Prognosis of 18 H7N9 avian influenza patients in Shanghai.
OBJECTIVE
To provide prognosis of an 18 patient cohort who were confirmed to have H7N9 lung infection in Shanghai.


METHODS
Patients' history, clinical manifestation, laboratory test, treatment strategy and mortality were followed and recorded for data analysis.


RESULTS
A total of 18 patients had been admitted into Shanghai Public Health Clinical Center from April 8th to July 29, 2013. 22.2% of the patients were found to have live poultry contact history and 80% were aged male patients with multiple co-morbidities including diabetes, hypertension and/or chronic obstructive pulmonary disease (COPD). This group of patients was admitted to the clinical center around 10 days after disease onset. According to laboratory examinations, increased C reactive protein (CRP), Procalcitonin (PCT), Plasma thromboplastin antecedent (PTA) and virus positive time (days) were indicative of patients' mortality. After multivariate analysis, only CRP level showed significant prediction of mortality (P = 0.013) while results of prothrombin time (PT) analysis almost reached statistical significance (P = 0.056).


CONCLUSIONS
H7N9 infection induced pneumonia of different severity ranging from mild to severe pneumonia or acute lung injury/acute respiratory distress syndrome to multiple organ failure. Certain laboratory parameters such as plasma CRP, PCT, PTA and virus positive days predicted mortality of H7N9 infection and plasma CRP is an independent predictor of mortality in these patients.
Department of Tuberculosis, Shanghai Public Health Clinical Center, Shanghai, China.
Shuihua
S
Lu
Department of Tuberculosis, Shanghai Public Health Clinical Center, Shanghai, China.
Tao
T
Li
Department of Tuberculosis, Shanghai Public Health Clinical Center, Shanghai, China.
Xiuhong
X
Xi
Department of Tuberculosis, Shanghai Public Health Clinical Center, Shanghai, China.
Qingguo
Q
Chen
Department of Tuberculosis, Shanghai Public Health Clinical Center, Shanghai, China.
Xuhui
X
Liu
Department of Tuberculosis, Shanghai Public Health Clinical Center, Shanghai, China.
Binxing
B
Zhang
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Jiaxian
J
Ou
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Jie
J
Liu
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Qin
Q
Wang
Department of Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
Biao
B
Zhu
Department of Tuberculosis, Shanghai Public Health Clinical Center, Shanghai, China.
Xinian
X
Liu
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Chunxue
C
Bai
Department of Pulmonary Medicine, Huadong Hospital, Fudan University, Shanghai, China.
Jieming
J
Qu
Department of Tuberculosis, Shanghai Public Health Clinical Center, Shanghai, China.
Hongzhou
H
Lu
Department of Tuberculosis, Shanghai Public Health Clinical Center, Shanghai, China.
Zhiyong
Z
Zhang
Department of Tuberculosis, Shanghai Public Health Clinical Center, Shanghai, China; Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Pulmonary Medicine, Zhongshan Hospital, Qingpu Branch, Shanghai, China.
Yuanlin
Y
Song
D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002681:China / Q000453:epidemiology; D018572:Disease-Free Survival; D005172:Factor XI / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D064766:Influenza A Virus, H7N9 Subtype; D007251:Influenza, Human / Q000097:blood* / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011498:Protein Precursors / Q000097:blood*; D011517:Prothrombin Time; D015996:Survival Rate
C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D005172:Factor XI; D015740:Calcitonin Gene-Related Peptide