J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 5, Number 4, August 2013, pages 286-293

An Observational Retrospective Study Provide Information on Hospitalization and Severe Outcomes of the 2009 A(H1N1) Infection in Italy

Figure 1. Week distribution of hospitalized patients with suspected influenza infection and of patients with laboratory confirmed 2009 pandemic A(H1N1) virus infection (July 2009 - March 2010).

**Table 1.** Incidence of Hospitalization, ICU Admission and Fatal Outcomes in the 141 Patients With 2009 Pandemic A(H1N1) Laboratory Confirmed Infection
Age group (years)	Population (n)	Hospital admitted n (%)	Incidence per 100,000 inhabitants	ICU admitted	Incidence per 100,000 inhabitants	Death	Incidence per 100,000 inhabitants
0 - 17	136,563	47 (33)	34.4	1	0.7	0	0
18 - 64	589,592	63 (45)	10.7	8	1.4	2	0.3
≥ 65	225,514	31 (22)	13.7	5	2.2	4	1.8
Total	951,669	141 (100)	14.8	14	1.5	6	0.6

Table 1. Incidence of Hospitalization, ICU Admission and Fatal Outcomes in the 141 Patients With 2009 Pandemic A(H1N1) Laboratory Confirmed Infection

Age group (years)

Population (n)

Hospital admitted n (%)

Incidence per 100,000 inhabitants

ICU admitted

Incidence per 100,000 inhabitants

Death

Incidence per 100,000 inhabitants

0 - 17

136,563

47 (33)

34.4

0.7

18 - 64

589,592

63 (45)

10.7

1.4

0.3

≥ 65

225,514

31 (22)

13.7

2.2

1.8

Total

951,669

141 (100)

14.8

1.5

0.6

**Table 2.** Demographic Characteristics and Comorbidities of Hospitalized Patients With A(H1N1) Laboratory Confirmed Infection and Comparison of Patients in GMW and in ICU
	Hospitalized (n = 141)	GMW* (n = 127)	ICU** (n = 14)	ICU vs GMW P value
GMW: General Medical Ward; ICU: Intensive Care Unit; a: More than one possible medical condition per patient; b: From either medication or immune disorders; c: Calculated as percentages of pregnancy considering the 25 fertile women (15 - 44 years).
Age, mean (range)	37 (1 m - 93 y)	35 (1 m - 93 y)	54 (1 m - 83 y)	0.022
Female	66 (47%)	60 (47%)	6 (43%)	0.755
Comorbidities n (%)^a
Any comorbidity	78 (55)	66 (52)	12 (86)	0.016
Respiratory diseases	18 (13)	15 (12)	3 (21)	0.306
Asthma	5 (4)	5 (4)	0 (0)	0.450
Diabetes	21 (15)	17 (13)	4 (29)	0.130
Cardiovascular diseases	33 (23)	26 (20)	7( 50)	0.013
Renal diseases	2 (1)	1 (1)	1 (7)	0.056
Neurological diseases	16 (11)	11 (9)	5 (36)	0.002
Immuno compromised^b	12 (9)	8 (6)	4 (29)	0.005
Pregnancy^c	8/25 (32)	7/22 (32)	1/3 (33)	0.5439

Table 2. Demographic Characteristics and Comorbidities of Hospitalized Patients With A(H1N1) Laboratory Confirmed Infection and Comparison of Patients in GMW and in ICU

Hospitalized (n = 141)

GMW* (n = 127)

ICU** (n = 14)

ICU vs GMW
P value

GMW: General Medical Ward; ICU: Intensive Care Unit; a: More than one possible medical condition per patient; b: From either medication or immune disorders; c: Calculated as percentages of pregnancy considering the 25 fertile women (15 - 44 years).

Age, mean (range)

37 (1 m - 93 y)

35 (1 m - 93 y)

54 (1 m - 83 y)

0.022

Female

66 (47%)

60 (47%)

6 (43%)

0.755

Comorbidities n (%)^a

Any comorbidity

78 (55)

66 (52)

12 (86)

0.016

Respiratory diseases

18 (13)

15 (12)

3 (21)

0.306

Asthma

5 (4)

0 (0)

0.450

Diabetes

21 (15)

17 (13)

4 (29)

0.130

Cardiovascular diseases

33 (23)

26 (20)

7( 50)

0.013

Renal diseases

2 (1)

1 (1)

1 (7)

0.056

Neurological diseases

16 (11)

11 (9)

5 (36)

0.002

Immuno compromised^b

12 (9)

8 (6)

4 (29)

0.005

Pregnancy^c

8/25 (32)

7/22 (32)

1/3 (33)

