Influenza pneumonia among adolescents and adults: a concurrent comparison between influenza A (H1N1) pdm09 and A (H3N2) in the post-pandemic period

Clin Respir J. 2014 Apr;8(2):185-91. doi: 10.1111/crj.12056. Epub 2013 Nov 26.

Abstract

Introduction: Comparisons of the characteristics between the influenza A (H1N1) pdm09 and common seasonal influenza are important for both clinical management and epidemiological studies. However, the differences between pandemic and seasonal influenza during the post-pandemic period are poorly understood.

Objectives: The aim of our research was to investigate clinical and immune response differences between patients with influenza A (H1N1) pdm09 pneumonia and seasonal influenza A (H3N2) pneumonia in the post-pandemic period.

Methods: During the first flu season in post-pandemic period, patients from Beijing Network for Adult Community-Acquired Pneumonia present A (H1N1) pdm09 or A (H3N2) influenza were compared concurrently in the aspects of clinical characteristics and inflammatory profile in acute phase.

Result: Patients with A (H1N1) pdm09 influenza pneumonia showed a close mean age to A (H3N2) pneumonia (51 ± 20 vs 53 ± 16, mean ± standard deviation, years) but tended to have more underlying diseases (32.8% vs 10%, P=0.036). Although clinical characteristics were similar, no statistical difference were found in pneumonia severity index (PSI) score or intensive care unit admission rate or mortality, patients in A (H1N1) pdm09 cohort present higher levels of aspartate aminotransferase, lactase dehydrogenase (P=0.006, 0.018, respectively) in blood and also longer duration of fever than A (H3N2) cohort. Levels of interleukin (IL)-10 and IL-12 (p70) were higher in A (H1N1) pdm09 cohort (P=0.031, 0.047, respectively).

Conclusios: During the first post-pandemic flu season, patients with the A (H1N1) pdm09 pneumonia showed similar clinical characteristics but slightly higher disease severity and stronger systemic inflammatory response than A (H3N2) pneumonia.

Keywords: influenza A (H1N1) pdm09; pneumonia; post-pandemic; seasonal influenza A (H3N2).

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • China / epidemiology
  • Cytokines / blood
  • Female
  • Humans
  • Incidence
  • Influenza A Virus, H1N1 Subtype / genetics*
  • Influenza A Virus, H3N2 Subtype / genetics*
  • Influenza, Human / epidemiology*
  • Influenza, Human / immunology
  • Influenza, Human / virology
  • Male
  • Middle Aged
  • Pandemics*
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / immunology
  • Pneumonia, Viral / virology
  • RNA, Viral / analysis*
  • Real-Time Polymerase Chain Reaction
  • Young Adult

Substances

  • Cytokines
  • RNA, Viral