Prevalence and clinical features of pneumonia in patients with laboratory-confirmed pandemic influenza A H1N1 2009 infection in South Korea

Shin Na, Mi Na Kim, Won Young Kim, Wun Kim, Sang Bum Hong, Chae Man Lim, Younsuck Koh, Ji Won Kwon, Soo Jong Hong, Sang Oh Lee, Sang Ho Choi, Yang Soo Kim, Jun Hee Woo, Sung Han Kim

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

During the early stages of the pandemic influenza A H1N1 2009 (pH1N1) outbreak in South Korea, the government recommended antiviral therapy with laboratory confirmation in specialized hospitals. Hence we had a unique opportunity to test all patients suspected to have pH1N1, including those who initially presented with a mild illness, such as those who were not in at-risk groups and who had an uncomplicated illness. We therefore evaluated the proportion and clinical features of pneumonia in patients with laboratory-confirmed pH1N1. Of the 3253 patients who visited Asan Medical Center, Seoul, South Korea, between 24 August and 19 October 2009 for a suspected pH1N1 infection (temperature ≥37.5°C and at least 1 of the following symptoms: sore throat, cough, rhinorrhoea and nasal congestion), 553 (17%) were positive for pH1N1 by real-time reverse-transcriptase polymerase chain reaction. Chest radiographs were performed in 96 (17%) of the 553 patients. Of the 553 patients, 30 (5%; 95% confidence interval (CI) 48%) had pneumonia, including 26 (86%) with viral pneumonia and 4 (14%) with bacterial pneumonia. So, the proportion of pneumonia in patients with laboratory-confirmed pH1N1 was at least 5%. Multivariate analysis indicated that dyspnoea (odds ratio (OR) 57.8, p < 0.001), wheezing (OR 19.3, p 0.02), vomiting (OR 18.5, p < 0.001) and diarrhoea (OR 11.0, p 0.001) were independently associated with pneumonia. Antiviral therapy at >48 h after the onset of symptoms (OR 2.1, p 0.09) tended to be more common in patients with pneumonia than in those without pneumonia.

Original languageEnglish
Pages (from-to)19-26
Number of pages8
JournalScandinavian Journal of Infectious Diseases
Volume43
Issue number1
DOIs
StatePublished - 1 Jan 2010

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Republic of Korea
Pandemics
Human Influenza
Pneumonia
Infection
Odds Ratio
Viral Pneumonia
Bacterial Pneumonia
Pharyngitis
Reverse Transcriptase Polymerase Chain Reaction
Nose
Cough
Dyspnea
Antiviral Agents
Disease Outbreaks
Real-Time Polymerase Chain Reaction
Thorax
Multivariate Analysis
Confidence Intervals
Temperature

Cite this

Na, Shin ; Kim, Mi Na ; Kim, Won Young ; Kim, Wun ; Hong, Sang Bum ; Lim, Chae Man ; Koh, Younsuck ; Kwon, Ji Won ; Hong, Soo Jong ; Lee, Sang Oh ; Choi, Sang Ho ; Kim, Yang Soo ; Woo, Jun Hee ; Kim, Sung Han. / Prevalence and clinical features of pneumonia in patients with laboratory-confirmed pandemic influenza A H1N1 2009 infection in South Korea. In: Scandinavian Journal of Infectious Diseases. 2010 ; Vol. 43, No. 1. pp. 19-26.
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abstract = "During the early stages of the pandemic influenza A H1N1 2009 (pH1N1) outbreak in South Korea, the government recommended antiviral therapy with laboratory confirmation in specialized hospitals. Hence we had a unique opportunity to test all patients suspected to have pH1N1, including those who initially presented with a mild illness, such as those who were not in at-risk groups and who had an uncomplicated illness. We therefore evaluated the proportion and clinical features of pneumonia in patients with laboratory-confirmed pH1N1. Of the 3253 patients who visited Asan Medical Center, Seoul, South Korea, between 24 August and 19 October 2009 for a suspected pH1N1 infection (temperature ≥37.5°C and at least 1 of the following symptoms: sore throat, cough, rhinorrhoea and nasal congestion), 553 (17{\%}) were positive for pH1N1 by real-time reverse-transcriptase polymerase chain reaction. Chest radiographs were performed in 96 (17{\%}) of the 553 patients. Of the 553 patients, 30 (5{\%}; 95{\%} confidence interval (CI) 48{\%}) had pneumonia, including 26 (86{\%}) with viral pneumonia and 4 (14{\%}) with bacterial pneumonia. So, the proportion of pneumonia in patients with laboratory-confirmed pH1N1 was at least 5{\%}. Multivariate analysis indicated that dyspnoea (odds ratio (OR) 57.8, p < 0.001), wheezing (OR 19.3, p 0.02), vomiting (OR 18.5, p < 0.001) and diarrhoea (OR 11.0, p 0.001) were independently associated with pneumonia. Antiviral therapy at >48 h after the onset of symptoms (OR 2.1, p 0.09) tended to be more common in patients with pneumonia than in those without pneumonia.",
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Prevalence and clinical features of pneumonia in patients with laboratory-confirmed pandemic influenza A H1N1 2009 infection in South Korea. / Na, Shin; Kim, Mi Na; Kim, Won Young; Kim, Wun; Hong, Sang Bum; Lim, Chae Man; Koh, Younsuck; Kwon, Ji Won; Hong, Soo Jong; Lee, Sang Oh; Choi, Sang Ho; Kim, Yang Soo; Woo, Jun Hee; Kim, Sung Han.

In: Scandinavian Journal of Infectious Diseases, Vol. 43, No. 1, 01.01.2010, p. 19-26.

Research output: Contribution to journalArticle

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T1 - Prevalence and clinical features of pneumonia in patients with laboratory-confirmed pandemic influenza A H1N1 2009 infection in South Korea

AU - Na, Shin

AU - Kim, Mi Na

AU - Kim, Won Young

AU - Kim, Wun

AU - Hong, Sang Bum

AU - Lim, Chae Man

AU - Koh, Younsuck

AU - Kwon, Ji Won

AU - Hong, Soo Jong

AU - Lee, Sang Oh

AU - Choi, Sang Ho

AU - Kim, Yang Soo

AU - Woo, Jun Hee

AU - Kim, Sung Han

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