Email this article Outcomes of severe pandemic influenza A/H1N1/2009
- Authors: Klimova E.A.1, Yushchuk N.D.1, Karetkina G.N.1, Boytsov P.V.1, Serobyan A.G.1, Kelli E.I.1, Malyshev N.A.1, Golokhvastova N.O.1, Esaulova M.R.1, Karchevskaya N.A.1, Avdeev S.N.1, Klimova EA2, Yushchuk ND2, Karetkina GN2, Boitsov PV3, Serobyan AG3, Kelli EI3, Malyshev NA3, Golokhvastova NO2, Esaulova MR3, Karchevskaya NA4, Avdeyev SN4
-
Affiliations:
- Moscow State University of Medicine and Dentistry
- Infectious Clinical Hospital One
- Research Institute of Pulmonology, Federal Biomedical Agency
- Issue: Vol 82, No 11 (2010)
- Pages: 15-18
- Section: Editorial
- URL: https://ter-arkhiv.ru/0040-3660/article/view/30696
- ID: 30696
Cite item
Full Text
Abstract
Subjects and methods. The study enrolled 24 patients, including 8 males and 16 females (10 of whom were pregnant), aged 17 to 58 years, with a laboratorily verified diagnosis of pandemic influenza A/H1N1/2009, treated at the intensive care unit for the significant symptoms of acute respiratory failure (RF). Real-time RT-PCR was used to verify the diagnosis. Organs and tissues from deceased patients were histologically studied; chest computed tomography, body plethysmography, fibrobronchoscopy, breath test, and 6-minute walk test were performed in the late period.
Results. Within the first 30 days, a fatal outcome caused by therapy-resistant progressive RF was observed in 33% of the patients with pandemic influenza treated at the intensive care unit. Diffuse alveolar damage caused by influenza virus, which gives rise to hyaline membranes, underlies RF. Lung tissue fibrosis formed in recovered patients.
Conclusion. The severity of pandemic influenza A/H1N1/2009 was determined by massive bilateral pneumonia, interstitial (alveolar) pulmonary edema, formation of diffuse bilateral lung fibrosis at the outcome of severe virus pneumonia (acute respiratory distress syndrome) with a decrease in vital and diffusing capacities, thereby generating a need to follow up this patient category and, possibly, to elaborate special rehabilitation programs.
About the authors
Elena Anatol'evna Klimova
Email: elena_klimova@mail.ru
Nikolay Dmitrievich Yushchuk
Email: msmsu_rector@mtu-net.ru
Galina Nikolaevna Karetkina
Email: karetkinagn@mail.ru
Pavel Vladimirovich Boytsov
Email: ikb1@mosgorzdrav.ru
Avet Grigor'evich Serobyan
Email: ikb1@mosgorzdrav.ru
Elena Ivanovna Kelli
Email: ekelly@yandex.ru
Nikolay Aleksandrovich Malyshev
Email: ikb1@mosgorzdrav.ru
Natal'ya Olegovna Golokhvastova
Email: pavo@mail.ru
Madina Ruslanovna Esaulova
Email: emadina@inbox.ru
Natal'ya Anatol'evna Karchevskaya
Email: karchevskaia@mail.ru
Sergey Nikolaevich Avdeev
Email: serg_avdeev@list.ru
E A Klimova
Moscow State University of Medicine and DentistryMoscow State University of Medicine and Dentistry
N D Yushchuk
Moscow State University of Medicine and DentistryMoscow State University of Medicine and Dentistry
G N Karetkina
Moscow State University of Medicine and DentistryMoscow State University of Medicine and Dentistry
P V Boitsov
Infectious Clinical Hospital OneInfectious Clinical Hospital One
A G Serobyan
Infectious Clinical Hospital OneInfectious Clinical Hospital One
E I Kelli
Infectious Clinical Hospital OneInfectious Clinical Hospital One
N A Malyshev
Infectious Clinical Hospital OneInfectious Clinical Hospital One
N O Golokhvastova
Moscow State University of Medicine and DentistryMoscow State University of Medicine and Dentistry
M R Esaulova
Infectious Clinical Hospital OneInfectious Clinical Hospital One
N A Karchevskaya
Research Institute of Pulmonology, Federal Biomedical AgencyResearch Institute of Pulmonology, Federal Biomedical Agency
S N Avdeyev
Research Institute of Pulmonology, Federal Biomedical AgencyResearch Institute of Pulmonology, Federal Biomedical Agency
References
- Онищенко Г. Г. Эпидемическая ситуация по гриппу, вызванному высокопатогенным вирусом типа A(H1N1) в Российской Федерации и в мире. Журн. микробиол. 2010; 1: 3-9.
- Киселев О. И., Ершов Ф. И., Быков А. Т., Покровский В. И. Пандемия гриппа 2009/10: противовирусная терапия и тактика лечения. СПб.: НИИ гриппа СЗО РАМН; 2010.
- CDC news conference with Thomas R. Frieden, Centers for Disease Control and Prevention, Dec. 10, 2009. CDC web site, "CDC Estimates of 2009 H1N1 Influenza Cases, Hospitalizations and Deaths in the United States, April-November 14, 2009", Dec. 10, 2009. http:flu.gov/individualfamily/about/ h1n1/estimates_2009_h1n1.html.
- CDC estimates of 2009 H1N1 influenza cases, hospitalizations and deaths in the United States, April 2009-February 13, 2010. Atlanta: Centers for Disease Control and Prevention, 2010. (Accessed April 9, 2010, at http://flu.gov/individualfamily/about/h1n1/estimates_2009_h1n1.html).
- Writing Committee of the WHO Consultation on Clinical Aspects of Pandemic (H1N1) 2009 Influenza. Clinical aspects of pandemic 2009 influenza A(H1N1) virus infection. N. Engl. J. Med. 2010; 362:1708-1719.
- CDC, Influenza Division. FluView. Available at: http:// www.cdc.gov/flu/weekly/Accessed September 16, 2009.
- Гендон Ю. З. Проблема профилактики гриппа у беременных женщин и новорожденных детей. Вопр. вирусол. 2009; 2: 4-10.
- Jamieson D. J., Honein M. A., Rasmussen S. A. et al. H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet 2009; 374: 451-458.
- Mangtani P., Mak T. K., Pfeifer D. Pandemic H1N1 infection in pregnant women in the USA. Lancet 2009; 374: 429-430.
Supplementary files
