The impact of the 2009 H1N1 influenza pandemic on pediatric patients with sickle cell disease
Identifieur interne : 000E51 ( Istex/Corpus ); précédent : 000E50; suivant : 000E52The impact of the 2009 H1N1 influenza pandemic on pediatric patients with sickle cell disease
Auteurs : Alex George ; Jennifer Benton ; Jesse Pratt ; Mi-Ok Kim ; Karen A. Kalinyak ; Theodosia A. Kalfa ; Clinton H. JoinerSource :
- Pediatric Blood & Cancer [ 1545-5009 ] ; 2011-10.
English descriptors
- Teeft :
- Acute chest syndrome, Acute illness, Admission rate, Airway, Alex george, Apical pneumothorax, Blood culture, Blood diseases institute, Brief hospital, Chronic therapy, Chronic transfusion, Chronic transfusion therapy, Cincinnati hospital, Clinical course, Common cause, Common diagnosis, Control group, Disease severity, Emergency department, Exchange transfusion, Febrile illness, Future pandemics, Guideline, Hematology clinic, Hemoglobin concentrations, Higher admission rate, Higher rate, Hydroxyurea, Hydroxyurea therapy, Initial evaluation, Laboratory data, Mechanical ventilation, Negative testing, Occult pneumonia, Oseltamivir, Oseltamivir therapy, Outpatient basis, Pain crises, Pandemic, Past complications, Past episodes, Past history, Patient characteristics, Patient population, Pediatr, Pediatr blood cancer, Pediatric patients, Pulmonary complications, Reactive, Reactive airway disease, Respiratory distress, Seasonal epidemics, Sickle, Sickle cell center, Sickle cell disease, Sickle cell disease care consortium guidelines, Sickle cell patients, Simple transfusions, Small sample size, Splenic sequestration, Statistical analysis, Transfusion, Uncomplicated courses.
Abstract
Background: Respiratory infections are associated with clinically significant illness in patients with sickle cell disease (SCD). The 2009 H1N1 pandemic was perceived as a significant threat to this population. Methods: We undertook a chart review of all patients with SCD followed at our institution to identify those with confirmed H1N1 infection. Further chart and laboratory data was collected on affected patients to analyze clinical courses and the factors that correlated with disease severity. Results: Approximately half of the patients with confirmed H1N1 infection were managed successfully on an outpatient basis with oseltamivir therapy. Among the patients admitted, the most common diagnosis was acute chest syndrome (ACS). Most admitted patients had uncomplicated clinical courses, with a median length of admission of 3 days and no mortality or requirement for mechanical ventilation. A past history of ACS or reactive airway disease correlated with a higher rate of admission and of ACS incidence during the acute illness. Chronic transfusion therapy or hydroxyurea therapy with high hemoglobin F levels had a strong inverse correlation with incidence of ACS. Conclusions: Our results indicate that that in general the impact of the H1N1 influenza pandemic on patients with SCD was mild but that past clinical history correlated with the severity of illness. Additionally, effective hydroxyurea therapy and chronic transfusion therapy appeared to be protective against the incidence of ACS. Our results suggest guidelines for the management of patients with SCD during future influenza pandemics as well as during seasonal influenza epidemics. Pediatr Blood Cancer 2011; 57: 648–653. © 2011 Wiley‐Liss, Inc.
