title: [Influence of concomitant illness on clinical manifestations and severity of A/H1N1 influenza infection among patients hospitalized in the Hospital of Infectious Diseases in Warsaw--clinical cases].
abstract: Many cases of swine flu is mild or even asymptomatic. The recent cases have been much more severe, and many patients have presented pneumonia, respiratory failure and acute respiratory distress syndrome (ARDS). Illness-related fatalities have been recorded among individuals hospitalized in The Hospital For Infectious Diseases in Warsaw, Poland. There were 109 patients (age: 17-71y), with A/H1N1 infection confirmed by PCR. In this article have shown cases of H1N1 influenza - related complications. We observed bacterial superinfections associated with swine flu, ARDS and shock syndrome, secondary bacterial pneumonia and neurological complications. Severe hypoxemia, multilobar pneumonia, and dramatic signs and symptoms progression, were reported in 8 individuals. All patients required admission to intensive care unit and the mechanical ventilation. One patient died due to ARDS and encephalitis. Many people have experienced risk factors, e.g.: asthma, sarcoidosis, or chronic bronchitis and other pulmonary illness. One patient after renal transplant with immunosuppressive therapy recovered, as well as two patients with chronic lymphatic leucaemia in remission. Two woman with clinically-relevant obesity have developed rapid progression of respiratory insufficiency and were still on mechanical ventilation. Influenza A/H1N1 were observed in 10 pregnant women, without co-morbidities. Three of them developed interstitial pneumonia. Consequently pregnant women with confirmed pandemic A/H1N1 infection received treatment with oseltamivir.
  
  
  CONCLUSIONS
  Among 109 hospitalized individuals with A/H1N1 infection, eight (7%) developed severe pulmonary complications, and one of this patient died. The risk factors of progression to acute respiratory distress syndrome (ARDS) have all of this group patients.
authors.affiliation: SP ZOZ Wojewódzki Szpital Zakaźny w Warszawie cholegra@zakazny.pl
authors.forename: Grazyna
authors.initials: G
authors.lastname: Cholewińska
authors.forename: Józef
authors.initials: J
authors.lastname: Higersberger
authors.forename: Regina
authors.initials: R
authors.lastname: Podlasin
authors.forename: Alicja
authors.initials: A
authors.lastname: Wiercińska-Drapało
authors.forename: Dariusz
authors.initials: D
authors.lastname: Lipowski
authors.forename: Maria
authors.initials: M
authors.lastname: Olszyńska-Krowicka
authors.forename: Witold
authors.initials: W
authors.lastname: Przyjałkowski
authors.forename: Andrzej
authors.initials: A
authors.lastname: Horban
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D015897:Comorbidity; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification; D007251:Influenza, Human / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011024:Pneumonia, Viral / Q000453:epidemiology; D011044:Poland / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D012128:Respiratory Distress Syndrome / Q000453:epidemiology; D012131:Respiratory Insufficiency / Q000453:epidemiology*; D012507:Sarcoidosis / Q000453:epidemiology; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult