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