Url:
DOI: 10.1002/pbc.23030
Links to Exploration step
ISTEX:45EE8CBB34E3A0DD3CF590F7A6C70A2F497A1962Le document en format XML
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Kalinyak</name><affiliation><mods:affiliation>Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</mods:affiliation></affiliation></author><author><name sortKey="Kalfa, Theodosia A" sort="Kalfa, Theodosia A" uniqKey="Kalfa T" first="Theodosia A." last="Kalfa">Theodosia A. Kalfa</name><affiliation><mods:affiliation>Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</mods:affiliation></affiliation></author><author><name sortKey="Joiner, Clinton H" sort="Joiner, Clinton H" uniqKey="Joiner C" first="Clinton H." last="Joiner">Clinton H. 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Kalinyak</name><affiliation><mods:affiliation>Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</mods:affiliation></affiliation></author><author><name sortKey="Kalfa, Theodosia A" sort="Kalfa, Theodosia A" uniqKey="Kalfa T" first="Theodosia A." last="Kalfa">Theodosia A. Kalfa</name><affiliation><mods:affiliation>Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</mods:affiliation></affiliation></author><author><name sortKey="Joiner, Clinton H" sort="Joiner, Clinton H" uniqKey="Joiner C" first="Clinton H." last="Joiner">Clinton H. Joiner</name><affiliation><mods:affiliation>Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Pediatric Blood & Cancer</title><title level="j" type="alt">PEDIATRIC BLOOD AND CANCER</title><idno type="ISSN">1545-5009</idno><idno type="eISSN">1545-5017</idno><imprint><biblScope unit="vol">57</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="648">648</biblScope><biblScope unit="page" to="653">653</biblScope><biblScope unit="page-count">6</biblScope><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2011-10">2011-10</date></imprint><idno type="ISSN">1545-5009</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1545-5009</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Acute chest syndrome</term><term>Acute illness</term><term>Admission rate</term><term>Airway</term><term>Alex george</term><term>Apical pneumothorax</term><term>Blood culture</term><term>Blood diseases institute</term><term>Brief hospital</term><term>Chronic therapy</term><term>Chronic transfusion</term><term>Chronic transfusion therapy</term><term>Cincinnati hospital</term><term>Clinical course</term><term>Common cause</term><term>Common diagnosis</term><term>Control group</term><term>Disease severity</term><term>Emergency department</term><term>Exchange transfusion</term><term>Febrile illness</term><term>Future pandemics</term><term>Guideline</term><term>Hematology clinic</term><term>Hemoglobin concentrations</term><term>Higher admission rate</term><term>Higher rate</term><term>Hydroxyurea</term><term>Hydroxyurea therapy</term><term>Initial evaluation</term><term>Laboratory data</term><term>Mechanical ventilation</term><term>Negative testing</term><term>Occult pneumonia</term><term>Oseltamivir</term><term>Oseltamivir therapy</term><term>Outpatient basis</term><term>Pain crises</term><term>Pandemic</term><term>Past complications</term><term>Past episodes</term><term>Past history</term><term>Patient characteristics</term><term>Patient population</term><term>Pediatr</term><term>Pediatr blood cancer</term><term>Pediatric patients</term><term>Pulmonary complications</term><term>Reactive</term><term>Reactive airway disease</term><term>Respiratory distress</term><term>Seasonal epidemics</term><term>Sickle</term><term>Sickle cell center</term><term>Sickle cell disease</term><term>Sickle cell disease care consortium guidelines</term><term>Sickle cell patients</term><term>Simple transfusions</term><term>Small sample size</term><term>Splenic sequestration</term><term>Statistical analysis</term><term>Transfusion</term><term>Uncomplicated courses</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: Respiratory infections are associated with clinically significant illness in patients with sickle cell disease (SCD). The 2009 H1N1 pandemic was perceived as a significant threat to this population. Methods: We undertook a chart review of all patients with SCD followed at our institution to identify those with confirmed H1N1 infection. Further chart and laboratory data was collected on affected patients to analyze clinical courses and the factors that correlated with disease severity. Results: Approximately half of the patients with confirmed H1N1 infection were managed successfully on an outpatient basis with oseltamivir therapy. Among the patients admitted, the most common diagnosis was acute chest syndrome (ACS). Most admitted patients had uncomplicated clinical courses, with a median length of admission of 3 days and no mortality or requirement for mechanical ventilation. A past history of ACS or reactive airway disease correlated with a higher rate of admission and of ACS incidence during the acute illness. Chronic transfusion therapy or hydroxyurea therapy with high hemoglobin F levels had a strong inverse correlation with incidence of ACS. Conclusions: Our results indicate that that in general the impact of the H1N1 influenza pandemic on patients with SCD was mild but that past clinical history correlated with the severity of illness. Additionally, effective hydroxyurea therapy and chronic transfusion therapy appeared to be protective against the incidence of ACS. Our results suggest guidelines for the management of patients with SCD during future influenza pandemics as well as during seasonal influenza epidemics. Pediatr Blood Cancer 2011; 57: 648–653. © 2011 Wiley‐Liss, Inc.