Volume 24, Issue 101, January - February, 2020

Evaluation of prevalence and severity of acute respiratory distress syndrome in hospitalized patients due to H1N1 outbreak in Kerman, Iran

Mehdi Ahmadi Nejad¹, Morteza Hashemian², Hoda Ganjalikhani³, Maryam Ahmadipour^4♦

¹Associated Professor, Fellowship of Critical Care, Faculty of Medicine, Department of Anesthesia, Kerman University of Medical Sciences, Kerman, Iran
²Assistant Professor, Fellowship of Pain, Faculty of Medicine, Department of Anesthesia, Kerman University of Medical Sciences, Kerman, Iran
³General Physician, Kerman University of Medical Sciences, Kerman, Iran
⁴Assistant Professor, Pediatric Cardiologist, Faculty of Medicine, Department of Pediatric, Kerman University of Medical Sciences, Kerman, Iran

^♦Corresponding author
Assistant Professor, Pediatric Cardiologist, Faculty of Medicine, Department of Pediatric, Kerman University of Medical Sciences, Kerman, Iran

ABSTRACT

Influenza is an acute respiratory viral disease which affects the upper and lower respiratory tract. The main cause of hospitalization was involvement of lower respiratory tract in the form of primary viral pneumonia due to direct invasion of lung tissue by virus. Primary pathological findings suggest extensive alveolar injury of interstitial hemorrhagic pneumonitis along with lymphocytic proliferation and relative neutrophil reduction in this tissue plus ARDS. Considering that there is no record of incidence and severity of ARDS in patients with H1N1 influenza in Iran, particularly in Kerman, this study seems to be necessary as a basic study for further preparation of possible future epidemics. This was a cross-sectional study conducted in the Afzalipour Hospital in Kerman in 2016. The sampling method was census-based; the studied population included patients admitted to the Afzalipur Hospital from March 21, 2015 to March 19, 2016 due to definitive development (PCR of sputum sample of H1N1-infected patients) of H1N1 influenza. After collecting data, data was analyzed by SPSS software, version 20. In patients with mild, moderate and severe ARDS, 18 (58.9%), 16 (76.42%) and 27 (79.41%) had underlying diseases. Frequency of ARDS severity was significantly different in terms of underlying diseases (p-value = 0.012); 22 (70.9%) of patients with mild ARDS, 15 (71.42%) of patients with moderate ARDS, and 24 (70.76%) of patients with severe ARDS were male. Frequency of ARDS severity was not significantly different in terms of gender (p-value = 0.112). The mean age was 51.54 ± 15.575 years in patients with mild ARDS, 53.98 ± 14.652 years in patients with moderate ARDS and 53.64 ± 14.942 years in patients with severe ARDS; no significant difference was observed in terms of age (p-value = 0.062). According to mortality results, there was a significant difference and mortality was significantly higher in patients with ARDS (p-value = 0.035). The results of this study showed that ARDS was higher in patients with underlying diseases and ARDS severity was higher in these patients than in other patients. Mortality rate also had a significant relationship with ARDS; most of mortalities were in these patients.

Keywords: Influenza, ARDS, Mortality

Medical Science, 2020, 24(101), 135-142

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