Comparison of hospitalized solid organ transplant recipients and nonimmunocompromised patients with pandemic H1N1 infection: a retrospective cohort study.
Identifieur interne : 000541 ( Main/Exploration ); précédent : 000540; suivant : 000542Comparison of hospitalized solid organ transplant recipients and nonimmunocompromised patients with pandemic H1N1 infection: a retrospective cohort study.
Auteurs : Brian J. Minnema [Canada] ; Mehul Patel ; Coleman Rotstein ; Tony Mazzulli ; Susy Hota ; Edward H. Cole ; Eberhard L. Renner ; Heather J. Ross ; Lianne G. Singer ; Shahid HusainSource :
- Transplantation [ 1534-6080 ] ; 2011.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Canada, Facteurs de risque, Femelle, Grippe humaine (), Grippe humaine (physiopathologie), Grippe humaine (épidémiologie), Humains, Indice de gravité médicale, Mâle, Oxygénation extracorporelle sur oxygénateur à membrane, Pandémies, Patients hospitalisés, Prévalence, Résultat thérapeutique, Sous-type H1N1 du virus de la grippe A, Sujet immunodéprimé, Sujet âgé, Sujet âgé de 80 ans ou plus, Transplantation, Transplantation d'organe, Ventilation à haute fréquence, Études de cohortes, Études rétrospectives.
- MESH :
- physiopathologie : Grippe humaine.
- épidémiologie : Grippe humaine.
- Adulte, Adulte d'âge moyen, Canada, Facteurs de risque, Femelle, Grippe humaine, Humains, Indice de gravité médicale, Mâle, Oxygénation extracorporelle sur oxygénateur à membrane, Pandémies, Patients hospitalisés, Prévalence, Résultat thérapeutique, Sous-type H1N1 du virus de la grippe A, Sujet immunodéprimé, Sujet âgé, Sujet âgé de 80 ans ou plus, Transplantation, Transplantation d'organe, Ventilation à haute fréquence, Études de cohortes, Études rétrospectives.
- Wicri :
- geographic : Canada.
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Canada, Cohort Studies, Extracorporeal Membrane Oxygenation, Female, High-Frequency Ventilation, Humans, Immunocompromised Host, Influenza A Virus, H1N1 Subtype, Influenza, Human (epidemiology), Influenza, Human (physiopathology), Influenza, Human (therapy), Inpatients, Male, Middle Aged, Organ Transplantation, Pandemics, Prevalence, Retrospective Studies, Risk Factors, Severity of Illness Index, Transplantation, Treatment Outcome.
- MESH :
- geographic : Canada.
- epidemiology : Influenza, Human.
- physiopathology : Influenza, Human.
- therapy : Influenza, Human.
- Adult, Aged, Aged, 80 and over, Cohort Studies, Extracorporeal Membrane Oxygenation, Female, High-Frequency Ventilation, Humans, Immunocompromised Host, Influenza A Virus, H1N1 Subtype, Inpatients, Male, Middle Aged, Organ Transplantation, Pandemics, Prevalence, Retrospective Studies, Risk Factors, Severity of Illness Index, Transplantation, Treatment Outcome.
Abstract
BACKGROUND
Pandemic H1N1 influenza has been associated with a worldwide outbreak of febrile respiratory illness. Although impaired cell mediated immunity, such as that caused by transplant immunosuppression, has been identified as a risk factor for severe infection with this virus, the course of this infection has not been adequately characterized in solid organ transplant (SOT) recipients in comparison with nontransplanted controls. We report our experience with severe pH1N1 infection in transplant recipients and compare this group with nonimmunosuppressed patients.
METHODS
Data were retrospectively collected on all patients admitted to our institution with proven pH1N1 infection. Clinical characteristics, treatments, and outcomes were compared between SOT recipients and nonimmunocompromised controls.
RESULTS
Seventeen SOT recipients and 49 controls were identified. The control group had higher baseline rates of asthma (P = 0.02) and smoking (P = 0.05) at baseline. No difference in clinical features of H1N1 infection was detected except for a greater prevalence of wheeze in the non-SOT group (P = 0.02). No statistical differences in outcomes could be detected between the groups. Several markers of severity, including use of high frequency oscillatory ventilation, extracorporeal membrane oxygenation, and death were slightly more frequent in the control group.