</div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>transfusion</json:string><json:string>sickle</json:string><json:string>hydroxyurea</json:string><json:string>sickle cell disease</json:string><json:string>guideline</json:string><json:string>chronic transfusion</json:string><json:string>chronic transfusion therapy</json:string><json:string>pediatr</json:string><json:string>airway</json:string><json:string>oseltamivir</json:string><json:string>reactive</json:string><json:string>reactive airway disease</json:string><json:string>hydroxyurea therapy</json:string><json:string>pediatr blood cancer</json:string><json:string>acute chest syndrome</json:string><json:string>cincinnati hospital</json:string><json:string>seasonal epidemics</json:string><json:string>admission rate</json:string><json:string>pandemic</json:string><json:string>past history</json:string><json:string>outpatient basis</json:string><json:string>patient population</json:string><json:string>pediatric patients</json:string><json:string>chronic therapy</json:string><json:string>mechanical ventilation</json:string><json:string>higher rate</json:string><json:string>initial evaluation</json:string><json:string>pain crises</json:string><json:string>splenic sequestration</json:string><json:string>simple transfusions</json:string><json:string>uncomplicated courses</json:string><json:string>acute illness</json:string><json:string>disease severity</json:string><json:string>blood diseases institute</json:string><json:string>alex george</json:string><json:string>brief hospital</json:string><json:string>common diagnosis</json:string><json:string>small sample size</json:string><json:string>statistical analysis</json:string><json:string>sickle cell center</json:string><json:string>hematology clinic</json:string><json:string>emergency department</json:string><json:string>febrile illness</json:string><json:string>sickle cell disease care consortium guidelines</json:string><json:string>clinical course</json:string><json:string>future pandemics</json:string><json:string>laboratory data</json:string><json:string>occult pneumonia</json:string><json:string>blood culture</json:string><json:string>common cause</json:string><json:string>respiratory distress</json:string><json:string>apical pneumothorax</json:string><json:string>hemoglobin concentrations</json:string><json:string>exchange transfusion</json:string><json:string>sickle cell patients</json:string><json:string>control group</json:string><json:string>negative testing</json:string><json:string>patient characteristics</json:string><json:string>higher admission rate</json:string><json:string>past episodes</json:string><json:string>oseltamivir therapy</json:string><json:string>past complications</json:string><json:string>pulmonary complications</json:string></teeft></keywords><author><json:item><name>Alex George MD, PhD</name><affiliations><json:string>Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</json:string><json:string>E-mail: alex.george@cchmc.org</json:string><json:string>Correspondence address: MLC 7015, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229.===</json:string></affiliations></json:item><json:item><name>Jennifer Benton</name><affiliations><json:string>Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</json:string></affiliations></json:item><json:item><name>Jesse Pratt MS</name><affiliations><json:string>Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</json:string></affiliations></json:item><json:item><name>Mi‐Ok Kim PhD</name><affiliations><json:string>Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</json:string></affiliations></json:item><json:item><name>Karen A. Kalinyak MD</name><affiliations><json:string>Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</json:string></affiliations></json:item><json:item><name>Theodosia A. Kalfa MD, PhD</name><affiliations><json:string>Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</json:string></affiliations></json:item><json:item><name>Clinton H. Joiner MD, PhD</name><affiliations><json:string>Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>hemoglobinopathies</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>infections</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>sickle cell disease</value></json:item></subject><articleId><json:string>PBC23030</json:string></articleId><arkIstex>ark:/67375/WNG-0VJBS0ND-V</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Background: Respiratory infections are associated with clinically significant illness in patients with sickle cell disease (SCD). The 2009 H1N1 