0.5439

**Table 3.** Symptoms and Laboratory Findings at Hospital Admission, Clinical Course and Outcome in Hospitalized Patients With A(H1N1) Laboratory Confirmed Infection and Comparison of Patients in GMW and in ICU
	Hospitalized (n = 141)	GMW (n = 127)	ICU (n = 14)	ICU vs GMW P value
Symptoms n (%)
Fever	137 (97)	124 (98)	13 (93)	0.307
Myalgia	40 (28)	38 (30)	2 (14)	0.218
Cough	110 (78)	100 (79)	10 (71)	0.167
Headache	37 (26)	35 (28)	2 (14)	0.284
Nasal congestion	29 (21)	28 (22)	1 (7)	0.190
Rhinorrhea	19 (13)	17 (13)	2 (14)	0.925
Sore throat	52 (37)	51 (40)	1 (7)	0.015
Respiratory distress	46 (33)	37 (29)	9 (64)	0.008
Diarrhea	19 (13)	14 (11)	5 (36)	0.010
Abdominal pain or vomiting	26 (18)	24 (19)	2 (14)	0.673
Radiological and Laboratory findings n (%)
Pneumonia seen on chest radiography	54/110 (49)	42/96 (44)	12/14 (86)	0.003
Anemia	81 (57)	70 (55)	11 (79)	0.092
Leukocytosis	50 (35)	42 (33)	8 (57)	0.074
Leukopenia	33 (23)	28 (22)	5 (36)	0.252
Thrombocytosis	19 (13)	16 (13)	3 (21)	0.358
Thrombocytopenia	13 (9)	9 (7)	4 (29)	0.008
Transaminase alteration	39 (28)	31 (24)	8 (57)	0.009
Cpk* alteration	21 (15)	16 (13)	5 (36)	0.021
Pharmacological treatment n (%)
Antiviral	66 (47)	52 (41)	14 (100)	0.000
Antibiotic	116 (82)	102 (80)	14 (100)	0.067
Corticosteroid	23 (16)	20 (16)	3 (21)	0.585
Course mean days (range)
Interval from onset of illness to hospital admission	3 (0-14)	3 (0-14)	3 (0-9)	0.855
Hospital stay	9 (1-69)	8 (1-69)	19 (3-59)	0.000
Outcome n (%)
Survived	135 (96)	127 (100)	8 (57)	0.000
Expired	6 (4)	0	6 (43)	0.000

Table 3. Symptoms and Laboratory Findings at Hospital Admission, Clinical Course and Outcome in Hospitalized Patients With A(H1N1) Laboratory Confirmed Infection and Comparison of Patients in GMW and in ICU

Hospitalized
(n = 141)

GMW
(n = 127)

ICU
(n = 14)

ICU vs GMW
P value

Symptoms n (%)

Fever

137 (97)

124 (98)

13 (93)

0.307

Myalgia

40 (28)

38 (30)

2 (14)

0.218

Cough

110 (78)

100 (79)

10 (71)

0.167

Headache

37 (26)

35 (28)

2 (14)

0.284

Nasal congestion

29 (21)

28 (22)

1 (7)

0.190

Rhinorrhea

19 (13)

17 (13)

2 (14)

0.925

Sore throat

52 (37)

51 (40)

1 (7)

0.015

Respiratory distress

46 (33)

37 (29)

9 (64)

0.008

Diarrhea

19 (13)

14 (11)

5 (36)

0.010

Abdominal pain or vomiting

26 (18)

24 (19)

2 (14)

0.673

Radiological and Laboratory findings n (%)

Pneumonia seen on chest radiography

54/110 (49)

42/96 (44)

12/14 (86)

0.003

Anemia

81 (57)

70 (55)

11 (79)

0.092

Leukocytosis

50 (35)

42 (33)

8 (57)

0.074

Leukopenia

33 (23)

28 (22)

5 (36)

0.252

Thrombocytosis

19 (13)

16 (13)

3 (21)

0.358

Thrombocytopenia

13 (9)

9 (7)

4 (29)

0.008

Transaminase alteration

39 (28)

31 (24)

8 (57)

0.009

Cpk* alteration

21 (15)

16 (13)

5 (36)

0.021

Pharmacological treatment n (%)

Antiviral

66 (47)

52 (41)

14 (100)

0.000

Antibiotic

116 (82)

102 (80)

14 (100)

0.067

Corticosteroid

23 (16)

20 (16)

3 (21)

0.585

Course mean days (range)

Interval from onset of illness to hospital admission

3 (0-14)

3 (0-9)

0.855

Hospital stay

9 (1-69)

8 (1-69)

19 (3-59)

0.000

Outcome n (%)

Survived

135 (96)

127 (100)

8 (57)

0.000

Expired

6 (4)

6 (43)

0.000