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Meta-Analysis
. 2014 Jan 10;9(1):e78583.
doi: 10.1371/journal.pone.0078583. eCollection 2014.

Influenza A(H1N1)pdm09 and cystic fibrosis lung disease: a systematic meta-analysis

Hanna Renk  1 , Nicolas Regamey  2 , Dominik Hartl  1
Affiliations
Meta-Analysis

Influenza A(H1N1)pdm09 and cystic fibrosis lung disease: a systematic meta-analysis

Hanna Renk et al. PLoS One. .

Erratum in

  • PLoS One. 2014;9(3):e93142

Abstract

Background: To systematically assess the literature published on the clinical impact of Influenza A(H1N1)pdm09 on cystic fibrosis (CF) patients.

Methods: An online search in PUBMED database was conducted. Original articles on CF patients with Influenza A(H1N1)pdm09 infection were included. We analyzed incidence, symptoms, clinical course and treatment.

Results: Four surveys with a total of 202 CF patients infected by Influenza A(H1N1)pdm09 were included. The meta-analysis showed that hospitalisation rates were higher in CF patients compared to the general population. While general disease symptoms were comparable, the clinical course was more severe and case fatality rate (CFR) was higher in CF patients compared to asthmatics and the general population.

Conclusions: Evidence so far suggests that CF patients infected with Influenza A(H1N1)pdm09 show increased morbidity and a higher CFR compared to patients with other chronic respiratory diseases and healthy controls. Particularly, CF patients with advanced stage disease seem to be more susceptible to severe lung disease. Accordingly, early antiviral and antibiotic treatment strategies are essential in CF patients. Preventive measures, including vaccination as well as hygiene measures during the influenza season, should be reinforced and improved in CF patients.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Symptoms of Influenza A(H1N1)pdm09 infection in CF, asthmatics and healthy controls.
Frequency of presenting symptoms in CF patients, asthmatics and healthy controls from four studies of Influenza A(H1N1)pdm09 infection in CF patients –, and a study of asthmatics and healthy controls during the 2009 pandemic.
Figure 2
Figure 2. Clinical course of Influenza A(H1N1)pdm09 infection in CF patients.
Number of CF patients with mild, moderate or severe course of Influenza A(H1N1)pdm09 infection in the analyzed studies –. Mild course: outpatient treatment. Moderate course: hospitalization without complications. Serious course: intensive care treatment, mechanical ventilation, or death.
See this image and copyright information in PMC

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