pandemic was perceived as a significant threat to this population. Methods: We undertook a chart review of all patients with SCD followed at our institution to identify those with confirmed H1N1 infection. Further chart and laboratory data was collected on affected patients to analyze clinical courses and the factors that correlated with disease severity. Results: Approximately half of the patients with confirmed H1N1 infection were managed successfully on an outpatient basis with oseltamivir therapy. Among the patients admitted, the most common diagnosis was acute chest syndrome (ACS). Most admitted patients had uncomplicated clinical courses, with a median length of admission of 3 days and no mortality or requirement for mechanical ventilation. A past history of ACS or reactive airway disease correlated with a higher rate of admission and of ACS incidence during the acute illness. Chronic transfusion therapy or hydroxyurea therapy with high hemoglobin F levels had a strong inverse correlation with incidence of ACS. Conclusions: Our results indicate that that in general the impact of the H1N1 influenza pandemic on patients with SCD was mild but that past clinical history correlated with the severity of illness. Additionally, effective hydroxyurea therapy and chronic transfusion therapy appeared to be protective against the incidence of ACS. Our results suggest guidelines for the management of patients with SCD during future influenza pandemics as well as during seasonal influenza epidemics. 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Disease</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><licence>Copyright © 2011 Wiley‐Liss, Inc.</licence></availability><date type="published" when="2011-10"></date></publicationStmt><notesStmt><note type="content-type" subtype="article" source="article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="article"><analytic><title level="a" type="main">The impact of the 2009 H1N1 influenza pandemic on pediatric patients with sickle cell disease</title><title level="a" type="short" xml:lang="en">H1N1 Influenza and Sickle Cell Disease</title><author xml:id="author-0000" role="corresp"><persName><forename type="first">Alex</forename><surname>George</surname><roleName type="degree">MD, PhD</roleName></persName><email>alex.george@cchmc.org</email><affiliation><orgName type="institution">Cancer and Blood Diseases Institute</orgName><orgName type="institution">Cincinnati Children's Hospital Medical Center</orgName><address><addrLine>Cincinnati</addrLine><addrLine>Ohio</addrLine><country key="US" xml:lang="en">UNITED STATES</country></address></affiliation></author><author xml:id="author-0001"><persName><forename type="first">Jennifer</forename><surname>Benton</surname></persName><affiliation><orgName type="institution">Cancer and Blood Diseases Institute</orgName><orgName type="institution">Cincinnati Children's Hospital Medical Center</orgName><address><addrLine>Cincinnati</addrLine><addrLine>Ohio</addrLine><country key="US" xml:lang="en">UNITED STATES</country></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">Jesse</forename><surname>Pratt</surname><roleName type="degree">MS</roleName></persName><affiliation><orgName type="department">Division of Biostatistics and Epidemiology</orgName><orgName type="institution">Cincinnati Children's Hospital Medical Center</orgName><address><addrLine>Cincinnati</addrLine><addrLine>Ohio</addrLine><country key="US" xml:lang="en">UNITED STATES</country></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">Mi‐Ok</forename><surname>Kim</surname><roleName type="degree">PhD</roleName></persName><affiliation><orgName type="department">Division of Biostatistics and Epidemiology</orgName><orgName type="institution">Cincinnati Children's Hospital Medical Center</orgName><address><addrLine>Cincinnati</addrLine><addrLine>Ohio</addrLine><country key="US" xml:lang="en">UNITED STATES</country></address></affiliation></author><author xml:id="author-0004"><persName><forename type="first">Karen A.</forename><surname>Kalinyak</surname><roleName type="degree">MD</roleName></persName><affiliation><orgName type="institution">Cancer and Blood Diseases Institute</orgName><orgName type="institution">Cincinnati Children's Hospital Medical Center</orgName><address><addrLine>Cincinnati</addrLine><addrLine>Ohio</addrLine><country key="US" xml:lang="en">UNITED STATES</country></address></affiliation></author><author xml:id="author-0005"><persName><forename type="first">Theodosia A.</forename><surname>Kalfa</surname><roleName type="degree">MD, PhD</roleName></persName><affiliation><orgName type="institution">Cancer and Blood Diseases Institute</orgName><orgName type="institution">Cincinnati Children's Hospital Medical Center</orgName><address><addrLine>Cincinnati</addrLine><addrLine>Ohio</addrLine><country key="US" xml:lang="en">UNITED STATES</country></address></affiliation></author><author xml:id="author-0006"><persName><forename type="first">Clinton H.