Medicinski Glasnik Specijalne Bolnice za Bolesti Štitaste Žlezde i Bolesti Metabolizma "Zlatibor" (Jan 2020)
Epidemic of influenzae A H1N1 in 2019 in the Zlatibor district
Abstract
Introduction: Influenza A H1N1 occurs worldwide sporadically or epidemically. There have been several epidemics of this disease in recent decades. Millions of people fell ill and hundreds of thousands died. The clinical picture varies from asymptomatic to lethal outcome. Older age, male gender and obesity are the most common risk factors for adverse disease. The aim of the research was to examine the clinical course and outcome of the disease of patients with pneumonia during the epidemic of influenza A H1N1 in 2019 in the Zlatibor district. Methods: Epidemiological, clinical, microbiological and radiographic data of patients with influenza A H1N1 treated at the Department of Infectious and Tropical Diseases and the Intensive Care Unit of the General Hospital of Uzice were retrogradely collected and analyzed. Virological and serological analyzes were performed at the Institute of Immunology and Virology "Torlak" in Belgrade. The diagnosis of acute respiratory distress syndrome (ARDS) was made according to the Berlin definition. Statistical analysis was performed using the Statistical Package for Social Sciences SPSS (version 16.0). Results: Out of a total of 274 patients, women accounted for 52.9%. The most common age was 61 to 70 years. 55.4% of patients had comorbidities, 61.8% of that had cardiovascular disease. C reactive protein was elevated in 79.2% of patients. Pneumonia confirmed by radiographic findings was present in 82.8% of patients, 51.5% of that had bilateral pneumonia. Four patients were pregnant, GML 5-9. Two of them had a mild clinical course of infection, one moderate with unilateral pneumonia. All three had a favorable disease outcome. A fourth pregnant woman was admitted in a severe clinical condition and was immediately referred to a tertiary health institution where the disease ended in death. 10.2% of patients were treated in the intensive care unit. Complications occurred in 23.7% of patients, ARDS in 52.3% of that. 55.9% of patients with ARDS were aged 61 to 70 years, and 58.8% were male. Among patients with ARDS, 94.1% had associated diseases, most often CVD (85.3%). C reactive protein was elevated in 85.3% of patients with ARDS. In 8.4% of patients, the disease had an unfavorable course and ended in death. Among these patients, 65.2% were women, and 73.9% were over 65 years of age. Associated diseases were present in 95.6% of these patients, cardiovascular diseases was present in 87% of that. Conclusion: During the influenza epidemic in 2019 in the Zlatibor district, pneumonia, most often bilateral, was most often in patients aged 61-70 with associated cardiovascular diseases. These were also the main risk factors for complications and adverse disease outcome. ARDS was the most common comlication and risk factor for the lethal outcome of the diseases.
