Retrospective review of epidemic viral pneumonia cases in Turkey: A multicenter study

Çörtük,Mustafa; Acat,Murat; Yazici,Onur; Yasar,Zehra; Kiraz,Kemal; Ataman,Sena Yapicioglu; Tanriverdi,Elif; Zitouni,Burcak; Kirakli,Cenk; Ediboglu,Ozlem; Tuksavul,Fevziye; Dirican,Adem; Celik,Hale Kefeli; Ozkaya,Sevket; Cetinkaya,Erdogan

doi:10.3892/etm.2017.4153

Retrospective review of epidemic viral pneumonia cases in Turkey: A multicenter study

Authors:
- Mustafa Çörtük
- Murat Acat
- Onur Yazici
- Zehra Yasar
- Kemal Kiraz
- Sena Yapicioglu Ataman
- Elif Tanriverdi
- Burcak Zitouni
- Cenk Kirakli
- Ozlem Ediboglu
- Fevziye Tuksavul
- Adem Dirican
- Hale Kefeli Celik
- Sevket Ozkaya
- Erdogan Cetinkaya
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Affiliations: Department of Chest Diseases, Karabük University Faculty of Medicine, 78200 Karabük, Turkey, Department of Chest Diseases, Adnan Menderes University Faculty of Medicine, 09010 Aydın, Turkey, Department of Chest Diseases, Abant İzzet Baysal University Faculty of Medicine, 14280 Bolu, Turkey, Department of Chest Diseases, Antalya Atatürk State Hospital, 07040 Antalya, Turkey, Department of Chest Diseases, Izmir Dr Suat Seren Thoracic Diseases and Surgery Training and Research Hospital, 35110 İzmir, Turkey, Department of Chest Diseases, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, 34020 İstanbul, Turkey, Department of Pulmonary Medicine, Samsun Medical Park Hospital, 55200 Samsun, Turkey, Department of Anesthesiology and Intensive Care Unit, Samsun Training and Research Hospital, 55100 Samsun, Turkey, Department of Pulmonary Medicine, Bahcesehir University Faculty of Medicine, 34720 Istanbul, Turkey
Published online on: February 22, 2017 https://doi.org/10.3892/etm.2017.4153
Pages: 1431-1437
Copyright: © Çörtük et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Influenza A (H1N1) caused its first pandemic in 2009 in USA and Mexico. Since then, clinicians have exercised great care in order to make an early diagnosis of viral pneumonias. This is due in part to pandemic influenza A infection having greater impact on populations <65 years old than other viral strains, including seasonal influenza. Chest radiographies of those affected displayed a rapid progression of patchy infiltrates, and a large proportion of individuals required admission to intensive care units (ICU). Despite efforts, patients infected with the virus had a high mortality rate. The present multicenter study aimed to retrospectively evaluate the clinical, demographic and prognostic characteristics of patients diagnosed with epidemic viral pneumonia in Turkey. A total of 92 patients were included in the study. The Student's t‑test and Chi‑square tests were performed to analyze quantitative data, assuming a normal distribution, and to analyze qualitative data, respectively. Stepwise logistic regression was used to evaluate the effects of demographic variables and laboratory values on the virus mortality rate. The male/female ratio was 42/50 and the mean age was 48.74±16.65 years. A total of 69 (75%) patients were unvaccinated against influenza. The most common symptoms were cough (87%) and fever (63%). Chest computed tomography showed peripheral patchy areas of the lungs of ground glass density in 38 patients (41.3%). A total of 22 (59.4%) patients had H1N1, 5 (12.5%) patients had influenza B, and 38 (41.3%) patients met the criteria for admission to the ICU. Of these patients, 20 (52.63%) were monitored with a mechanical ventilator, with a noninvasive ventilator being adequate for 10 (26.32%) of patients. The length of stay in the ICU was 6.45±5.97 days and the duration of mechanical ventilation was 5.06±4.69 days. A total of 12 (13.04%) patients in the ICU succumbed. Logistic regression analysis revealed that among the parameters possibly associated with mortality, being an active smoker increased the risk of mortality 7.08‑fold compared to other groups (P=0.005). In conclusion, viral pneumonia remains a significant health problem during the winter period. Considering the high number of ICU admissions and high rate of mortality for patients in the present study, earlier initiation of antiviral therapy is necessary. Active smoking increased mortality in viral pneumonia.

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