</forename><surname>Joiner</surname><roleName type="degree">MD, PhD</roleName></persName><affiliation><orgName type="institution">Cancer and Blood Diseases Institute</orgName><orgName type="institution">Cincinnati Children's Hospital Medical Center</orgName><address><addrLine>Cincinnati</addrLine><addrLine>Ohio</addrLine><country key="US" xml:lang="en">UNITED STATES</country></address></affiliation></author><idno type="istex">45EE8CBB34E3A0DD3CF590F7A6C70A2F497A1962</idno><idno type="ark">ark:/67375/WNG-0VJBS0ND-V</idno><idno type="DOI">10.1002/pbc.23030</idno><idno type="unit">PBC23030</idno><idno type="toTypesetVersion">file:PBC.PBC23030.pdf</idno></analytic><monogr><title level="j" type="main">Pediatric Blood & Cancer</title><title level="j" type="alt">PEDIATRIC BLOOD AND CANCER</title><idno type="pISSN">1545-5009</idno><idno type="eISSN">1545-5017</idno><idno type="book-DOI">10.1002/(ISSN)1545-5017</idno><idno type="book-part-DOI">10.1002/pbc.v57.4</idno><idno 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<ref target="http://www.tei-c.org/">We use TEI</ref></desc></application></appInfo></encodingDesc><profileDesc><abstract xml:lang="en" style="main"><head>Abstract</head><head>Background</head><p>Respiratory infections are associated with clinically significant illness in patients with sickle cell disease (SCD). The 2009 H1N1 pandemic was perceived as a significant threat to this population.</p><head>Methods</head><p>We undertook a chart review of all patients with SCD followed at our institution to identify those with confirmed H1N1 infection. Further chart and laboratory data was collected on affected patients to analyze clinical courses and the factors that correlated with disease severity.</p><head>Results</head><p>Approximately half of the patients with confirmed H1N1 infection were managed successfully on an outpatient basis with oseltamivir therapy. Among the patients admitted, the most common diagnosis was acute chest syndrome (ACS). Most admitted patients had uncomplicated clinical courses, with a median length of admission of 3 days and no mortality or requirement for mechanical ventilation. A past history of ACS or reactive airway disease correlated with a higher rate of admission and of ACS incidence during the acute illness. Chronic transfusion therapy or hydroxyurea therapy with high hemoglobin F levels had a strong inverse correlation with incidence of ACS.</p><head>Conclusions</head><p>Our results indicate that that in general the impact of the H1N1 influenza pandemic on patients with SCD was mild but that past clinical history correlated with the severity of illness. Additionally, effective hydroxyurea therapy and chronic transfusion therapy appeared to be protective against the incidence of ACS. Our results suggest guidelines for the management of patients with SCD during future influenza pandemics as well as during seasonal influenza epidemics. Pediatr Blood Cancer 2011; 57: 648–653. © 2011 Wiley‐Liss, Inc.</p></abstract><textClass><keywords xml:lang="en"><term xml:id="kwd1">hemoglobinopathies</term><term xml:id="kwd2">infections</term><term xml:id="kwd3">sickle cell disease</term></keywords><keywords rend="articleCategory"><term>Research Article</term></keywords><keywords rend="tocHeading1"><term>Research Articles</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc><revisionDesc><change when="2019-12-20" who="#istex" xml:id="pub2tei">formatting</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-0VJBS0ND-V/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1545-5017</doi><issn type="print">1545-5009</issn><issn type="electronic">1545-5017</issn><idGroup><id type="product" value="PBC"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="PEDIATRIC BLOOD AND CANCER">Pediatric Blood & Cancer</title><title type="short">Pediatr. Blood Cancer</title></titleGroup><selfCitationGroup><citation type="ancestor" xml:id="cit1"><journalTitle>Medical and Pediatric Oncology</journalTitle><accessionId ref="info:x-wiley/issn/00960802">0096-0802</accessionId><accessionId ref="info:x-wiley/issn/1096911X">1096-911X</accessionId><pubYear year="2003">2003</pubYear><vol>41</vol><issue>6</issue></citation></selfCitationGroup></publicationMeta><publicationMeta level="part" position="40"><doi origin="wiley" registered="yes">10.1002/pbc.v57.4</doi><numberingGroup><numbering type="journalVolume" number="57">57</numbering><numbering type="journalIssue">4</numbering></numberingGroup><coverDate startDate="2011-10">October 2011</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="220" status="forIssue"><doi origin="wiley" registered="yes">10.1002/pbc.23030</doi><idGroup><id type="unit" value="PBC23030"></id></idGroup><countGroup><count type="pageTotal" number="6"></count></countGroup><titleGroup><title type="articleCategory">Research Article</title><title type="tocHeading1">Research Articles</title></titleGroup><copyright ownership="publisher">Copyright © 2011 Wiley‐Liss, Inc.