Pneumonia, Raised CRP Level Tied to Severe H1N1 Outcomes

Especially true in those with obesity, pulmonary conditions, but healthy people often hospitalized
By Monica Smith
HealthDay Reporter

TUESDAY, July 13 (HealthDay News) -- Pandemic H1N1 influenza infection often leads to hospitalization in previously healthy individuals, as well as people with underlying conditions, and an abnormal chest X-ray or an elevated C-reactive protein (CRP) level -- particularly in obese individuals or those with pulmonary conditions other than asthma or chronic obstructive pulmonary disease (COPD) -- is associated with a potentially serious outcome, according to research published in the July issue of Thorax.

Jonathan S. Nguyen-Van-Tam, of the University of Nottingham in the United Kingdom, and colleagues investigated 631 cases of patients hospitalized with H1N1 influenza in the United Kingdom in order to describe the clinical characteristics and risk factors for severe outcomes in these patients.

The researchers note that death occurred in 5 percent of the patients, and 13 percent of patients were admitted to a critical care or high dependency unit. Only 5 percent were age 65 or older, 36 percent were under 16, and there was a disproportionately high number of pregnant and non-white patients; 45 percent of patients had one or more underlying conditions, and 13 percent had received antiviral medications before admission. Severe outcomes were associated with obesity, pneumonia confirmed by radiology, high CRP levels, and pulmonary conditions other than asthma or COPD. Twenty-nine percent of patients with documented chest X-rays when they were admitted had evidence of pneumonia. Of the in-hospital deaths, 59 percent occurred in previously healthy individuals.

"Pandemic H1N1 infection causes disease requiring hospitalization of previously fit individuals as well as those with underlying conditions. An abnormal chest X-ray or a raised CRP level, especially in patients who are recorded as obese or who have pulmonary conditions other than asthma or COPD, indicate a potentially serious outcome. These findings support the use of pandemic vaccine in pregnant women, children less than 5 years of age, and those with chronic lung disease," the authors write.

Several authors disclosed financial relationships with pharmaceutical companies.

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