Pandemic 2009 Influenza A (H1N1) virus infection in cancer and hematopoietic stem cell transplant recipients; a multicenter observational study.

• DOI: 10.12688/f1000research.5251.2
• Publication Date: 2015-08-25T15:25:09Z
• Authors: Maria Cecilia Dig...; Patricia Costantini; Claudia Salgueira; Rosana Jordán; Graciela Guerrini; Alejandra Valledor; Fabián Herrera; Andrea Nenna; Claudia Mora; Inés Roccia-Rossi; Daniel Stecher; Edith Carbone; Ana Laborde; Ernesto Efron; Javier Altclas; Aníbal Calmaggi; José Cozzi
• Keywords: Epidemiology; Immunology; Infectious disease (medical specialty); FOS: Health sciences; Hematopoietic stem cell; 03 medical and health sciences; 0302 clinical medicine; Observational study; Virology; Health Sciences; Epidemiology and Pathogenesis of Respiratory Viral Infections; Open peer review; Genetics; Disease; Biology; Internal medicine; Cancer; Plant biology; Stem cell; Pandemic; FOS: Clinical medicine; H1N1; Botany; Gastrointestinal Viral Infections and Vaccines Development; Influenza; Virus; 3. Good health; Coronavirus disease 2019 (COVID-19); Infectious Diseases; Haematopoiesis; Influenza A virus; FOS: Biological sciences; Medicine; Influenza Virus Research and Epidemiology; Pandemic influenza; Research Article

Background: During March 2009 a novel Influenza A virus emerged in Mexico. We describe the clinical picture of the pandemic Influenza A (H1N1) Influenza in cancer patients during the 2009 influenza season.Methods: Twelve centers participated in a multicenter retrospective observational study of cancer patients with confirmed infection with the 2009 H1N1 Influenza A virus (influenza-like illness or pneumonia plus positive PCR for the 2009 H1N1 Influenza A virus in respiratory secretions). Clinical data were obtained by retrospective chart review and analyzed. Results: From May to August 2009, data of 65 patients were collected. Median age was 51 years, 57 % of the patients were female. Most patients (47) had onco-hematological cancers and 18 had solid tumors. Cancer treatment mainly consisted of chemotherapy (46), or stem cell transplantation (SCT) (16). Only 19 of 64 patients had received the 2009 seasonal Influenza vaccine. Clinical presentation included pneumonia (43) and upper respiratory tract infection (22). Forty five of 58 ambulatory patients were admitted. Mechanical ventilation was required in 12 patients (18%). Treatment included oseltamivir monotherapy or in combination with amantadine for a median of 7 days. The global 30-day mortality rate was 18%. All 12 deaths were among the non-vaccinated patients. No deaths were observed among the 19 vaccinated patients. Oxygen saturation <96% at presentation was a predictor of mortality (OR 19.5; 95%CI: 2.28 to 165.9).Conclusions: In our cancer patient population, the pandemic 2009 Influenza A (H1N1) virus was associated with high incidence of pneumonia (66%), and 30-day mortality (18.5%). Saturation <96% was significantly associated with death. No deaths were observed among vaccinated patients.