</copyright><eventGroup><event type="manuscriptReceived" date="2010-09-13"></event><event type="manuscriptAccepted" date="2010-12-17"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.5.2 mode:FullText" date="2011-08-08"></event><event type="publishedOnlineEarlyUnpaginated" date="2011-02-25"></event><event type="publishedOnlineFinalForm" date="2011-08-08"></event><event type="firstOnline" date="2011-02-25"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:4.0.1" date="2014-03-20"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-11-03"></event></eventGroup><numberingGroup><numbering type="pageFirst">648</numbering><numbering type="pageLast">653</numbering></numberingGroup><correspondenceTo>MLC 7015, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229.===</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:PBC.PBC23030.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="0"></count><count type="tableTotal" number="5"></count><count type="referenceTotal" number="12"></count><count type="wordTotal" number="5203"></count></countGroup><titleGroup><title type="main" xml:lang="en">The impact of the 2009 H1N1 influenza pandemic on pediatric patients with sickle cell disease<link href="#fn1"></link><link href="#fn2"></link></title><title type="short" xml:lang="en">H1N1 Influenza and Sickle Cell Disease</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Alex</givenNames><familyName>George</familyName><degrees>MD, PhD</degrees></personName><contactDetails><email>alex.george@cchmc.org</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Jennifer</givenNames><familyName>Benton</familyName></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Jesse</givenNames><familyName>Pratt</familyName><degrees>MS</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Mi‐Ok</givenNames><familyName>Kim</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Karen A.</givenNames><familyName>Kalinyak</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Theodosia A.</givenNames><familyName>Kalfa</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Clinton H.</givenNames><familyName>Joiner</familyName><degrees>MD, PhD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="US" type="organization"><unparsedAffiliation>Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="US" type="organization"><unparsedAffiliation>Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">hemoglobinopathies</keyword><keyword xml:id="kwd2">infections</keyword><keyword xml:id="kwd3">sickle cell disease</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><section xml:id="abs1-1"><title type="main">Background</title><p>Respiratory infections are associated with clinically significant illness in patients with sickle cell disease (SCD). The 2009 H1N1 pandemic was perceived as a significant threat to this population.</p></section><section xml:id="abs1-2"><title type="main">Methods</title><p>We undertook a chart review of all patients with SCD followed at our institution to identify those with confirmed H1N1 infection. Further chart and laboratory data was collected on affected patients to analyze clinical courses and the factors that correlated with disease severity.</p></section><section xml:id="abs1-3"><title type="main">Results</title><p>Approximately half of the patients with confirmed H1N1 infection were managed successfully on an outpatient basis with oseltamivir therapy. Among the patients admitted, the most common diagnosis was acute chest syndrome (ACS). Most admitted patients had uncomplicated clinical courses, with a median length of admission of 3 days and no mortality or requirement for mechanical ventilation. A past history of ACS or reactive airway disease correlated with a higher rate of admission and of ACS incidence during the acute illness. Chronic transfusion therapy or hydroxyurea therapy with high hemoglobin F levels had a strong inverse correlation with incidence of ACS.</p></section><section xml:id="abs1-4"><title type="main">Conclusions</title><p>Our results indicate that that in general the impact of the H1N1 influenza pandemic on patients with SCD was mild but that past clinical history correlated with the severity of illness. Additionally, effective hydroxyurea therapy and chronic transfusion therapy appeared to be protective against the incidence of ACS. Our results suggest guidelines for the management of patients with SCD during future influenza pandemics as well as during seasonal influenza epidemics. Pediatr Blood Cancer 2011; 57: 648–653. © 2011 Wiley‐Liss, Inc.</p></section></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p>Conflict of interest: Nothing to declare.</p></note><note xml:id="fn2"><p>Alex George and Jennifer Benton contributed equally to this work.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>The impact of the 2009 H1N1 influenza pandemic on pediatric patients with sickle cell disease</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>H1N1 Influenza and Sickle Cell Disease</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>The impact of the 2009 H1N1 influenza pandemic on pediatric patients with sickle cell disease</title></titleInfo><name type="personal"><namePart type="given">Alex</namePart><namePart type="family">George</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</affiliation><affiliation>E-mail: alex.george@cchmc.org</affiliation><affiliation>Correspondence address: MLC 7015, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229.