Srpski arhiv za celokupno lekarstvo 2016 Volume 144, Issue 11-12, Pages: 626-632
https://doi.org/10.2298/SARH1612626R
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Risk factors for severe influenza a virus infections in post-2009 pandemic period
Radovanov Jelena (Institute of Public Health of Vojvodina, Center of Virology, Novi Sad)
Hrnjaković-Cvjetković Ivana (Institute of Public Health of Vojvodina, Center of Virology, Novi Sad + Medical Faculty, Novi Sad)
Nikolić Nataša (Institute of Public Health of Vojvodina, Center of Virology, Novi Sad + Medical Faculty, Novi Sad)
Jovanović-Galović Aleksandra (Institute of Public Health of Vojvodina, Center of Virology, Novi Sad)
Kovačević Gordana (Institute of Public Health of Vojvodina, Center of Virology, Novi Sad)
Patić Aleksandra (Institute of Public Health of Vojvodina, Center of Virology, Novi Sad + Medical Faculty, Novi Sad)
Milošević Uroš (Medical Faculty, Novi Sad + Clinical Centre of Vojvodina, Novi Sad)
Milošević Vesna (Institute of Public Health of Vojvodina, Center of Virology, Novi Sad + Medical Faculty, Novi Sad)
Introduction. Literature data concerning risk factors for severe influenza in
post-2009 pandemic period, from low- and middle-income Central and Eastern
European countries are very limited. Objective. The aim of this study was to
investigate the risk factors for severe A(H1N1)pdm09 and A(H3N2) influenza
during the post-2009 pandemic period. Methods. During four consecutive
seasons of 2010/2011-2013/2014, nasopharyngeal or nasal and pharyngeal swab
samples from 153 patients with mild and 147 patients with severe influenza
were tested using real-time reverse transcription polymerase chain reaction
(real-time RT PCR) assays. Results. The study indicated three statistically
significant risk factors of influenza severity, including presence of chronic
underlying illness/condition [odds ratio (OR) of 15.2, 95% confidence
interval (CI) of 1.8-125.4, p = 0.001), age ≥15 years (OR 9.2, 95% CI
3.5-24.1, p < 0.001), and delay in medical care of more than two days after
the symptoms onset (OR 3.2, 95% CI 1.6-6.4, p = 0.001). Conclusion. Obtained
results confirmed that patients with chronic underlying illness/condition and
older than 15 years had the highest risk for serious complications from
influenza and highlighted the importance of start of antiviral therapy within
the first two days of illness in order to reduce the risk for the most severe
outcomes of influenza, such as acute respiratory distress syndrome and lethal
outcome.
Keywords: influenza A, acute respiratory infections, real-time RT PCR