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Clinical factors associated with severity in hospitalized children infected with avian influenza (H5N1)

Hiroyuki Furuya1, Shoji Kawachi, Mika Shigematsu

  • 1Center for Molecular Prevention and Environmental Medicine, Basic Clinical Science and Public Health, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan. furuya@is.icc.u-tokai.ac.jp

Environmental Health and Preventive Medicine
|March 25, 2011
PubMed

Insights

Decreased white blood cell (WBC) and platelet (PLT) counts are predictors of poor prognosis in young patients with avian influenza A (H5N1) virus infection. These findings aid in early clinical assessment and treatment strategies for H5N1 cases.

Area of Science:

  • Infectious Diseases
  • Virology
  • Pediatrics

Background:

  • Avian influenza A (H5N1) virus has caused significant human mortality globally.
  • Over 50% of reported H5N1 cases involve individuals under 20 years of age.
  • Limited data exists on clinical factors predicting H5N1 prognosis in pediatric populations.

Purpose of the Study:

  • To identify clinical and laboratory factors associated with prognosis in H5N1 influenza patients.
  • To perform a pooled analysis of H5N1 cases to overcome limitations of small sample sizes in individual studies.
  • To investigate the predictive value of laboratory markers for H5N1 outcomes in children and adolescents.

Main Methods:

  • Pooled analysis of 36 pediatric H5N1 cases (<18 years) from five case reports (2004-2009).
  • Investigation of associations between prognosis and laboratory findings (WBC, PLT, AST, ALT).
  • Linear regression analysis adjusted for age and sex to assess predictor significance.

Main Results:

  • Mortality was negatively associated with lower white blood cell (WBC) and platelet (PLT) counts, adjusted for age and sex.
  • Elevated aspartate aminotransferase (AST) levels showed a trend towards association with poor prognosis (p=0.054).
  • Alanine aminotransferase (ALT) levels did not show a significant association with survival.

Conclusions:

  • Decreased WBC and PLT counts are significant predictors of poor prognosis in pediatric H5N1 influenza.
  • These laboratory markers can aid in early risk stratification for H5N1-infected children.
  • Further research is warranted to fully elucidate prognostic factors in H5N1 infection.
Abstract

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