title: Clinical findings in 111 cases of influenza A (H7N9) virus infection.
abstract: BACKGROUND
  During the spring of 2013, a novel avian-origin influenza A (H7N9) virus emerged and spread among humans in China. Data were lacking on the clinical characteristics of the infections caused by this virus.
  
  
  METHODS
  Using medical charts, we collected data on 111 patients with laboratory-confirmed avian-origin influenza A (H7N9) infection through May 10, 2013.
  
  
  RESULTS
  Of the 111 patients we studied, 76.6% were admitted to an intensive care unit (ICU), and 27.0% died. The median age was 61 years, and 42.3% were 65 years of age or older; 31.5% were female. A total of 61.3% of the patients had at least one underlying medical condition. Fever and cough were the most common presenting symptoms. On admission, 108 patients (97.3%) had findings consistent with pneumonia. Bilateral ground-glass opacities and consolidation were the typical radiologic findings. Lymphocytopenia was observed in 88.3% of patients, and thrombocytopenia in 73.0%. Treatment with antiviral drugs was initiated in 108 patients (97.3%) at a median of 7 days after the onset of illness. The median times from the onset of illness and from the initiation of antiviral therapy to a negative viral test result on real-time reverse-transcriptase-polymerase-chain-reaction assay were 11 days (interquartile range, 9 to 16) and 6 days (interquartile range, 4 to 7), respectively. Multivariate analysis revealed that the presence of a coexisting medical condition was the only independent risk factor for the acute respiratory distress syndrome (ARDS) (odds ratio, 3.42; 95% confidence interval, 1.21 to 9.70; P=0.02).
  
  
  CONCLUSIONS
  During the evaluation period, the novel H7N9 virus caused severe illness, including pneumonia and ARDS, with high rates of ICU admission and death. (Funded by the National Natural Science Foundation of China and others.).
authors.affiliation: State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Diseases, First Affiliated College of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Hai-Nv
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authors.lastname: Gao
authors.forename: Hong-Zhou
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authors.lastname: Lu
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authors.lastname: Du
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authors.forename: Yi-Da
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authors.forename: Qiang
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authors.forename: Xian-Mei
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authors.forename: Hong-Ping
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authors.forename: Fang-Ming
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authors.forename: Wei
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authors.lastname: Gao
authors.forename: Guang-Fa
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authors.lastname: Wang
authors.forename: Ling-Xiang
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authors.lastname: Ruan
authors.forename: Wei-Hong
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authors.lastname: Wang
authors.forename: Jun
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authors.lastname: Ye
authors.forename: Hui-Fang
authors.initials: HF
authors.lastname: Cao
authors.forename: Xing-Wang
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authors.lastname: Li
authors.forename: Wen-Hong
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authors.lastname: Zhang
authors.forename: Xu-Chen
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authors.lastname: Fang
authors.forename: Jian
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authors.lastname: He
authors.forename: Wei-Feng
authors.initials: WF
authors.lastname: Liang
authors.forename: Juan
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authors.forename: Mei
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authors.lastname: Zeng
authors.forename: Xian-Zheng
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authors.lastname: Wu
authors.forename: Jun
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authors.lastname: Li
authors.forename: Qi
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authors.lastname: Xia
authors.forename: Zhao-Chen
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authors.forename: Qi
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authors.forename: Chao
authors.initials: C
authors.lastname: Tang
authors.forename: Zhi-Yong
authors.initials: ZY
authors.lastname: Zhang
authors.forename: Bao-Min
authors.initials: BM
authors.lastname: Hou
authors.forename: Zhi-Xian
authors.initials: ZX
authors.lastname: Feng
authors.forename: Ji-Fang
authors.initials: JF
authors.lastname: Sheng
authors.forename: Nan-Shan
authors.initials: NS
authors.lastname: Zhong
authors.forename: Lan-Juan
authors.initials: LJ
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001717:Birds; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D009980:Influenza A virus / Q000145:classification; D005585:Influenza in Birds / Q000635:transmission; D007251:Influenza, Human / Q000150:complications / Q000453:epidemiology / Q000401:mortality / Q000821:virology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000209:etiology; D012189:Retrospective Studies; D019562:Viral Load; D055815:Young Adult