CONCLUSION
SOT recipients admitted to hospital with pH1N1 infection did not have significantly more severe outcomes of their infection compared with their nonimmunocompromised counterparts, despite their immune suppressed status.
DOI: 10.1097/TP.0b013e3182200e5c
PubMed: 21577178
Affiliations:
Links toward previous steps (curation, corpus...)
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Minnema</name><affiliation wicri:level="4"><nlm:affiliation>Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Patel, Mehul" sort="Patel, Mehul" uniqKey="Patel M" first="Mehul" last="Patel">Mehul Patel</name></author><author><name sortKey="Rotstein, Coleman" sort="Rotstein, Coleman" uniqKey="Rotstein C" first="Coleman" last="Rotstein">Coleman Rotstein</name></author><author><name sortKey="Mazzulli, Tony" sort="Mazzulli, Tony" uniqKey="Mazzulli T" first="Tony" last="Mazzulli">Tony Mazzulli</name></author><author><name sortKey="Hota, Susy" sort="Hota, Susy" uniqKey="Hota S" first="Susy" last="Hota">Susy Hota</name></author><author><name sortKey="Cole, Edward H" sort="Cole, Edward H" uniqKey="Cole E" first="Edward H" last="Cole">Edward H. Cole</name></author><author><name sortKey="Renner, Eberhard L" sort="Renner, Eberhard L" uniqKey="Renner E" first="Eberhard L" last="Renner">Eberhard L. Renner</name></author><author><name sortKey="Ross, Heather J" sort="Ross, Heather J" uniqKey="Ross H" first="Heather J" last="Ross">Heather J. Ross</name></author><author><name sortKey="Singer, Lianne G" sort="Singer, Lianne G" uniqKey="Singer L" first="Lianne G" last="Singer">Lianne G. 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Minnema</name><affiliation wicri:level="4"><nlm:affiliation>Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Patel, Mehul" sort="Patel, Mehul" uniqKey="Patel M" first="Mehul" last="Patel">Mehul Patel</name></author><author><name sortKey="Rotstein, Coleman" sort="Rotstein, Coleman" uniqKey="Rotstein C" first="Coleman" last="Rotstein">Coleman Rotstein</name></author><author><name sortKey="Mazzulli, Tony" sort="Mazzulli, Tony" uniqKey="Mazzulli T" first="Tony" last="Mazzulli">Tony Mazzulli</name></author><author><name sortKey="Hota, Susy" sort="Hota, Susy" uniqKey="Hota S" first="Susy" last="Hota">Susy Hota</name></author><author><name sortKey="Cole, Edward H" sort="Cole, Edward H" uniqKey="Cole E" first="Edward H" last="Cole">Edward H. 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Singer</name></author><author><name sortKey="Husain, Shahid" sort="Husain, Shahid" uniqKey="Husain S" first="Shahid" last="Husain">Shahid Husain</name></author></analytic><series><title level="j">Transplantation</title><idno type="eISSN">1534-6080</idno><imprint><date when="2011" type="published">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Canada</term><term>Cohort Studies</term><term>Extracorporeal Membrane Oxygenation</term><term>Female</term><term>High-Frequency Ventilation</term><term>Humans</term><term>Immunocompromised Host</term><term>Influenza A Virus, H1N1 Subtype</term><term>Influenza, Human (epidemiology)</term><term>Influenza, Human (physiopathology)</term><term>Influenza, Human (therapy)</term><term>Inpatients</term><term>Male</term><term>Middle Aged</term><term>Organ Transplantation</term><term>Pandemics</term><term>Prevalence</term><term>Retrospective Studies</term><term>Risk Factors</term><term>Severity of Illness Index</term><term>Transplantation</term><term>Treatment Outcome</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Canada</term><term>Facteurs de risque</term><term>Femelle</term><term>Grippe humaine ()</term><term>Grippe humaine (physiopathologie)</term><term>Grippe humaine (épidémiologie)</term><term>Humains</term><term>Indice de gravité médicale</term><term>Mâle</term><term>Oxygénation extracorporelle sur oxygénateur à membrane</term><term>Pandémies</term><term>Patients hospitalisés</term><term>Prévalence</term><term>Résultat thérapeutique</term><term>Sous-type H1N1 du virus de la grippe A</term><term>Sujet immunodéprimé</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Transplantation</term><term>Transplantation d'organe</term><term>Ventilation à haute fréquence</term><term>Études de cohortes</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Canada</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Cohort Studies</term><term>Extracorporeal Membrane Oxygenation</term><term>Female</term><term>High-Frequency Ventilation</term><term>Humans</term><term>Immunocompromised Host</term><term>Influenza A Virus, H1N1 Subtype</term><term>Inpatients</term><term>Male</term><term>Middle Aged</term><term>Organ Transplantation</term><term>Pandemics</term><term>Prevalence</term><term>Retrospective