The Comparison of Clinical Characteristics and Courses of Pediatric Patients Hospitalized with Pandemic Influenza A (H1N1) and Seasonal Influenza from 2009 to 2011

Song I Yang; Jung Hee Rho; Yong Han Sun; Kang Ho Cho; So Yeon Shim; Byung Wook Eun; Jee Eun Kim; Dong Woo Son; Hann Tchah

doi:10.7581/pard.2012.22.3.292

Journal List > Pediatr Allergy Respir Dis > v.22(3) > 1033187

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Yang, Rho, Sun, Cho, Shim, Eun, Kim, Son, and Tchah: The Comparison of Clinical Characteristics and Courses of Pediatric Patients Hospitalized with Pandemic Influenza A (H1N1) and Seasonal Influenza from 2009 to 2011

Original Article

Pediatric Allergy and Respiratory Disease

Pediatric Allergy and Respiratory Disease 2012; 22(3): 292-301.

Published online: 30 September 2012

DOI: https://doi.org/10.7581/pard.2012.22.3.292

The Comparison of Clinical Characteristics and Courses of Pediatric Patients Hospitalized with Pandemic Influenza A (H1N1) and Seasonal Influenza from 2009 to 2011

Song I Yang, MD¹, Jung Hee Rho, MD¹, Yong Han Sun, MD¹, Kang Ho Cho, MD¹, So Yeon Shim, MD¹, Byung Wook Eun, MD¹, Jee Eun Kim, MD², Dong Woo Son, MD¹, Hann Tchah, MD¹

¹Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea.

²Department of Radiology, Gachon University Gil Medical Center, Incheon, Korea.

Corresponding author (chdsyh@gilhospital.com)

Received 18 June 2012 Revised 21 August 2012 Accepted 3 September 2012

Abstract

Purpose

Pandemic influenza viruses have caused significant morbidity and mortality. Pandemic influenza A (H1N1) was detected in April 2009 and caused worldwide outbreak. We investigated the differences in clinical characteristics and courses between pandemic and seasonal influenzas.

Methods

We reviewed the medical records of pediatric patients, (≤18 years) with influenza hospitalized to Gachon University Gil Medical Center from the 1 April 2009 to the 31 August 2011.

Results

Two hundred twenty-six patients with pandemic influenza and 118 patients with seasonal influenza were included. Age, sex, and proportion of underlying diseases were similar between the two groups. Hypoxemia, shortness of breath, and tachypnea were more common in pandemic influenza.(P<0.05) Oxygen supplementation and radiologically confirmed pneumonia were more common in pandemic influenza.(P<0.005) However, there were no significant differences in the mean duration of hospitalization, proportion of patients admitted to the intensive care unit, need for mechanical ventilation, and death.

Conclusion

Pandemic influenza caused more frequently lower respiratory tract infection and pneumonia. However, the courses of pandemic influenza were not different from those of seasonal influenza; probably, due to the effects of several factors, including antiviral therapy.

Keywords: Hospitalization, Influenza, Pandemics, Pediatrics

Figures and Tables

Fig. 1

Epidemiologic curve of date of hospitalization of 2009 pandemic influenza A (H1N1) and seasonal influenza.

Table 1

Demographics and Underlying Diseases of Hospitalized Pediatric Patients with 2009 Pandemic Influenza A (H1N1) and Seasonal Influenza

Values are presented as mean±SD or number (%).

^*Obesity is defined as ≥95th percentile body mass index (kg/m²) for age in patients 2 years of age or over. ^†Seizure disorder, cerebral palsy, mental retardation. ^‡Chemotherapy, splenectomy state. ^§Bronchopulmonary dysplasia. ^∥Type 1 diabetes mellitus.

Table 2

Clinical Characteristics of Hospitalized Pediatric Patients with 2009 Pandemic Influenza A (H1N1) and Seasonal Influenza

Values are presented as number (%).

^*Hypoxemia was defined as an oxygen saturation of less than 94% while the patient was breathing room air. ^†Tachypnea was defined by age, >60/min (birth to 3 mo), >50/min (3 mo to 1 yr), >40/min (1 to <3 yr), >35/min (3 to <6 yr), >30/min (6 to <12 yr) and >20/min (≥12 yr) (Data were derived from Centers for Disease Control and Prevention)30). ^‡Exclude adverse effect of antiviral drug. ^§One patient with seasonal influenza had underlying seizure disorder.

Table 3

Treatment and Clinical Courses of Hospitalized Pediatric Patients with 2009 Pandemic Influenza A (H1N1) and Seasonal Influenza

Values are presented as number (%) or mean±SD.

ICU, intensive care unit.

Table 4

Laboratory Findings of Hospitalized Pediatric Patients with 2009 Pandemic Influenza A (H1N1) and Seasonal Influenza

Values are presented as mean±SD or number (%).

WBC, white blood cell; CRP, C-reactive protein.

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