Characteristics and outcomes of hospitalized patients with
influenza (H1N1) during 2018–19 at a tertiary care hospital, Peshawar,
Pakistan. Muhammad Asim1, Zia ul Haq2,
Omer Nasim3, Saima Afaq2,4, Muhammad
Shah Fahad3, Muhammad Khizar Hayat5,
Zeinab Hussain6
1Consultant Pulmonologist, Northwest General Hospital
& Research Centre, Peshawar
2 Institute of Public Health and Social Sciences,
Khyber Medical University Peshawar
3Medical Officers, Shaukat Khanam Memorial Cancer
Hospital and Research Centre
4School of Public Health, Imperial College London, UK
5House Officer, Rehman Medical Institute, Peshawar
6Final Year Student, Rehman Medical College, Peshawar
Author for
correspondence
Dr Saima Afaq
Research Associate Imperial College London
Assistant Professor Khyber Medical University Peshawar
Email:
s.afaq11@imperial.ac.uk;
Saima.iph@kmu.edu.pk
Dr Muhammad Asim
Consultant Pulmonologist
Northwest General Hospital & Research Centre
Email:
dr.asimwazir@yahoo.co.uk
Abstract
Swine-origin influenza (H1N1) virus appeared in 2009 which spread
worldwide, and it still circulates in the population. This study aimed
at exploring the clinical manifestations and results in admitted
patients having H1N1 influenza. All patients with confirmed or suspected
influenza (H1N1) who reported to NWGH & RC, Peshawar, Pakistan from
January 2018 till December 2019 were included in the study. Data was
collected on
demographics,
preexisting medical conditions, duration of hospital stay, clinical
laboratory data, outcome, and clinical features. Distribution of
variables was assessed using histograms, comparison of continuous
variables was done via independent Student’s t -test and of
categorical variables using Chi Square test. A p value of ≤0.05 was set
as cut-off for significance. A total of 39 patients presented to the
hospital during the study period. Mean age was 52 (15.8) years and the
proportion of male and female participants was 43.6% and 56.4%
respectively. Clinical features included fever, shortness of breath,
cough, chest pain, body aches and sore throat. The most commonly
occurring comorbidities were hypertension [21 (53.8%)], diabetes
[11 (28.2%)], and chronic kidney disease [3 (7.7%)]. Real time
PCR positivity was present in 36 (92.3%) patients. Overall, 30 (76.9%)
survived while 09 (23.1%) died. Comparison of the clinical parameters
of survivors and non-survivors showed that non-survivors had
significantly higher risk of renal failure (p=0.01), ionotropic
disturbances (p=0.001), secondary infection (p=0.03), septic shock
(p=0.001), and respiratory problems, requiring non-invasive ventilation
and invasive mechanical ventilation (p=0.001).
Keywords: Infectious disease, H1N1, Influenza, Mortality,
morbidity, Pakistan, South Asia