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Volume 20, Number 9—September 2014

Dispatch

Risk Factors for Severe Influenza A–Related Pneumonia in Adult Cohort, Mexico, 2013–14

Alejandro Gómez-GómezComments to Author , Martin Magaña-Aquino, Sofía Bernal-Silva, Javier Araujo-Meléndez, Andreu Comas-García, Emma Alonso-Zúñiga, Eliana Torres-Torres, and Daniel E. Noyola
Author affiliations: Hospital Central “Dr. Ignacio Morones Prieto,” San Luis Potosí, Mexico (A. Gómez-Gómez, M. Magaña-Aquino, J. Araujo-Meléndez); Instituto Nacional de Salud Pública, Cuernavaca, Mexico (A. Comas-García); Universidad Autónoma de San Luis Potosí, San Luis Potosí (A. Gómez-Gómez, M. Magaña-Aquino, S. Bernal-Silva, J. Araujo-Meléndez, E. Alonso-Zúñiga, E. Torres-Torres, D. E. Noyola)

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Table 2

Demographic features of adult patients admitted with confirmed influenza virus pneumonia during December 5, 2013–February 7, 2014 compared with patients with confirmed influenza A(H1N1)pdm09 infection during the 2009–10 pandemic period, San Luis Potosí, Mexico*

Characteristics 2009–10, n = 100 2013–14, n = 55  p value
Age, y, mean (SD) median (range) 38.9 (13.1), 37 (15–71) 46.1 (14), 45 (19–79) 0.002
Sex, no. (%)
M 52 (52) 28 (50.9) 0.89
F 48 (48) 27 (49.1)
Presence of ≥1 underlying conditions, no. (%) 68 (68) 47 (85.5) 0.017
Obesity (body mass index>30)† 39 (39.8) 40 (74.1) <0.001
Diabetes mellitus 20 (20) 15 (27.3) 0.3
Immunosuppression 8 (8) ‡ 3 (5.5) § 0.75
Asthma-COPD-bronchiectasis 9 (9) 2 (3.6) 0.33
Other 19 (19) 4 (7.3) # 0.049
Any underlying disorder excluding obesity, no. (%) 45 (45) 23 (41.8) 0.7
Influenza vaccination during most recent season, no. (%)** 4 (4) 3 (5.5) 0.7
Clinical findings
Body mass index, mean (SD) † 28.9 (5.9) 31.9 (3.9) <0.001
PaO2/FiO2, mean (SD) †† 152.1 (102.5) 156.2 (69.3) 0.32
Total WBCs, K/μL, mean (SD) † 8.4 (5.3) 6.4 (3.2) 0.02
Lymphocytes, K/μL, mean (SD) ‡‡ 0.94 (0.5) 0.85 (0.72) 0.37
C-reactive protein, mg/dL, mean (SD) § § 14.1 (9.8) 17.9 (10.9) 0.03
Lactate dehydrogenase, U/L, mean (SD) ¶¶ 1,099.4 (769.6) 581.8 (387.9) <0.001
Creatine phosphokinase, U/L, mean (SD) ## 530 (820.6) 480.6 (513.9) 0.69
Duration of symptoms before dyspnea, days, mean (SD) *** 2.1 (3.5) 3 (3.4) 0.13
Dyspnea duration before admission, days, mean (SD) ††† 2.7 (2.7) 3.8 (2.6) 0.03
Duration of symptoms before hospital admission, days, mean (SD) ** 4.7 (6.6) 6.6 (3.8) 0.003
Other features
Requirement for mechanical ventilation, no. (%) 47 (47) 36 (65.5) 0.03
Death within 5 d from admission, no. (%) 6 (6) 6 (10.9) 0.35

*Statistical analyses used included Fisher exact test, chi-square test, Student t test, and Mann Whitney u test; S/D, standard deviation; COPD, chronic obstructive pulmonary disease; PaO2/FiO2, partial pressure arterial oxygen and fraction of inspired oxygen ratio; U/L, units per liter.
† Data was available for 152 patients.
‡ Includes chronic renal failure (4 cases), chronic steroid use (3 cases), and leukemia (1 case).
§ HIV infection (1 case), autoimmune disorder (2 cases; 1 had renal transplant),
¶ Some patients had >1 underlying condition: heart failure (6 cases), pregnancy/puerperium (6 cases), hypothyroidism (4 cases), seizure disorder (2 cases), ischemic cardiopathy (1 case), microcephaly (1 case), Down syndrome (1 case), obstructive sleep apnea (1 case).
# Down syndrome (2 cases); hypothyroidism (1 case), cardiopathy (1 case).
** Data available for 154 patients.
†† Data available for 147 patients.
‡‡ Data available for 151 patients.
§ § Data available for 144 patients.
¶¶ Data available for 135 patients.
## Data available for 131 patients.
*** Data available for 139 patients
††† Data available for 138 patients

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