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[Clinical characteristics of influenza acute respiratory distress syndrome in 2017 to 2018]

Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases | 12 Jan 2019

B Sun, X Tang, XY Li, HY He, R Wang, YL Liu, Y Li and ZH Tong
Abstract
Objective: To describe the clinical characteristics of acute respiratory distress syndrome (ARDS) caused by severe influenza virus in our hospital. Method: From November 2017 to February 2018, 48 patients were diagnosed with ARDS caused by influenza virus pneumonia. There characteristics, treatment, and outcomes were summarized and analyzed. According to the prognosis, the patients were divided into a survival group and a death group for comparative analysis. The multivariable logistic regression analysis was used for risk factors of hospital mortality. Result: Thirty-one patients were confirmed to have influenza A virus infection, 3 influenza B virus, 2 mixed infection, while 12 patients were diagnosed by clinical criteria. Eighteen patients died, with a mortality of 38%. Twenty-six patients (54%) were co-infected by other pathogenic microorganisms, including 17 cases of invasive aspergillus infection. Sixteen patients (33%) acquired nosocomial infection that significantly correlated with the hospital mortality, P=0.003. Multivariable logistic regression analysis showed that higher age (OR=1.086, 95% CI: 1.016-1.016), P=0.015), longer duration of flu-like symptoms to RICU time (OR=1.196, 95% CI: 1.031-1.031, P=0.018) and lower PaO(2)/FiO(2) (OR=0.973, 95% CI: 0.951-0.951, P=0.017) were independent risk factors for hospital mortality. Conclusion: In the flu season of 2017-2018, the patients of ARDS caused by severe influenza pneumonia were mainly influenza A virus, with a mortality of 38%. Co-infection was very common, especially aspergillus infection. Nosocomial infection was common and significantly correlated with high mortality. Lower PaO(2)/FiO(2), higher age and the longer duration from influenza-like symptoms to RICU was independent risk factors for high hospital mortality.
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