five P<0.05. The decrease in oxygenation indexes were observed in most cases and more significantly in fatal cases after week three P<0.05, and the value of nearly all fatal cases were below 200 mmHg during our evaluation period.

Conclusions

Among cases with H7N9 virus infection, increased age accompanied by co-morbidities was the risk of death. The severity of lung infection at admission, the persistence of lymphocytopenia, and the extended duration of lower oxygenation index all contributed to worsened outcomes of patients with H7N9 virus infection.



Autor: Hong Ji , Qin Gu , Li-ling Chen , Ke Xu , Xia Ling , Chang-jun Bao , Fen-yang Tang, Xian Qi, Ying-qiu Wu, Jing Ai, Gu-yu Shen, Da

Fuente: http://plos.srce.hr/



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