Outcome of Pandemic H1N1 Pneumonia: Clinical and Radiological Findings for Severity Assessment.
10.3904/kjim.2011.26.2.160
- Author:
Woo Hyun CHO
1
;
Yun Seong KIM
;
Doo Soo JEON
;
Ji Eun KIM
;
Kun Il KIM
;
Hee Yun SEOL
;
Ki Uk KIM
;
Hye Kyung PARK
;
Min Ki LEE
;
Soon Kew PARK
;
Yeon Joo JEONG
Author Information
1. Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
- Publication Type:Original Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
- Keywords:
Influenza A virus, H1N1 subtype;
Pneumonia;
Severity of illness index
- MeSH:
Adolescent;
Adult;
Aged;
Alanine Transaminase/blood;
Antiviral Agents/therapeutic use;
Aspartate Aminotransferases/blood;
Biological Markers/blood;
Chi-Square Distribution;
Clinical Enzyme Tests;
Female;
Humans;
Influenza A Virus, H1N1 Subtype/*pathogenicity;
Influenza, Human/*diagnosis/mortality/radiography/therapy/virology;
L-Lactate Dehydrogenase/blood;
Lung/*radiography/virology;
Male;
Middle Aged;
*Pandemics;
Pneumonia, Viral/*diagnosis/mortality/radiography/therapy/virology;
Predictive Value of Tests;
Prognosis;
Republic of Korea/epidemiology;
Respiration, Artificial;
Retrospective Studies;
Risk Assessment;
Risk Factors;
Severity of Illness Index;
*Tomography, X-Ray Computed;
Young Adult
- From:The Korean Journal of Internal Medicine
2011;26(2):160-167
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Pandemic influenza A (H1N1) virus infection presents with variable severity. However, little is known about clinical predictors of disease severity. We studied the clinical predictors of severe pandemic H1N1 pneumonia and their correlation with radiological findings. METHODS: We reviewed medical and radiological records of adults with pandemic H1N1 pneumonia. After classification of patients into severe and non-severe groups, the following data were evaluated: demographic data, pneumonia severity index (PSI), CURB65, risk factors, time to first dose of antiviral medication, routine laboratory data, clinical outcome, and radiological characteristics. RESULTS: Of 37 patients with pandemic H1N1 pneumonia, 12 and 25 were assigned to the severe and non-severe groups, respectively. PSI score, serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dyhydrogenase (LDH) levels were higher in the severe group than in the non-severe group (p = 0.035, 0.0003, 0.0023, and 0.0002, respectively). AST, ALT, and LDH levels were positively correlated with the radiological findings (p < 0.0001, 0.0003, and < 0.0001, respectively) and with the number of involved lobes (p = 0.663, 0.0134, and 0.0019, respectively). The most common finding on high resolution computed tomography (HRCT) scans was ground-glass attenuation with consolidation (n = 22, 60%), which had a predominantly patchy distribution (n = 31). CONCLUSIONS: We demonstrated a positive correlation between clinical findings, such as serum AST, ALT, and LDH levels, and radiological findings. A combination of clinical and HRCT indicators would be useful in predicting the clinical outcome of pandemic H1N1 pneumonia.
