Publication:

Retrospective study of clinical profile and management of patients with swine flu at tertiary care hospital

Background The first isolation of a swine influenza virus from a human occurred in 1974. There are no unique clinical features that distinguish swine influenza in humans from typical influenza. Thus, clinical course and management were recorded as per a planned pro forma and analysed. This type of study has not been done previously in Himalayan region.

Methods Retrospective observational study done in a group of patients diagnosed with swine flu admitted in department of pulmonary medicine at the tertiary care hospital from November 2016 to July 2017.

Results Out of 30 patients, 53.3% were male, mean age was 48.8±17.7, history of travel or contact to infected person was only 13.3%. Most common symptom recorded was fever (83.3%), followed by dyspnoea, cough, throat pain. Most common co-morbidity was diabetes and presence were significantly associated with admission in an ICU (P<0.05). Bilateral lung infiltrate seen in 53.3% on chest X-ray. Organ involved other than respiratory were renal followed by liver involvement. 40% of patients received corticosteroid for an average of 6days, mostly given in patients with sepsis, septic shock, multi organ involvement. Out of 40%, 16.6% patient expired, 6.6% left against medical advice and 16.6% were discharged, corticosteroid doesn’t help in reducing mortality.

Conclusions A multivariate model to identify independent predictors associated with mortality in swine flu were the use of vasopressor, respiratory failure, requirement of mechanical ventilation and number of organ failure. Use of corticosteroid is controversial.