Author/Authors :
Abelleira, Romina University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain , Ruano-Ravina, Alberto Department of Preventive Medicine and Public Health - University of Santiago de Compostela, Santiago de Compostela, Spain , Lama, Adriana University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain , Barbeito, Gema Service of Microbiology - University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain , Toubes, Marıa E. University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain , Domınguez-Antelo, Cristina Critical Care Department - University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain , Gonzalez-Barcala, Francisco J. University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain , Rodrıguez-Nunez, Nuria University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain , J.Marcos, Pedro Service of Pneumology - University Hospital of A Coruña, A Coruña, Spain , Perez delMolino, Marıa L. Service of Microbiology - University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain , Valdes, Luis University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
Abstract :
Introduction. Influenza A H1N1 community-acquired pneumonia (CAP) is a quite frequent respiratory disease. Despite being
considered more serious than other CAPs, there are very few studies comparing its characteristics with noninfluenza CAP. We
aim to establish the differences between pneumonia due to H1N1 virus and pneumonia not caused by H1N1 influenza virus and to
determine the probability that a pneumonia is due to an H1N1 virus infection based on the most relevant variables. Methods. We
used a case-control study where cases were H1N1 CAP patients with confirmed microbiological diagnosis and controls were
patients with CAP admitted to hospital. H1N1 and other influenza types were discarded among controls. We calculated the
probability of being a case or control using multivariate logistic regression. Results. We included 99 cases and 270 controls. Cases
were younger than controls (53 vs 71 years, respectively). Mortality was much higher for H1N1 patients (13% vs 0.3%), and
admission to intensive care unit was more frequent for H1N1 cases. 'e variables most associated with presenting H1N1 CAP
were bilateral affectation on chest X-rays (OR: 5.70; 95% CI 2.69–10.40), followed by presence of arthromyalgias, with cases
presenting close to three times more arthromyalgias compared to controls. Low leukocytes count and high AST values were also
significantly associated with H1N1 CAP. H1N1 CAPs are characterized by bilateral affectation, low leukocyte count, presence of
arthromyalgias, and high AST. Conclusions. A few and easy to obtain clinical parameters might be extremely useful to distinguish
H1N1 CAP from CAPs of other origin.
