Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: McKenna JJ[original query] |
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Adults With diabetes hospitalized with pandemic influenza A(H1N1)pdm09--U.S. 2009
Ganatra RB , McKenna JJ , Bramley AM , Skarbinski J , Fry AM , Finelli L , Jain S . Diabetes Care 2013 36 (7) e94 In the U.S., diabetes was common among adults hospitalized with pandemic influenza A(H1N1)pdm09 virus (pH1N1) infection, with a prevalence of 15–25% in national case series (1–3). Despite the influenza burden among patients with diabetes, clinical data are limited. | Through two U.S. pH1N1 hospitalizations case series conducted during the spring and fall of 2009 (1,2), medical records of adults ≥18 years old hospitalized with laboratory-confirmed pH1N1 infection were reviewed. Data were collected as part of public health emergency response and deemed not to be research. We compared clinical features between patients with and without diabetes and performed a Mantel-Haenszel analysis, controlling for obesity (BMI ≥30 kg/m2). | Among 319 adults hospitalized with pH1N1 infection, 72 (23%) had diabetes, including 33 of 169 patients (20%) in the spring and 39 of 150 patients (26%) in the fall of 2009. Patients with diabetes were more likely than those without diabetes to be obese (79 vs. 46%, P < 0.01), to be older (median age 49 vs. 38 years, P < 0.01), and to have cardiovascular disease (32 vs. 18%, Mantel-Haenszel odds ratio 2.2 [95% CI 1.1–4.6]); there were no differences in clinical presentation or median length of stay (4 days). Similar proportions of patients with and without diabetes were admitted ≤2 days of symptom onset (39 vs. 40%). Patients with diabetes were not more likely than patients without diabetes to have pneumonia (37 vs. 47%, 0.6 [0.3–1.2]), sepsis (12 vs. 12%, 1.0 [0.4–2.9]), or acute respiratory distress syndrome (12 vs. 16%, 0.6 [0.2–1.5]). There were no significant differences in receipt of influenza antiviral agents between the two groups (84 vs. 76%, 1.5 [0.7–3.4]), including ≤2 days of symptom onset (32 vs. 37%, 0.8 [0.4–1.6]) and ≤2 days of admission (83 vs. 89%, 0.6 [0.2–1.6]). Patients with diabetes were less likely to require intensive care unit admission than those without diabetes (25 vs. 42%, 0.4 [0.2–0.9]); there was no significant difference in frequency of death (9 vs. 11%, 0.7 [0.2–2.0]). |
Asthma in patients hospitalized with pandemic influenza A(H1N1)pdm09 virus infection-United States, 2009
McKenna JJ , Bramley AM , Skarbinski J , Fry AM , Finelli L , Jain S . BMC Infect Dis 2013 13 57 BACKGROUND: Asthma was the most common co-morbidity among patients hospitalized with pandemic influenza A(H1N1)pdm09 [pH1N1] infection. The objective was to compare characteristics of hospitalized pH1N1 patients with and without asthma and assess factors associated with severity among asthma patients. METHODS: Patient data were derived from two 2009 pandemic case-series of U.S. pH1N1 hospitalizations. A case was defined as a person ≥ 2 years old hospitalized with laboratory-confirmed pH1N1. Asthma status was determined through chart review. RESULTS: Among 473 cases, 29% had asthma. Persons with asthma were more likely to be 2-17 years old (39% vs. 30%, p = 0.04) and black (29% vs. 18%, p < 0.01), and have chronic obstructive pulmonary disease (13% vs. 9%, p = 0.04) but less likely to have pneumonia (37% vs. 47%, p = 0.05), need mechanical ventilation (13% vs. 23%, p = 0.02), and die (4% vs. 10%, p = 0.04) than those without asthma. Among patients with asthma, those admitted to an intensive care unit (ICU) or who died (n = 38) compared with survivors not admitted to an ICU (n = 99) were more likely to have pneumonia on admission (60% vs. 27%, p < 0.01) or acute respiratory distress syndrome (24% vs. 0%, p < 0.01) and less likely to receive influenza antiviral agents ≤ 2 days of admission (73% vs. 92%, p = 0.02). CONCLUSIONS: The majority of persons with asthma had an uncomplicated course; however, severe disease, including ICU admission and death, occurred in asthma patients who presented with pneumonia. Influenza antiviral agents should be started early in hospitalized patients with suspected influenza, including those with asthma. |
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