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Many Children Hospitalized With H1N1 Were in ICU or Died

Premature infants, those with underlying illnesses had higher rate of severe complications

TUESDAY, Nov. 2 (HealthDay News) -- Among children hospitalized with 2009 novel influenza A(H1N1) in California, more than one-fourth were placed in intensive care units (ICUs) or died, according to a study published in the November Archives of Pediatrics & Adolescent Medicine. According to another study in the same issue that assessed children in Israel, those who had underlying illnesses and premature infants were at higher risk of severe complications from H1N1.

In one study, Janice K. Louie, M.D., of the California Department of Public Health in Richmond, and colleagues analyzed data from 345 children who were hospitalized with H1N1 or died from it. Ninety-four (27 percent) required intensive care and nine (3 percent) died. Two-thirds had comorbidities, and congenital heart disease (odds ratio, 5.0) and cerebral palsy/developmental delay (odds ratio, 3.5) were linked to higher chances of ICU admission or death.

In the other study, Michal Stein, M.D., of the Edith Wolfson Medical Center in Holon, Israel, and colleagues analyzed data from 478 patients ages 18 and younger who were hospitalized with laboratory-confirmed H1N1. Of these, 42 patients (8.8 percent) were admitted to a pediatric ICU and three (0.6 percent) died. Nearly half (48.7 percent) had predisposing underlying illnesses, and those with metabolic and neurologic conditions had particularly high risk for severe complications (relative risks, 6.5 and 2.9, respectively). Also, patients with cyanotic heart lesions and infants 3 months or younger who were born at or earlier than 33 weeks' gestation were more likely to have higher rates of mechanical ventilation.

"The severity variables for 2009 influenza A(H1N1) were similar to the figures reported for seasonal influenza. Patients with underlying metabolic and neurologic metabolic disorders and presumably patients with cyanotic heart lesions and infants born prematurely are at highest risk for severe complications following 2009 influenza A(H1N1) infection," Stein and colleagues conclude.

Abstract - Louie
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Abstract - Stein
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