Clinical features and factors associated with outcomes of patients infected with a Novel Influenza A (H7N9) virus: a preliminary study

PLoS One. 2013 Sep 17;8(9):e73362. doi: 10.1371/journal.pone.0073362. eCollection 2013.

Abstract

Objective: The present study aimed to analyze clinical features and factors associated with treatment outcomes of H7N9 influenza A virus infection.

Methods: The clinical progress in 18 H7N9-infected patients was monitored and recorded. The clinical features of H7N9 infection were noted and factors associated with treatment outcomes were analyzed by univariate analyses.

Results: The average ages of patients in recovered and critical conditions were 67.0±10.83 years and 72.75±12.0 years, respectively. Renal insufficiency developed more frequently in critically ill patients (P = 0.023). The duration of traditional Chinese medicine (TCM) therapy was longer in recovered patients than in critically ill patients (P = 0.01). Laboratory tests showed that levels of C-reactive protein, serum creatinine, and myoglobin were significantly higher in critically ill patients than in recovered patients (P = 0.011, 0.04, and 0.016, respectively). Meanwhile, levels of all T cell subsets examined including total CD3(+), CD4(+), CD8(+), and CD45(+) T cells were lower in critically ill patients than in recovered patients (P = 0.033, 0.059, 0.015, and 0.039, respectively). Logistic regression analysis demonstrated that C-reactive protein level, myoglobin level and TCM therapy duration were likely associated with treatment outcomes of H7N9 infection (P = 0.032, 0.041 and 0.017, respectively).

Conclusion: Elderly people may have increased risk for H7N9 virus infection. T cell-mediated responses play an important role in defense against the H7N9 virus. C-reactive protein level, myoglobin level and TCM duration may be associated with treatment outcomes of H7N9 infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • C-Reactive Protein / metabolism
  • Creatinine / blood
  • Female
  • Humans
  • Influenza A Virus, H7N9 Subtype / pathogenicity*
  • Influenza, Human
  • Logistic Models
  • Male
  • Medicine, Chinese Traditional / methods*
  • Middle Aged
  • Myoglobin / metabolism

Substances

  • Myoglobin
  • C-Reactive Protein
  • Creatinine

Grants and funding

This work was supported mainly by the National Science and Technology Major Projects of the Twelfth Five-year Plan (2012ZX10004301004) and the Shanghai Traditional Chinese Medicine Development of the Three-year Action Plan (ZYSNXD-GW-JDJS). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.