title: Clinical presentation, microbiological features and correlates of disease severity of 2009 pandemic influenza A (H1N1) infection.
abstract: The purpose of this study was to describe epidemiological, clinical and microbiological characteristics of confirmed novel influenza A (H1N1) infection, investigating factors associated with disease severity. We retrospectively selected patients seeking care for respiratory symptoms in two periods (May-August and September-November 2009) with different epidemiological characteristics. Only patients with confirmed pandemic influenza A (H1N1) were enrolled in this study. A total of 104 patients with H1N1 infection were evaluated, mostly referring classic influenza symptoms; in addition, diarrhea and vomiting were often referred. Clinical signs, symptoms and respiratory complications were different in the two periods. Of all patients, 18 (17%) had pneumonia. Patients older than 50 years showed a lower probability of pneumonia diagnosis when compared to children aged 0-13 (p = 0.049); a longer duration of symptoms before medical care was associated with a higher probability of pneumonia (p = 0.026). Phylogenetic analysis showed a low variability both in hemagglutinin and neuraminidase genes. In addition, no neuraminidase mutation associated with antiviral resistance was detected. A detailed description of respiratory diseases associated with H1N1 infection was provided and factors associated with its severity were investigated, thus contributing to the insight into epidemiological, clinical and microbiological knowledge of the disease.
authors.affiliation: Institute of Clinical Infectious Diseases, Catholic University of Sacred Heart, Largo F. Vito1, 00168, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Di Giambenedetto
authors.forename: L
authors.initials: L
authors.lastname: Zileri Dal Verme
authors.forename: M
authors.initials: M
authors.lastname: Sali
authors.forename: S
authors.initials: S
authors.lastname: Farina
authors.forename: V
authors.initials: V
authors.lastname: Di Cristo
authors.forename: S
authors.initials: S
authors.lastname: Manzara
authors.forename: A
authors.initials: A
authors.lastname: De Luca
authors.forename: G
authors.initials: G
authors.lastname: Pignataro
authors.forename: M
authors.initials: M
authors.lastname: Prosperi
authors.forename: A
authors.initials: A
authors.lastname: Di Franco
authors.forename: N
authors.initials: N
authors.lastname: Gentiloni Silveri
authors.forename: G
authors.initials: G
authors.lastname: Delogu
authors.forename: R
authors.initials: R
authors.lastname: Cauda
authors.forename: M
authors.initials: M
authors.lastname: Fabbiani
authors.forename: G
authors.initials: G
authors.lastname: Fadda
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents; D002648:Child; D003967:Diarrhea / Q000821:virology; D004196:Disease Outbreaks; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification / Q000472:pathogenicity*; D007251:Influenza, Human / Q000453:epidemiology* / Q000503:physiopathology* / Q000821:virology; D007558:Italy / Q000453:epidemiology; D008297:Male; D058873:Pandemics; D010802:Phylogeny; D011024:Pneumonia, Viral / Q000821:virology; D012720:Severity of Illness Index; D014839:Vomiting / Q000821:virology; D055815:Young Adult
chemical_list: D000998:Antiviral Agents