Prognosis of 18 H7N9 avian influenza patients in Shanghai

PLoS One. 2014 Apr 2;9(4):e88728. doi: 10.1371/journal.pone.0088728. eCollection 2014.

Abstract

Purpose: To provide prognosis of an 18 patient cohort who were confirmed to have H7N9 lung infection in Shanghai.

Methods: Patients' history, clinical manifestation, laboratory test, treatment strategy and mortality were followed and recorded for data analysis.

Results: A total of 18 patients had been admitted into Shanghai Public Health Clinical Center from April 8th to July 29, 2013. 22.2% of the patients were found to have live poultry contact history and 80% were aged male patients with multiple co-morbidities including diabetes, hypertension and/or chronic obstructive pulmonary disease (COPD). This group of patients was admitted to the clinical center around 10 days after disease onset. According to laboratory examinations, increased C reactive protein (CRP), Procalcitonin (PCT), Plasma thromboplastin antecedent (PTA) and virus positive time (days) were indicative of patients' mortality. After multivariate analysis, only CRP level showed significant prediction of mortality (P = 0.013) while results of prothrombin time (PT) analysis almost reached statistical significance (P = 0.056).

Conclusions: H7N9 infection induced pneumonia of different severity ranging from mild to severe pneumonia or acute lung injury/acute respiratory distress syndrome to multiple organ failure. Certain laboratory parameters such as plasma CRP, PCT, PTA and virus positive days predicted mortality of H7N9 infection and plasma CRP is an independent predictor of mortality in these patients.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • C-Reactive Protein / metabolism*
  • Calcitonin / blood*
  • Calcitonin Gene-Related Peptide
  • China / epidemiology
  • Disease-Free Survival
  • Factor XI / metabolism*
  • Female
  • Follow-Up Studies
  • Humans
  • Influenza A Virus, H7N9 Subtype*
  • Influenza, Human / blood*
  • Influenza, Human / mortality*
  • Influenza, Human / therapy
  • Male
  • Middle Aged
  • Protein Precursors / blood*
  • Prothrombin Time
  • Survival Rate

Substances

  • CALCA protein, human
  • Protein Precursors
  • Calcitonin
  • C-Reactive Protein
  • Factor XI
  • Calcitonin Gene-Related Peptide

Grant support

This research was supported by Shanghai Leading Academic Discipline Project (B115), and National Natural Science Foundation of China (30930090, 81100046, 81170056). Dr. Yuanlin Song was supported by the Program for Professor of Special Appointment (Eastern Scholar) at Shanghai Institutions of Higher Learning and Key Medical grant from Shanghai Science and Technology Committee (11411951102, 12JC1402300). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.