Clinical characteristics and outcomes of diabetic patients who were hospitalised with 2009 pandemic influenza A H1N1 infection

J Infect. 2012 Feb;64(2):218-24. doi: 10.1016/j.jinf.2011.11.022. Epub 2011 Nov 25.

Abstract

Objectives: To describe demographic and clinical data and outcomes of severe cases of 2009 pandemic influenza A H1N1 (pH1N1) infections for persons with diabetes.

Methods: We selected all person with diabetes (N = 252) among severe laboratory confirmed cases reported to the Spanish Surveillance System for detection of pH1N1 from June through December, 2009. One patient without diabetes matched by age and sex was selected. Collected variables included demographic characteristics, underlying medical conditions, outcome, clinical course and treatment.

Results: Among those suffering diabetes only 15.9% did not report any other underlying condition. 38% of diabetic patients and 27.4% of non diabetic patients were admitted to ICU (p = 0.008). Thirty subjects suffering diabetes and fifteen without the disease died (11.9% vs. 6%[p = 0.019]). Multivariable analysis showed that the independent risk factors for ICU admission or death were suffering cardiovascular disease (OR = 2.28), morbid obesity (OR = 2.08) and antiviral treatment started after 48 h of onset of symptoms (OR = 1.89). Suffering diabetes was not independent risk factors for ICU admission or death after adjusting for covariates.

Conclusions: The worse outcome among diabetes sufferers could be a consequence of the higher prevalence of comorbid underlying medical conditions but not diabetes itself. Further prospective studies are needed to verify these results.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use
  • Child
  • Comorbidity
  • Diabetes Complications
  • Diabetes Mellitus / epidemiology*
  • Disease Outbreaks
  • Female
  • Hospitalization
  • Humans
  • Influenza A Virus, H1N1 Subtype*
  • Influenza, Human / epidemiology*
  • Influenza, Human / mortality*
  • Influenza, Human / virology
  • Male
  • Middle Aged
  • Risk Factors
  • Spain / epidemiology
  • Treatment Outcome
  • Young Adult

Substances

  • Antiviral Agents