Clinical and epidemiological features of Turkish children with 2009 pandemic influenza A (H1N1) infection: experience from multiple tertiary paediatric centres in Turkey.
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Çiftçi Ergin, Tuygun Nilden, Özdemir Halil, Tezer Hasan, Şensoy Gülnar, Devrim İlker, Dalgiç Nazan, Kara Ateş, Turgut Mehmet, Tapisiz Anil, Keser Melike, Çelebi Solmaz, Bayram Nuri, Kocabaş Emine, Dinleyici Ener Çağri, Özen Metehan, Soysal Ahmet, Kuyucu Necdet, Tanir Gönül, Çelikel Elif, Belet Nurşen, Evren Gültaç, Aytaç Didem Büyüktaş, Cengiz Ali Bülent, Canöz Perihan Yasemen, Derinöz Okşan, İnce Erdal, Hacimustafaoğlu Mustafa, Anil Murat, Özgür Özlem, Kuzdan Canan, Özaydin Eda, Aşilioğlu Nazik, Dizdarer Ceyhun, Ceyhan Mehmet, Bucak Ibrahim Hakan, Kendirli Tanil, Yakut Halil İbrahim, Fişgin Tunç, Ünal Nurettin, Altindağ Hakan, Kilinç Ayşe Ayzit, Zöhre Seray Umut, Elhan Atilla Halil, Doğru Ülker
Аннотация
METHODS: We conducted a retrospective multicentre analysis of case records involving children hospitalized with influenza-like illness, in whom 2009 H1N1 influenza was diagnosed by reverse-transcriptase polymerase chain reaction assay, at 17 different tertiary hospitals.
RESULTS: A total of 821 children with 2009 pandemic H1N1 were hospitalized. The majority of admitted children (56.9%) were younger than 5 y of age. Three hundred and seventy-six children (45.8%) had 1 or more pre-existing conditions. Respiratory complications including wheezing, pneumonia, pneumothorax, pneumomediastinum, and hypoxemia were seen in 272 (33.2%) children. Ninety of the patients (11.0%) were admitted or transferred to the paediatric intensive care units (PICU) and 52 (6.3%) received mechanical ventilation. Thirty-five children (4.3%) died. The mortality rate did not differ between age groups. Of the patients who died, 25.7% were healthy before the H1N1 virus infection. However, the death rate was significantly higher in patients with malignancy, chronic neurological disease, immunosuppressive therapy, at least 1 pre-existing condition, and respiratory complications. The most common causes of mortality were pneumonia and sepsis.
CONCLUSIONS: In Turkey, 2009 H1N1 infection caused high mortality and PICU admission due to severe respiratory illness and complications, especially in children with an underlying condition.