Clinical characteristics of 69 patients with influenza pneumonia from 2014 to 2018_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

WANG Youya , LI Ran ,  GAO Zhancheng

Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing 100044, P. R. China;

Corresponding author：

GAO Zhancheng, Email: zcgao@bjmu.edu.cn

Keywords：

Influenza; Pneumonia; Viral pneumonia

DOI：

10.7507/1671-6205.201908098

Video：

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Objective To investigate the clinical characteristics and prognostic factors of influenza pneumonia from 2014 to early 2018.Methods The general information, clinical symptoms, laboratory examination and treatment of 69 patients with influenza pneumonia from October 2014 to March 2018 were collected. The clinical characteristics of 32 patients with influenza pneumonia from 2017 to 2018 were compared with 37 patients with influenza pneumonia from 2014 to 2016. The prognostic factors of influenza pneumonia were also investigated.Results The median patient age was 68 (55-78) years, and 41 cases (59.4%) were men in 69 patients. The five most common comorbidities were hypertension (44.9%), diabetes (23.3%), chronic obstructive pulmonary disease (17.4%), coronary atherosclerotic heart disease (13.0%), and chronic kidney disease (10.1%). The median levels of fasting blood glucose, lactate dehydrogenase, C-reactive protein, and procalcitonin in the patients with influenza pneumonia in 2017-2018 were significantly higher than those in the same period of 2014-2016, which were respectively 7.1 (5.4 - 8.3)mmol/L vs. 5.2 (4.5 - 7.3)mmol/L (P=0.017), 213.0 (98.0 - 320.5)U/L vs. 178 (98.0 - 280.0)U/L (P=0.049), 65.5 (15.4 - 139.8)mg/L vs. 45.5 (14.1 - 75.3)mg/L (P=0.050), 0.66 (0.24 - 1.58)μg/L vs. 0.17 (0.11 - 0.43)μg/L (P=0.004). The proportion of bacterial infection, septic shock, acute renal failure and mortality in the patients with influenza pneumonia in 2017-2018 was higher than that in the 2014-2016 group, which were respectively 40.6% vs. 18.9% (P=0.047), 21.9% vs. 5.4% (P=0.043), 21.9% vs. 2.7% (P=0.035), 31.3% vs. 5.4% (P=0.005). Multivariate analysis showed that numbers of lymphocytes, blood urea nitrogen, and procalcitonin were independent risk factors for mortality in the patients with influenza pneumonia. The odds ratio was respectively 0.001 (95%CI 0.00 - 0.200), 1.342 (95%CI 0.996 - 1.808), 1.113. (95%CI 1.006 - 1.230).Conclusions Compared with the patients with influenza pneumonia in 2014-2016, the patients in 2017-2018 have higher levels of fasting blood glucose and lactate dehydrogenase, and are also susceptible to secondary bacterial infection, septic shock, and acute renal failure. Decreased lymphocytes, elevated blood urea nitrogen, and elevated procalcitonin are independent risk factors for death in patients with influenza pneumonia.

Citation： WANG Youya, LI Ran, GAO Zhancheng. Clinical characteristics of 69 patients with influenza pneumonia from 2014 to 2018. Chinese Journal of Respiratory and Critical Care Medicine, 2020, 19(3): 251-257. doi: 10.7507/1671-6205.201908098 Copy

1.	中国疾病预防控制中心传染病处, 国家流感中心. 我国进入今冬流感流行高峰季节. 疾病监测, 2017, 32(12): 952.
2.	中华人民共和国卫生部. 流行性感冒诊断与治疗指南(2011 年版). 国际流行病学传染病学杂志, 2012, 39(1): 1-9.
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6.	Barker WH, Mullooly JP. Pneumonia and influenza deaths during epidemics: implications for prevention. Arch Intern Med, 1982, 142(1): 85-89.
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9.	Likos AM, Kelvin DJ, Cameron CM, et al. Influenza viremia and the potential for blood‐borne transmission. Transfusion, 2010, 47(6): 1080-1088.
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11.	Brundage JF. Interactions between influenza and bacterial respiratory pathogens: implications for pandemic preparedness. Lancet Infect Dis, 2006, 6(5): 303-312.
12.	Petersdorf RG, Fusco JJ, Harter DH, et al. Pulmonary infections complicating Asian influenza. Arch Intern Med, 1959, 103(2): 262-272.
13.	Centers for Disease Control and Prevention (CDC). Bacterial coinfections in lung tissue specimens from fatal cases of 2009 pandemic influenza A (H1N1) - United States, May-August 2009. MMWR Morb Mortal Wkly Rep, 2009, 58(38): 1071-1074.
14.	中华人民共和国国家卫生和计划生育委员会. 流行性感冒诊疗方案(2018 年版). 中华临床感染病杂志, 2018, 11(1): 1-5.
15.	Cui W, Zhao HW, Xu L, et al. Factors associated with death in hospitalized pneumonia patients with 2009 H1N1 influenza in Shenyang, China. BMC Infect Dis, 2010, 10: 145.
16.	吴双胜, 杨鹏, 李海月, 等. 2007-2010 年北京市 18 岁以上居民流行性感冒疫苗接种情况及阻碍因素. 中华预防医学杂志, 2011, 45(12): 1077-1081.
17.	李海月, 吴双胜, 杨鹏, 等. 北京市 2008-2010 年老年人流行性感冒疫苗接种情况及影响因素分析. 中华流行病学杂志, 2012, 33(2): 247-248.
18.	WHO. Recommended composition of influenza virus vaccines for use in the 2017–2018 northern hemisphere influenza season. Wkly Epidemiol Rec, 2017, 92(11): 117-128.
19.	Abdelaty NM. Risk factors and prognostic criteria in 230 patients with influenza A (H1N1) infection. Egypt J Chest Dis Tuberc, 2013, 62(1): 1-8.
20.	Shi SJ, Li H, Liu M, et al. Mortality prediction to hospitalized patients with influenza pneumonia: PO₂/FiO₂ combined lymphocyte count is the answer. Clin Respir J, 2017, 11(3): 352.
21.	周乙华, 赵伟, 宋培新, 等. 外周血淋巴细胞减少可提示重型甲型 H1N1 流感. 中国病毒病杂志, 2012, 2(2): 128-132.

1. 中国疾病预防控制中心传染病处, 国家流感中心. 我国进入今冬流感流行高峰季节. 疾病监测, 2017, 32(12): 952.
2. 中华人民共和国卫生部. 流行性感冒诊断与治疗指南(2011 年版). 国际流行病学传染病学杂志, 2012, 39(1): 1-9.
3. Centers for Disease C, Prevention. Estimates of deaths associated with seasonal influenza -- United States, 1976-2007. MMWR Morb Mortal Wkly Rep, 2010, 59(33): 1057-1062.
4. Mauskopf J, Klesse M, Lee S, et al. The burden of influenza complications in different high-risk groups: a targeted literature review. J Med Econ, 2013, 16(2): 264-277.
5. Peng Z, Feng L, Carolyn GM, et al. Characterizing the epidemiology, virology, and clinical features of influenza in China’s first severe acute respiratory infection sentinel surveillance system, February 2011 – October 2013. BMC Infect Dis, 2015, 15(1): 143.
6. Barker WH, Mullooly JP. Pneumonia and influenza deaths during epidemics: implications for prevention. Arch Intern Med, 1982, 142(1): 85-89.
7. WHO. Review of the 2017–2018 influenza season in the northern hemisphere[EB/OL]. http://www.who.int/wer/2018/wer9334/en/.
8. Puigbarberà J, Natividadsancho A, Trushakova S, et al. Epidemiology of hospital admissions with influenza during the 2013/2014 northern hemisphere influenza season: results from the Global Influenza Hospital Surveillance Network. PLoS One, 2016, 11(5): e0154970.
9. Likos AM, Kelvin DJ, Cameron CM, et al. Influenza viremia and the potential for blood‐borne transmission. Transfusion, 2010, 47(6): 1080-1088.
10. Hong KW, Cheong HJ, Choi WS, et al. Clinical courses and outcomes of hospitalized adult patients with seasonal influenza in Korea, 2011-2012: hospital-based influenza morbidity & mortality (HIMM) surveillance. J Infect Chemother, 2014, 20(1): 9-14.
11. Brundage JF. Interactions between influenza and bacterial respiratory pathogens: implications for pandemic preparedness. Lancet Infect Dis, 2006, 6(5): 303-312.
12. Petersdorf RG, Fusco JJ, Harter DH, et al. Pulmonary infections complicating Asian influenza. Arch Intern Med, 1959, 103(2): 262-272.
13. Centers for Disease Control and Prevention (CDC). Bacterial coinfections in lung tissue specimens from fatal cases of 2009 pandemic influenza A (H1N1) - United States, May-August 2009. MMWR Morb Mortal Wkly Rep, 2009, 58(38): 1071-1074.
14. 中华人民共和国国家卫生和计划生育委员会. 流行性感冒诊疗方案(2018 年版). 中华临床感染病杂志, 2018, 11(1): 1-5.
15. Cui W, Zhao HW, Xu L, et al. Factors associated with death in hospitalized pneumonia patients with 2009 H1N1 influenza in Shenyang, China. BMC Infect Dis, 2010, 10: 145.
16. 吴双胜, 杨鹏, 李海月, 等. 2007-2010 年北京市 18 岁以上居民流行性感冒疫苗接种情况及阻碍因素. 中华预防医学杂志, 2011, 45(12): 1077-1081.
17. 李海月, 吴双胜, 杨鹏, 等. 北京市 2008-2010 年老年人流行性感冒疫苗接种情况及影响因素分析. 中华流行病学杂志, 2012, 33(2): 247-248.
18. WHO. Recommended composition of influenza virus vaccines for use in the 2017–2018 northern hemisphere influenza season. Wkly Epidemiol Rec, 2017, 92(11): 117-128.
19. Abdelaty NM. Risk factors and prognostic criteria in 230 patients with influenza A (H1N1) infection. Egypt J Chest Dis Tuberc, 2013, 62(1): 1-8.
20. Shi SJ, Li H, Liu M, et al. Mortality prediction to hospitalized patients with influenza pneumonia: PO₂/FiO₂ combined lymphocyte count is the answer. Clin Respir J, 2017, 11(3): 352.
21. 周乙华, 赵伟, 宋培新, 等. 外周血淋巴细胞减少可提示重型甲型 H1N1 流感. 中国病毒病杂志, 2012, 2(2): 128-132.

Chinese Journal of Respiratory and Critical Care Medicine

Clinical characteristics of 69 patients with influenza pneumonia from 2014 to 2018

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