Corticosteroid therapy in pneumonia from swine-origin influenza A (H1N1) in China

J Med Virol. 2018 Nov;90(11):1675-1680. doi: 10.1002/jmv.25077. Epub 2018 Jun 13.

Abstract

The first three cases of confirmed infection with the virus in China were documented between May 10 and May 15, 2009. Although the clinical characteristics of the H1N1 pneumonia were described in clinical reports, the therapy has few been described. Therefore, we report our experiences of 53 cases of the H1N1 pneumonia with treatment. We describe clinical characteristic of 53 patients who were hospitalized for laboratory-confirmed H1N1 pneumonia at the 2nd Clinical College of Harbin Medical University. In addition, we measure the role of corticosteroid, mechanical ventilation, and non-corticosteroid antiviral therapy in the management of pneumonia patients with novel H1N1 infection. Real-time reverse-transcriptase-polymerase chain (RT-PCR) testing was used to confirm infection. The outcome of therapy was compared in scores of PaO2 and CT. The data was statistical analyzed by the Shapiro-Wilk, anova, Student-Newman-Keuls Test, and Kruskal-Wallis Test. The most common symptoms were dyspnea. In moderate ill patients, the changes in the increased PaO2 were lower in the non-corticosteroid antiviral therapy group than in the combination of corticosteroid and non-corticosteroid antiviral therapy after 5 days' therapy. The therapy protocol of non-corticosteriod + mechanical ventilation played important role in the recovery of severe ill patients.

Keywords: H1N1; antiviral; pneumonia; therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / administration & dosage*
  • Adult
  • Anti-Inflammatory Agents / administration & dosage*
  • China
  • Female
  • Hospitals, University
  • Humans
  • Influenza A Virus, H1N1 Subtype / genetics
  • Influenza A Virus, H1N1 Subtype / isolation & purification*
  • Influenza, Human / complications*
  • Influenza, Human / pathology
  • Influenza, Human / virology*
  • Male
  • Middle Aged
  • Pneumonia / drug therapy*
  • Pneumonia / pathology
  • Pneumonia / virology
  • Real-Time Polymerase Chain Reaction
  • Retrospective Studies
  • Reverse Transcriptase Polymerase Chain Reaction
  • Treatment Outcome
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents