Pandemic 2009 A(H1N1) Infection Requiring Hospitalization of Elderly Spanish Adults

• Autores: José Ramón Paño Pardo, Diego Viasus, Jerónimo Pachón Díaz, Antoni Campins Colom, Francisco López Medrano, A. Villoslada, M. Gutiérrez Cuadra, Tomàs Pumarola Suñé, María Dolores del-Toro-López, José Antonio Oteo Revuelta, Joaquín Martínez Montauti, Juan Bautista Gutiérrez Aroca, Ferrán Segura Porta, Jordi Carratalà Fernández
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 60, Nº. 4, 2012, págs. 740-744
• Idioma: inglés
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• Resumen

  • Objectives: To describe the clinical presentation and prognosis of elderly adults hospitalized with pandemic 2009 A(H1N1) influenza infection and to compare these data with those of younger patients.

    Design: Prospective, observational, multicenter study.

    Setting: Thirteen hospitals in Spain.

    Participants: Adults admitted to the hospital with confirmed pandemic 2009 A(H1N1) influenza infection.

    Measurements: Demographic, clinical, laboratory, radiological, and outcome variables.

    Results: Between June 12 and November 10, 2009, 585 adults with confirmed 2009 A(H1N1) influenza were hospitalized, of whom 50 (8.5%) were aged 65 and older (median age 72, range 65�87). Older adults (?65) were more likely to have associated comorbidities (88.0% vs 51.2%; P < .001), primarily chronic pulmonary diseases (46.0% vs 27.3%; P < .001). Lower respiratory tract symptoms and signs such as dyspnea (60.0% vs 45.6%) and wheezing (46.0% vs 27.8%; P = .007) were also more common in these elderly adults, although pulmonary infiltrates were present in just 14 (28.0%) of the older adults, compared with 221 (41.3%) of the younger adults (P = .06). Multilobar involvement was less frequent in elderly adults with pulmonary infiltrates than younger adults with pulmonary infiltrates (21.4% vs 60.0%; P = .05). Rhinorrhea (4.0% vs 21.9%; P = .003), myalgias (42.0% vs 59.1%; P = .01), and sore throat (14.0% vs 29.2%; P = .02) were more frequent in younger adults. Early antiviral therapy (<48 hours) was similar in the two groups (34.0% vs 37.9%; P = .58). Two older adults (4.0%) died during hospitalization, compared with 11 (2.1%) younger adults (P = .30).

    Conclusion: Elderly adults with 2009 A(H1N1) influenza had fewer viral-like upper respiratory symptoms than did younger adults. Pneumonia was more frequent in younger adults. No significant differences were observed in hospital mortality.