Tuberc Respir Dis > Volume 69(1); 2010 > Article
Tuberculosis and Respiratory Diseases 2010;69(1):24-30.
DOI:    Published online July 1, 2010.
Clinical Features of Hospitalized Adult Patients with Pneumonia in Novel Influenza A (H1N1) Infection.
Chang Hoon Han, Yu Kyung Hyun, Yu Ri Choi, Na Young Sung, Yoon Seon Park, Kkot Sil Lee, Jae Ho Chung
1Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Korea.
2Department of Internal Medicine, Myongji Hospital, Kwandong University College of Medicine, Korea.
3Medical Institute, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
A novel 2009 influenza A (H1N1) virus emerged and disseminated to all over the world. There are few reports on the clinical characteristics of patients with complications. We describe the clinical features of pneumonia in adult patients hospitalized, who have novel influenza infection. METHODS: There were 43 adult patients enrolled into the study with pneumonia of 528 hospitalized patients confirmed influenza A (H1N1) virus infection by real-time reverse transcriptase polymerase chain reaction testing, between 24 August 2009 and 31 January 2010. The clinical data of patients with pneumonia were collected retrospectively. RESULTS: There were 22 of 43 (51.2%) influenza patients with pneumonia that had higher risk factors for complications. Compared to 28 patients with influenza A (H1N1) viral pneumonia and 15 patients, who had isolated bacteria from cultures, those with mixed viral and bacterial pneumonia were significantly more likely to have unilobar consolidations on chest radiographs (53.3 vs. 10.7%, p<0.01) and higher scores of pneumonia severity index (PSI; 90 [66~100] vs. 53 [28~90], p=0.04). Six patients required mechanical ventilation support in an Intensive Care Unit and were more likely to have dyspnea (83.3 vs. 29.3%, p=0.02) and low levels of PaO2 (48.3 [37.0~70.5] vs 64.0 [60.0~74.5] mm Hg, p=0.02) and high levels of pneumonia severity index (PSI) score (108.0 [74.5~142.8] vs. 56.0 [40.5~91.0], p=0.03). CONCLUSION: The majority of pneumonia patients infected with novel influenza improved. Chest radiographic findings of unilobar consolidations suggest that mixed pneumonia is more likely. Initial dyspnea, hypoxemia, and high levels of PSI score are associated with undergoing mechanical ventilation support.
Key Words: Influenza A Virus, H1N1 Subtype, Pneumonia, Disease Outbreaks

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