===</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jennifer</namePart><namePart type="family">Benton</namePart><affiliation>Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jesse</namePart><namePart type="family">Pratt</namePart><namePart type="termsOfAddress">MS</namePart><affiliation>Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mi‐Ok</namePart><namePart type="family">Kim</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Karen A.</namePart><namePart type="family">Kalinyak</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Theodosia A.</namePart><namePart type="family">Kalfa</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Clinton H.</namePart><namePart type="family">Joiner</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2011-10</dateIssued><dateCaptured encoding="w3cdtf">2010-09-13</dateCaptured><dateValid encoding="w3cdtf">2010-12-17</dateValid><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><extent unit="figures">0</extent><extent unit="tables">5</extent><extent unit="references">12</extent><extent unit="words">5203</extent></physicalDescription><abstract lang="en">Background: Respiratory infections are associated with clinically significant illness in patients with sickle cell disease (SCD). The 2009 H1N1 pandemic was perceived as a significant threat to this population. Methods: We undertook a chart review of all patients with SCD followed at our institution to identify those with confirmed H1N1 infection. Further chart and laboratory data was collected on affected patients to analyze clinical courses and the factors that correlated with disease severity. Results: Approximately half of the patients with confirmed H1N1 infection were managed successfully on an outpatient basis with oseltamivir therapy. Among the patients admitted, the most common diagnosis was acute chest syndrome (ACS). Most admitted patients had uncomplicated clinical courses, with a median length of admission of 3 days and no mortality or requirement for mechanical ventilation. A past history of ACS or reactive airway disease correlated with a higher rate of admission and of ACS incidence during the acute illness. Chronic transfusion therapy or hydroxyurea therapy with high hemoglobin F levels had a strong inverse correlation with incidence of ACS. Conclusions: Our results indicate that that in general the impact of the H1N1 influenza pandemic on patients with SCD was mild but that past clinical history correlated with the severity of illness. Additionally, effective hydroxyurea therapy and chronic transfusion therapy appeared to be protective against the incidence of ACS. Our results suggest guidelines for the management of patients with SCD during future influenza pandemics as well as during seasonal influenza epidemics. Pediatr Blood Cancer 2011; 57: 648–653. © 2011 Wiley‐Liss, Inc.</abstract><note type="content">*Conflict of interest: Nothing to declare.</note><note type="content">*Alex George and Jennifer Benton contributed equally to this work.</note><subject lang="en"><genre>keywords</genre><topic>hemoglobinopathies</topic><topic>infections</topic><topic>sickle cell disease</topic></subject><relatedItem type="host"><titleInfo><title>Pediatric Blood & Cancer</title></titleInfo><titleInfo type="abbreviated"><title>Pediatr. Blood Cancer</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><subject><genre>article-category</genre><topic>Research Article</topic><topic>Research Articles</topic></subject><identifier type="ISSN">1545-5009</identifier><identifier type="eISSN">1545-5017</identifier><identifier type="DOI">10.1002/(ISSN)1545-5017</identifier><identifier type="PublisherID">PBC</identifier><part><date>2011</date><detail type="volume"><caption>vol.</caption><number>57</number></detail><detail type="issue"><caption>no.</caption><number>4</number></detail><extent unit="pages"><start>648</start><end>653</end><total>6</total></extent></part></relatedItem><relatedItem type="preceding"><titleInfo><title>Medical and Pediatric Oncology</title></titleInfo><identifier type="ISSN">0096-0802</identifier><identifier type="ISSN">1096-911X</identifier><part><date point="end">2003</date><detail type="volume"><caption>last vol.</caption><number>41</number></detail><detail type="issue"><caption>last no.</caption><number>6</number></detail></part></relatedItem><relatedItem type="references" displayLabel="cit2"><titleInfo><title>Definitions of the phenotypic manifestations of sickle cell disease</title></titleInfo><name type="personal"><namePart type="given">SK</namePart><namePart type="family">Ballas</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S</namePart><namePart type="family">Lieff</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">LJ</namePart><namePart type="family">Benjamin</namePart><role><roleTerm type="text">author</roleTerm></role></name><genre>journal-article</genre><note type="citation/reference">Ballas SK, Lieff S, Benjamin LJ, et al. 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