Pediatr Allergy Respir Dis.  2012 Jun;22(2):147-153.

The Determinant of the Severity Who was Hospitalized with Asthma-like Symptoms in Influenza A (H1N1) Season

• Hwang YH
• Choi SY
• Kim SW

Abstract

PURPOSE
The aim of study was to identify the predictors of severe asthma exacerbation with influenza A (H1N1) infection so that intensive care could be initiated immediately.
METHODS
Patients were diagnosed influenza A (H1N1), using a real-time reverse transcriptase polymerase chain reaction (RT-PCR) from the nasal aspirates in St. Mary's Medical Center, Busan, Korea, between September, 2009 and February, 2010. Medical records were retrospectively reviewed to collect data. Data were analyzed in two groups by severity of asthma exacerbation. The groups were severe groups and mild-moderate. Statistical analysis was performed by SPSS ver. 12.0.
RESULTS
A total of 1,054 children were diagnosed influenza A (H1N1) infection. Of 1,054, 318 (30.1%) were hospitalized. There were 200 boys (62.9%) and median age was 5.0 years (0.1 to 18.0 years). Among hospitalized, 25.2% (80/318) were diagnosed asthma exacerbation. Among 80 patients, 16 (20.0%) were severe group. and 64 (80.0%) were mild-moderate. High leukocyte counts, neutrophil counts, and C-reactive protein (P<0.05) in serum had a greater risk for severe asthma exacerbation. Age, gender, early antiviral medication, gastrointestinal or neurological cosymptoms, allergic family history, sinusitis in water's view, total immunoglobulin E, Dermatophagoides pteronyssinus, Dermatophagoides farinae, mycoplasma coinfection, eosinophil and fever duration (P> or =0.05) were not reliable predictors.
CONCLUSION
Among who had influenza A (H1N1) infection with asthma-like symptoms, patients who had not been managed asthma before, had high leukocyte, neutrophil, and C-reactive protein in serum, are likely to progress severe asthma exacerbation.

Keyword

Influenza A virus; H1N1 subtype; Asthma exacerbation

MeSH Terms

Asthma
C-Reactive Protein
Child
Coinfection
Dermatophagoides farinae
Dermatophagoides pteronyssinus
Eosinophils
Fever
Humans
Immunoglobulin E
Immunoglobulins
Influenza A virus
Influenza, Human
Critical Care
Korea
Leukocyte Count
Leukocytes
Medical Records
Mycoplasma
Neutrophils
Retrospective Studies
Reverse Transcriptase Polymerase Chain Reaction
Seasons
Sinusitis
C-Reactive Protein
Immunoglobulin E
Immunoglobulins

Figure

• 

  Fig. 1 The numbers of pandemic H1N1 infection and asthma exacerbation monthly. September to November 2009, asthma exacerbations has increased dramatically. Asthma decreased thereafter. The incidence of severe asthma exacerbation was similar in each month.

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