title: Risk factors of severe novel influenza A (H1N1) infections in hospitalized children.
abstract: OBJECTIVE
  Data on hospitalized novel influenza A (H1N1) infected children are limited and urgently in demand. We conducted a clinical study to identify clinical features and risk factors associated with severe novel H1N1 infections of children in Taiwan.
  
  
  METHODS
  From July 24, 2009 to December 4, 2009, data from 61 hospitalized children infected with 2009 novel H1N1 were collected. Demographics, underlying medical conditions, clinical data, receipt of antiviral therapy, need for intensive care and outcome were analyzed to identify clinical features and risk factors of severe infections.
  
  
  RESULTS
  Of the 61 inpatients, the male to female ratio was 41 to 20 and the most common age group was between 6 and 12 years (36%). Almost all (98%) patients had fever, 53 (87%) patients received oseltamivir treatment and 51% of them received oseltamivir within 48 hours. Fourteen (23%) needed intensive care and 3 died. Obesity (a Body Mass Index ≥ 25 kg/m(2) in children ≥ 2 years of age, or a body weight ≥ the 95(th) percentile in children <2 years of age), dyspnea, C-reactive protein (CRP) > 3 mg/dL, pleural effusion, and delayed antiviral therapy were significantly associated with the need for intensive care and/or death.
  
  
  CONCLUSIONS
  Obesity, dyspnea, CRP > 3 mg/dL, pleural effusion, and delayed antiviral therapy are significantly associated with severe novel H1N1 infections in children.
authors.affiliation: Division of Pediatric Infectious Diseases, Department of Pediatrics, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.
authors.forename: Wei-Hua
authors.initials: WH
authors.lastname: Chen
authors.forename: Chun-Yi
authors.initials: CY
authors.lastname: Lu
authors.forename: Pei-Lan
authors.initials: PL
authors.lastname: Shao
authors.forename: Ping-Ing
authors.initials: PI
authors.lastname: Lee
authors.forename: Chuan-Liang
authors.initials: CL
authors.lastname: Kao
authors.forename: Ming-Yi
authors.initials: MY
authors.lastname: Chung
authors.forename: Luan-Yin
authors.initials: LY
authors.lastname: Chang
authors.forename: Li-Min
authors.initials: LM
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D008297:Male; D053139:Oseltamivir / Q000627:therapeutic use; D012307:Risk Factors; D012720:Severity of Illness Index; D013624:Taiwan; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir