Age and gender adjusted comparison of clinical features between severe cases infected with H7N9 and H1N1pdm influenza A in Jiangsu Province, China

PLoS One. 2015 Mar 27;10(3):e0120999. doi: 10.1371/journal.pone.0120999. eCollection 2015.

Abstract

Background: Influenza H7N9 and H1N1pdm can cause severe human infections. It is important to investigate the distinguishing clinical features between these two diseases. Several studies have compared the differences in general, however, age and gender adjusted comparisons may be more useful and informative to the health professionals.

Methods: A total of 184 severe H1N1pdm patients and 37 severe H7N9 patients from Jiangsu Province were included in this analysis to perform age and gender adjusted comparison of clinical features.

Results: After adjusting age and gender, no significant differences in chronic medical conditions or treatment were found between severely ill patients with H7N9 and H1N1pdm. Severely ill patients with H7N9 had significantly longer interval from onset of illness to neuraminidase inhibitor treatment and to death. They were more likely to have complications such as acute respiratory distress syndrome (ARDS), liver and renal dysfunctions, and had a significantly higher risk of death.

Conclusion: Our results suggests that age and gender should be adjusted as important confounding factors when comparing the clinical features between severe H7N9 and H1N1pdm patients to avoid any misunderstanding regarding the differences between these two diseases particularly in terms of clinical severity and prognosis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Child
  • China / epidemiology
  • Female
  • Humans
  • Influenza A Virus, H1N1 Subtype / physiology*
  • Influenza A Virus, H7N9 Subtype / physiology*
  • Influenza, Human / complications
  • Influenza, Human / pathology*
  • Influenza, Human / virology*
  • Male
  • Middle Aged
  • Pandemics
  • Prognosis
  • Sex Factors
  • Young Adult

Grants and funding

Bao C.J. is partly supported by Natural Science Foundation of China (No. 81373055, http://www.nsfc.gov.cn/), Jiangsu Province Science and Technology Support Program (No: BE2012769, http://www.jstd.gov.cn/), and the 10th Summit of Six Top Talents of Jiangsu Province (No: 2013-WSN-061, http://www.jshrss.gov.cn/sy2011/index.html). Huo X is supported in part by National Natural Science Foundation of China (81273143, http://www.nsfc.gov.cn/) and by Research Foundation of National Health and Family Planning Commission of China (W201303, http://www.nhfpc.gov.cn/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.