ORIGINAL ARTICLE   

Minerva Medica 2018 February;109(1):7-14

DOI: 10.23736/S0026-4806.17.05329-0

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Clinical course of asthma patients with H1N1 influenza infection and oseltamivir

Min-Hye KIM ¹, Woo-Jung SONG ^{2, 3}, Min-Suk YANG ^{2, 3, 4}, So-Hee LEE ^{2, 3}, Jae-Woo KWON ⁵, Sae-Hoon KIM ^{2, 3, 6}, Hye-Ryun KANG ^{2, 3}, Heung-Woo PARK ^{2, 3}, Young-Joo CHO ¹, Sang-Heon CHO ^{2, 3}, Kyung-Up MIN ^{2, 3}, You-Young KIM ⁷, Yoon-Seok CHANG ^{2, 3, 6} ✉

¹ Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea; ² Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea; ³ Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, South Korea; ⁴ Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea; ⁵ Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea; ⁶ Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; ⁷ Department of Internal Medicine, National Medical Center, Seoul, South Korea

BACKGROUND: H1N1 influenza virus prevailed throughout the world in 2009. However, there are few reports on the clinical features of H1N1 influenza infection in adult asthma patients. We evaluated the clinical features in asthma patients with H1N1 influenza infection who took oseltamivir and compared them to those with other upper respiratory infections.
METHODS: We reviewed asthma patients over 15 years of age who had visited Seoul National University Hospital and Seoul National University Bundang Hospital for suspected H1N1 influenza infection from August 2009 to March 2010. Various clinical features such as hospital admission days, respiratory symptoms, basal lung function, and past history was compared between H1N1 influenza PCR positive and negative groups.
RESULTS: A total of 111 asthmatics were enrolled. All patients took oseltamivir. H1N1 RT-PCR was positive in 62 patients (55.9%), negative in 49 patients (44.1%). Wheezing developed more frequently in the H1N1 positive group. (43.5 vs. 16.7%, P=0.044). The rate of acute asthma exacerbations and pneumonia development were higher in the H1N1 positive group (59.7 vs. 51%, P=0.015, 25.0% vs. 0%, P<0.001). The rates for emergency room visit, hospital admissions, intensive care unit admissions, hospital days were not different between the groups. Underlying medical conditions were accompanied more frequently in the H1N1 negative patients (21.6% vs. 30.6%, P=0.002), especially cardiac disease (7.2% vs. 15.3%, P=0.011).
CONCLUSIONS: H1N1 influenza infection may affect the clinical course of asthma combined with more severe manifestations; however, Oseltamivir could have affected the clinical course of H1N1 infected patients and made it milder than expected.

KEY WORDS: Influenza A virus, H1N1 subtype - Asthma - Oseltamivir - Respiratory tract infections