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. 2017 Dec 8;7(1):17275.
doi: 10.1038/s41598-017-17497-6.

Long term outcomes in survivors of epidemic Influenza A (H7N9) virus infection

Jiajia Chen  1   2 , Jie Wu  1   2 , Shaorui Hao  1   2 , Meifang Yang  1   2 , Xiaoqing Lu  1   2 , Xiaoxiao Chen  1   2 , Lanjuan Li  3   4
Affiliations

Long term outcomes in survivors of epidemic Influenza A (H7N9) virus infection

Jiajia Chen et al. Sci Rep. .

Abstract

Patients who survive influenza A (H7N9) virus infection are at risk of physical and psychological complications of lung injury and multi-organ dysfunction. However, there were no prospectively individualized assessments of physiological, functional and quality-of-life measures after hospital discharge. The current study aims to assess the main determinants of functional disability of these patients during the follow-up. Fifty-six influenza A (H7N9) survivors were investigated during the 2-year after discharge from the hospital. Results show interstitial change and fibrosis on pulmonary imaging remained 6 months after hospital discharge. Both ventilation and diffusion dysfunction improved, but restrictive and obstructive patterns on ventilation function test persisted throughout the follow-up period. For patients with acute respiratory distress syndrome lung functions improved faster during the first six months. Role-physical and Role-emotional domains in the 36-Item Short-Form Health Survey were worse than those of a sex- and age-matched general population group. The quality of life of survivors with ARDS was lower than those with no ARDS. Our findings suggest that pulmonary function and imaging findings improved during the first 6 months especially for those with ARDS, however long-term lung disability and psychological impairment in H7N9 survivors persisted at 2 years after discharge from the hospital.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Enrollment of patients with H7N9 infection and follow-up for 2-year after discharge from hospital.
Figure 2
Figure 2
Radiologic findings of 67-year-old female patient with severe avian H7N9 infections between admission and 1-year follow-up. (A) Initial bedside chest X-ray image showed white lung on the right side on day 13 after the onset of illness. (B) High-resolution CT (HRCT) scan obtained 40 days after disease onset still showed ground-glass opacities (GGOs), multifocal consolidation and pleural effusion. (C) At the 3-month visit from discharge, the same scan as B showed GGOs still presented. Consolidation and pleural effusion disappeared. Reticular pattern changes and bronchiectasis were seen. (D) and (E) At 6-month (D) and 12-month (E) visit, GGOs and fibrosis can still be seen but much improved on the same scan level as B.
Figure 3
Figure 3
The influence of ARDS on lung function changes of the survivors with H7N9 infections during follow up.
Figure 4
Figure 4
The influence of ARDS on Health-Related Quality of Life over time.
See this image and copyright information in PMC

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