Clinical manifestations and evolution of infection by influenza A (H1N1) in kidney transplant recipients

TVS Freitas, G Ono, L Corrêa, PS Gomes… - Brazilian Journal of …, 2011 - SciELO Brasil
TVS Freitas, G Ono, L Corrêa, PS Gomes, NZ Galante, H Tedesco-Silva, LFA Camargo…
Brazilian Journal of Nephrology, 2011SciELO Brasil
Introduction: The emergence of the pandemic outbreak of influenza A (H1N1) in April, 2009,
represented a logistic challenge for public health. Although most infected patients presented
clinical and evolutionary manifestations which were very similar to seasonal influenza, a
significant number of individuals developed pneumonia and severe acute respiratory failure.
The impact of influenza A (H1N1) in immunocompromised patients is not well established
yet. Method: This study aimed to analyze the clinical presentations and evolution of …
Introduction
The emergence of the pandemic outbreak of influenza A (H1N1) in April, 2009, represented a logistic challenge for public health. Although most infected patients presented clinical and evolutionary manifestations which were very similar to seasonal influenza, a significant number of individuals developed pneumonia and severe acute respiratory failure. The impact of influenza A (H1N1) in immunocompromised patients is not well established yet.
Method
This study aimed to analyze the clinical presentations and evolution of influenza A (H1N1) in 19 kidney transplant recipients. Influenza A (H1N1) infection was confirmed by RTPCR in all patients. Treatment included antiviral therapy with oseltamivir phosphate and antibiotics.
Results
The studied population was compounded mostly of white people (63%), males (79%), at a mean age of 38.6±17 years and patients with at least one comorbidity (53%). Influenza A (H1N1) infection was identified 41.6±49.6 months after transplantation. Common symptoms included cough (100%), fever (84%), dyspnea (79%), and myalgia (42%). Acute allograft dysfunction was observed in 42% of the patients. Five patients (26%) were admitted to the Intensive Care Unit, two (10%) required invasive ventilation support, and two (10%) required vasoactive drugs. Mortality rate was 10%.
Conclusions
Acute renal allograft dysfunction was a common finding. Clinical, laboratory, and evolutionary characteristics were comparable to those in the general population.
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