Risk factors for death from Influenza A(H1N1)pdm09, State of S��o Paulo, Brazil, 2009.
Ana Freitas Ribeiro, Alessandra Cristina Guedes Pellini, Beatriz Yuko Kitagawa, Daniel Marques, Geraldine Madalosso, Gerrita de Cassia Nogueira Figueira, Jo��o Fred, Ricardo Kerti Mangabeira Albernaz, Telma Regina Marques Pinto Carvalhanas, Dirce Maria Trevisan Zanetta
Author Information
Ana Freitas Ribeiro: Epidemiological Surveillance Center, Disease Control Coordination, State of S��o Paulo Department of Health, S��o Paulo, Brazil; Department of Epidemiology, School of Public Health, University of S��o Paulo, S��o Paulo, Brazil.
Alessandra Cristina Guedes Pellini: Epidemiological Surveillance Center, Disease Control Coordination, State of S��o Paulo Department of Health, S��o Paulo, Brazil.
Beatriz Yuko Kitagawa: Epidemiological Surveillance Center, Disease Control Coordination, State of S��o Paulo Department of Health, S��o Paulo, Brazil.
Daniel Marques: Epidemiological Surveillance Center, Disease Control Coordination, State of S��o Paulo Department of Health, S��o Paulo, Brazil.
Geraldine Madalosso: Epidemiological Surveillance Center, Disease Control Coordination, State of S��o Paulo Department of Health, S��o Paulo, Brazil.
Gerrita de Cassia Nogueira Figueira: Epidemiological Surveillance Center, Disease Control Coordination, State of S��o Paulo Department of Health, S��o Paulo, Brazil.
Jo��o Fred: Epidemiological Surveillance Center, Disease Control Coordination, State of S��o Paulo Department of Health, S��o Paulo, Brazil.
Ricardo Kerti Mangabeira Albernaz: Epidemiological Surveillance Center, Disease Control Coordination, State of S��o Paulo Department of Health, S��o Paulo, Brazil.
Telma Regina Marques Pinto Carvalhanas: Epidemiological Surveillance Center, Disease Control Coordination, State of S��o Paulo Department of Health, S��o Paulo, Brazil.
Dirce Maria Trevisan Zanetta: Department of Epidemiology, School of Public Health, University of S��o Paulo, S��o Paulo, Brazil.
This case-control study aimed to assess the risk factors for death from influenza A(H1N1)pdm09 in patients with laboratory confirmation, who had severe acute respiratory illness-SARI and were hospitalized between June 28th and August 29th 2009, in the metropolitan regions of S��o Paulo and Campinas, Brazil. Medical charts of all the 193 patients who died (cases) and the 386 randomly selected patients who recovered (controls) were investigated in 177 hospitals. Household interviews were conducted with those who had survived and the closest relative of those who had died. 73.6% of cases and 38.1% of controls were at risk of developing influenza-related complications. The 18-to-59-year age group (OR = 2.31, 95%CI: 1.31-4.10 (reference up to 18 years of age)), presence of risk conditions for severity of influenza (OR = 1.99, 95%CI: 1.11-3.57, if one or OR = 6.05, 95%CI: 2.76-13.28, if more than one), obesity (OR = 2.73, 95%CI: 1.28-5.83), immunosuppression (OR = 3.43, 95%CI: 1.28-9.19), and search for previous care associated with the hospitalization (OR = 3.35, 95%CI: 1.75-6.40) were risk factors for death. Antiviral treatment performed within 72 hours of the onset of symptoms (OR = 0.17, 95%CI: 0.08-0.37, if within 48hours, and OR = 0.30, 95%CI: 0.11-0.81, if between 48 and 72 hours) was protective against death. The identification of high-risk patients and early treatment are important factors for reducing morbi-mortality from influenza.
References
MMWR Morb Mortal Wkly Rep. 2009 May 8;58(17):467-70
[PMID: 19444150]
