Hospitalized Patients with Pandemic Influenza A (H1N1) 2009 in Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University

Abstract

Objectives: To study the epidemiology, high risk patients, clinical manifestations, treatment, outcomes and expenses of hospitalized patients with pandemic influenza A (H1N1) 2009 infection, and to compare between those who had and did not have pneumonia.

Methods: This study was a retrospective descriptive study. Medical records of the patients, who were diagnosed as influenza A (H1N1) 2009 by a real time reverse-transcription polymerase-chain reaction assay and were hospitalized in Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University between July 1, and October 31, 2009 were reviewed.

Results: There were 37 cases with pandemic influenza A (H1N1) 2009 infection; 45.9% were male and 54.1% were female. The median age of the patients was 31 years old. Twenty seven percent of the patients were high risk. All cases (100%) had fever and cough, other common symptoms included malaise (81.1%), rhinorrhea (75.7%), and headache (73.0%). More than half (59.5%) had only influenza-like illness while 40.5% also had pneumonia. Oseltamivir was given in 94.6% and antibiotics were used in 32.4 %. Only 1 patient (2.7%) was dead. The median hospitalized time was 5.0 days (interquartile range (IQR), 4.0-6.0) and the median expenses was 9,033.50 Baht (IQR 5,487.88-14,636.80). The high risk patients had higher incidence of pneumonia (80.0% vs 25.9%). Comparing between those who had and did not have pneumonia, those without pneumonia had significantly more often symptoms of rhinorrhea (95.5%) and headache (90.9%) than those with pneumonia (46.7% and 46.7%). However; those with pneumonia had significant more symptoms of dyspnea (46.7% vs 4.6%) and longer duration of hospitalized (6.0 vs 5.0 days) than those without pneumonia.

Conclusion: The main symptoms of patients with influenza A (H1N1) 2009 were the same as seasonal influenza infection. High risk patients had higher chance of pneumonia with longer hospitalized time.

Keywords: pandemic influenza A (H1N1) 2009, pneumonia, Thailand