Studies</term><term>Risk Factors</term><term>Severity of Illness Index</term><term>Transplantation</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Canada</term><term>Facteurs de risque</term><term>Femelle</term><term>Grippe humaine</term><term>Humains</term><term>Indice de gravité médicale</term><term>Mâle</term><term>Oxygénation extracorporelle sur oxygénateur à membrane</term><term>Pandémies</term><term>Patients hospitalisés</term><term>Prévalence</term><term>Résultat thérapeutique</term><term>Sous-type H1N1 du virus de la grippe A</term><term>Sujet immunodéprimé</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Transplantation</term><term>Transplantation d'organe</term><term>Ventilation à haute fréquence</term><term>Études de cohortes</term><term>Études rétrospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Canada</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Pandemic H1N1 influenza has been associated with a worldwide outbreak of febrile respiratory illness. Although impaired cell mediated immunity, such as that caused by transplant immunosuppression, has been identified as a risk factor for severe infection with this virus, the course of this infection has not been adequately characterized in solid organ transplant (SOT) recipients in comparison with nontransplanted controls. We report our experience with severe pH1N1 infection in transplant recipients and compare this group with nonimmunosuppressed patients.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Data were retrospectively collected on all patients admitted to our institution with proven pH1N1 infection. Clinical characteristics, treatments, and outcomes were compared between SOT recipients and nonimmunocompromised controls.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Seventeen SOT recipients and 49 controls were identified. The control group had higher baseline rates of asthma (P = 0.02) and smoking (P = 0.05) at baseline. No difference in clinical features of H1N1 infection was detected except for a greater prevalence of wheeze in the non-SOT group (P = 0.02). No statistical differences in outcomes could be detected between the groups. Several markers of severity, including use of high frequency oscillatory ventilation, extracorporeal membrane oxygenation, and death were slightly more frequent in the control group.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>SOT recipients admitted to hospital with pH1N1 infection did not have significantly more severe outcomes of their infection compared with their nonimmunocompromised counterparts, despite their immune suppressed status.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">21577178</PMID><DateCompleted><Year>2011</Year><Month>09</Month><Day>29</Day></DateCompleted><DateRevised><Year>2011</Year><Month>07</Month><Day>12</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1534-6080</ISSN><JournalIssue CitedMedium="Internet"><Volume>92</Volume><Issue>2</Issue><PubDate><Year>2011</Year><Month>Jul</Month><Day>27</Day></PubDate></JournalIssue><Title>Transplantation</Title><ISOAbbreviation>Transplantation</ISOAbbreviation></Journal><ArticleTitle>Comparison of hospitalized solid organ transplant recipients and nonimmunocompromised patients with pandemic H1N1 infection: a retrospective cohort study.</ArticleTitle><Pagination><MedlinePgn>230-4</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1097/TP.0b013e3182200e5c</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Pandemic H1N1 influenza has been associated with a worldwide outbreak of febrile respiratory illness. Although impaired cell mediated immunity, such as that caused by transplant immunosuppression, has been identified as a risk factor for severe infection with this virus, the course of this infection has not been adequately characterized in solid organ transplant (SOT) recipients in comparison with nontransplanted controls. We report our experience with severe pH1N1 infection in transplant recipients and compare this group with nonimmunosuppressed patients.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Data were retrospectively collected on all patients admitted to our institution with proven pH1N1 infection. Clinical characteristics, treatments, and outcomes were compared between SOT recipients and nonimmunocompromised controls.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Seventeen SOT recipients and 49 controls were identified. The control group had higher baseline rates of asthma (P = 0.02) and smoking (P = 0.05) at baseline. No difference in clinical features of H1N1 infection was detected except for a greater prevalence of wheeze in the non-SOT group (P = 0.02). No statistical differences in outcomes could be detected between the groups. Several markers of severity, including use of high frequency oscillatory ventilation, extracorporeal membrane oxygenation, and death were slightly more frequent in the control group.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">SOT recipients admitted to hospital with pH1N1 infection did not have significantly more severe outcomes of their infection compared with their nonimmunocompromised counterparts, despite their immune suppressed status.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Minnema</LastName><ForeName>Brian J</ForeName><Initials>BJ</Initials><AffiliationInfo><Affiliation>Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Patel</LastName><ForeName>Mehul</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Rotstein</LastName><ForeName>Coleman</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Mazzulli</LastName><ForeName>Tony</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Hota</LastName><ForeName>Susy</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Cole</LastName><ForeName>Edward H</ForeName><Initials>EH</Initials></Author><Author ValidYN="Y"><LastName>Renner</LastName><ForeName>Eberhard L</ForeName><Initials>EL</Initials></Author><Author ValidYN="Y"><LastName>Ross</LastName><ForeName>Heather J</ForeName><Initials>HJ</Initials></Author><Author ValidYN="Y"><LastName>Singer</LastName><ForeName>Lianne G</ForeName><Initials>LG</Initials></Author><Author ValidYN="Y"><LastName>Husain</LastName><ForeName>Shahid</ForeName><Initials>S</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Transplantation</MedlineTA><NlmUniqueID>0132144</NlmUniqueID><ISSNLinking>0041-1337</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002170" MajorTopicYN="N" Type="Geographic">Canada</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015331" MajorTopicYN="N">Cohort Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015199" MajorTopicYN="N">Extracorporeal Membrane Oxygenation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006612" MajorTopicYN="N">High-Frequency Ventilation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016867" MajorTopicYN="Y">Immunocompromised Host</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D053118" MajorTopicYN="Y">Influenza A Virus, H1N1 Subtype</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007297" MajorTopicYN="Y">Inpatients</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016377" MajorTopicYN="Y">Organ Transplantation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="Y">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015995" MajorTopicYN="N">Prevalence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014180" MajorTopicYN="Y">Transplantation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2011</Year><Month>5</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2011</Year><Month>5</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2011</Year><Month>10</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">21577178</ArticleId><ArticleId IdType="doi">10.1097/TP.0b013e3182200e5c</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Canada</li></country><region><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><noCountry><name sortKey="Cole, Edward H" sort="Cole, Edward H" uniqKey="Cole E" first="Edward H" last="Cole">Edward H. Cole</name><name sortKey="Hota, Susy" sort="Hota, Susy" uniqKey="Hota S" first="Susy" last="Hota">Susy Hota</name><name sortKey="Husain, Shahid" sort="Husain, Shahid" uniqKey="Husain S" first="Shahid" last="Husain">Shahid Husain</name><name sortKey="Mazzulli, Tony" sort="Mazzulli, Tony" uniqKey="Mazzulli T" first="Tony" last="Mazzulli">Tony Mazzulli</name><name sortKey="Patel, Mehul" sort="Patel, Mehul" uniqKey="Patel M" first="Mehul" last="Patel">Mehul Patel</name><name sortKey="Renner, Eberhard L" sort="Renner, Eberhard L" uniqKey="Renner E" first="Eberhard L" last="Renner">Eberhard L. Renner</name><name sortKey="Ross, Heather J" sort="Ross, Heather J" uniqKey="Ross H" first="Heather J" last="Ross">Heather J. Ross</name><name sortKey="Rotstein, Coleman" sort="Rotstein, Coleman" uniqKey="Rotstein C" first="Coleman" last="Rotstein">Coleman Rotstein</name><name sortKey="Singer, Lianne G" sort="Singer, Lianne G" uniqKey="Singer L" first="Lianne G" last="Singer">Lianne G. Singer</name></noCountry><country name="Canada"><region name="Ontario"><name sortKey="Minnema, Brian J" sort="Minnema, Brian J" uniqKey="Minnema B" first="Brian J" last="Minnema">Brian J. Minnema</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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