Información del artículo
Abstract
Although influenza is usually a self-limited disease, patients who develop complications are at increased risk of hospitalization, intensive care unit admission and death. Since preventive and early therapeutic measures should be prioritized in higher risk patients, identification of the risk factors for severe infection is important from a public health perspective. Risk factors for complications in pandemics may show some differences with regard to seasonal influenza. During the influenza A(H1N1)pmd09 pandemic, although many cases occurred in younger adults, the risk factors identified for severe infections and complications were similar to those for seasonal influenza, including chronic respiratory, renal, liver, and heart diseases. Aged patients, although less frequently affected, were also at higher risk. Obesity, and particularly morbid obesity (>40 body mass index) has been noted as a significant risk factor for severe disease in the 2009 influenza pandemic. Some interesting recent studies provide insights into the biological reasons behind the poor outcomes in morbidly obese patients. In terms of pregnancy, the studies have shown contradictory results due to variations in methodology and medical care. However, it seems that pregnancy, particularly during the third trimester, increases the risk of complications, and that early antiviral treatment is associated with improved outcomes.
Keywords:
Influenza infection
A(H1N1)
Pandemic influenza
Seasonal influenza
Influenza complications
Risk factors
Outcomes
Resumen
Aunque la gripe es habitualmente una enfermedad autolimitada, el desarrollo de complicaciones se asocia con mayor riesgo de ingreso, de necesidad de cuidados intensivos y de muerte. Dado que las medidas preventivas y terapéuticas deben priorizarse en los pacientes de mayor riesgo, el conocimiento de los factores de riesgo tiene gran importancia desde la perspectiva de la salud pública. Los factores de riesgo de enfermedad grave pueden ser distintos en las pandemias; los factores identificados durante la pandemia 2009 A(H1N1), a pesar de que muchos de los casos ocurrieron en personas jóvenes, son similares a los de la infección estacional, incluyendo las enfermedades respiratorias, renales, hepáticas y cardíacas crónicas. Los pacientes ancianos, aunque menos frecuentemente afectados, también mostraron mayor riesgo. La obesidad, sobre todo la mórbida (índice de masa corporal > 40) ha sido también un factor de riesgo significativo durante esta pandemia. Recientemente se han publicado datos interesantes sobre las posibles explicaciones biológicas de este hecho. Con respecto al embarazo, los datos de los estudios son contradictorios debido a diferencias metodológicas y de atención sanitaria. Sin embargo, parece que el embarazo, particularmente durante el tercer trimestre, aumenta el riesgo de complicaciones, y que el tratamiento antiviral precoz mejora el pronóstico.
Palabras clave:
Infección de gripe
A(H1N1)
Gripe pandémica
Gripe estacional
Complicaciones de la gripe
Factores de riesgo
Resultados
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