Hospitalization Fatality Risk of Influenza A(H1N1)pdm09: A Systematic Review and Meta-Analysis
Identifieur interne : 000011 ( Pmc/Curation ); précédent : 000010; suivant : 000012Hospitalization Fatality Risk of Influenza A(H1N1)pdm09: A Systematic Review and Meta-Analysis
Auteurs : Jessica Y. Wong ; Heath Kelly ; Chung-Mei M. Cheung ; Eunice Y. Shiu ; Peng Wu ; Michael Y. Ni ; Dennis K. M. Ip ; Benjamin J. CowlingSource :
- American Journal of Epidemiology [ 0002-9262 ] ; 2015.
Abstract
During the 2009 influenza pandemic, uncertainty surrounding the severity of human infections with the influenza A(H1N1)pdm09 virus hindered the calibration of the early public health response. The case fatality risk was widely used to assess severity, but another underexplored and potentially more immediate measure is the hospitalization fatality risk (HFR), defined as the probability of death among H1N1pdm09 cases who required hospitalization for medical reasons. In this review, we searched for relevant studies published in MEDLINE (PubMed) and EMBASE between April 1, 2009, and January 9, 2014. Crude estimates of the HFR ranged from 0% to 52%, with higher estimates from tertiary-care referral hospitals in countries with a lower gross domestic product, but in wealthy countries the estimate was 1%–3% in all settings. Point estimates increased substantially with age and with lower gross domestic product. Early in the next pandemic, estimation of a standardized HFR may provide a picture of the severity of infection, particularly if it is presented in comparison with a similarly standardized HFR for seasonal influenza in the same setting.
Url:
DOI: 10.1093/aje/kwv054
PubMed: 26188191
PubMed Central: 4528954
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<front><div type="abstract" xml:lang="en"><p>During the 2009 influenza pandemic, uncertainty surrounding the severity of human infections with the influenza A(H1N1)pdm09 virus hindered the calibration of the early public health response. The case fatality risk was widely used to assess severity, but another underexplored and potentially more immediate measure is the hospitalization fatality risk (HFR), defined as the probability of death among H1N1pdm09 cases who required hospitalization for medical reasons. In this review, we searched for relevant studies published in MEDLINE (PubMed) and EMBASE between April 1, 2009, and January 9, 2014. Crude estimates of the HFR ranged from 0% to 52%, with higher estimates from tertiary-care referral hospitals in countries with a lower gross domestic product, but in wealthy countries the estimate was 1%–3% in all settings. Point estimates increased substantially with age and with lower gross domestic product. Early in the next pandemic, estimation of a standardized HFR may provide a picture of the severity of infection, particularly if it is presented in comparison with a similarly standardized HFR for seasonal influenza in the same setting.</p>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">Am J Epidemiol</journal-id>
<journal-id journal-id-type="iso-abbrev">Am. J. Epidemiol</journal-id>
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<article-categories><subj-group subj-group-type="heading"><subject>Systematic Reviews and Meta- and Pooled Analyses</subject>
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<title-group><article-title>Hospitalization Fatality Risk of Influenza A(H1N1)pdm09: A Systematic Review and Meta-Analysis</article-title>
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<contrib-group><contrib contrib-type="author"><name><surname>Wong</surname>
<given-names>Jessica Y.</given-names>
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<contrib contrib-type="author"><name><surname>Kelly</surname>
<given-names>Heath</given-names>
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<contrib contrib-type="author"><name><surname>Cheung</surname>
<given-names>Chung-Mei M.</given-names>
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<contrib contrib-type="author"><name><surname>Shiu</surname>
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<contrib contrib-type="author"><name><surname>Wu</surname>
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<contrib contrib-type="author"><name><surname>Ni</surname>
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<contrib contrib-type="author"><name><surname>Ip</surname>
<given-names>Dennis K. M.</given-names>
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<contrib contrib-type="author"><name><surname>Cowling</surname>
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<xref ref-type="corresp" rid="cor1">*</xref>
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<author-notes><corresp id="cor1"><label>*</label>
Correspondence to Prof. Benjamin J. Cowling, School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China (e-mail: <email>bcowling@hku.hk</email>
).</corresp>
<fn id="AN1" fn-type="con"><p>Abbreviations: GDP, gross domestic product; HFR, hospitalization fatality risk; ICU, intensive care unit.</p>
</fn>
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<pub-date pub-type="ppub"><day>15</day>
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<volume>182</volume>
<issue>4</issue>
<fpage>294</fpage>
<lpage>301</lpage>
<history><date date-type="received"><day>25</day>
<month>8</month>
<year>2014</year>
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<date date-type="accepted"><day>20</day>
<month>2</month>
<year>2015</year>
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<permissions><copyright-statement>© The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</copyright-statement>
<copyright-year>2015</copyright-year>
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<self-uri content-type="pdf" xlink:type="simple" xlink:href="kwv054.pdf"></self-uri>
<abstract><p>During the 2009 influenza pandemic, uncertainty surrounding the severity of human infections with the influenza A(H1N1)pdm09 virus hindered the calibration of the early public health response. The case fatality risk was widely used to assess severity, but another underexplored and potentially more immediate measure is the hospitalization fatality risk (HFR), defined as the probability of death among H1N1pdm09 cases who required hospitalization for medical reasons. In this review, we searched for relevant studies published in MEDLINE (PubMed) and EMBASE between April 1, 2009, and January 9, 2014. Crude estimates of the HFR ranged from 0% to 52%, with higher estimates from tertiary-care referral hospitals in countries with a lower gross domestic product, but in wealthy countries the estimate was 1%–3% in all settings. Point estimates increased substantially with age and with lower gross domestic product. Early in the next pandemic, estimation of a standardized HFR may provide a picture of the severity of infection, particularly if it is presented in comparison with a similarly standardized HFR for seasonal influenza in the same setting.</p>
</abstract>
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