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Elisa Minchole, Ana L. Figueredo, Manuel Omeñaca, Carolina Panadero, Laura Royo, Jose J. Vengoechea, Sergio Fandos, Francisco de Pablo, Salvador Bello
Seasonal Influenza A H1N1pdm09 Virus and Severe Outcomes: A Reason for Broader Vaccination in Non-Elderly, At-Risk People
www.plosone.org
www.plosone.org
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3.7644 0 Td
(confounding)Tj
5.3745 0 Td
(factor,)Tj
2.7722 0 Td
(including)Tj
4.0422 0 Td
(influenza)Tj
3.9118 0 Td
(vaccine)Tj
3.1975 0 Td
(status,)Tj
2.7269 0 Td
(and)Tj
1.7291 0 Td
(to)Tj
1.0261 0 Td
(assess)Tj
2.5172 0 Td
(the)Tj
-34.7922 -1.2983 Td
(impact)Tj
2.9763 0 Td
(of)Tj
1.0148 0 Td
(vaccination)Tj
4.8302 0 Td
(in)Tj
1.0318 0 Td
(seasonal)Tj
3.5376 0 Td
(A\(H1N1\))Tj
4.0365 0 Td
(severe)Tj
2.6816 0 Td
(influenza.)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 629.1779 cm
BT
/F2 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Material)Tj
3.959 0 Td
(and)Tj
1.989 0 Td
(Methods)Tj
/F0 1 Tf
-5.948 -1.4976 Td
(Study)Tj
2.7543 0 Td
(Setting)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 594.1984 cm
BT
/F8 1 Tf
1 TL
-0.004 Tc
0 0 Td
(From)Tj
2.4434 0 Td
(1)Tj
0.6973 0 Td
(January)Tj
3.3165 0 Td
(to)Tj
1.0262 0 Td
(30)Tj
1.1735 0 Td
(April)Tj
2.3074 0 Td
(2014,)Tj
2.3471 0 Td
(all)Tj
1.1452 0 Td
(adult)Tj
2.2563 0 Td
(patients)Tj
3.3676 0 Td
(\()Tj
/F12 1 Tf
0 Tc
()Tj
/F8 1 Tf
-0.004 Tc
1.3322 0 Td
(18)Tj
1.1679 0 Td
(years\))Tj
2.6079 0 Td
(admitted)Tj
3.8154 0 Td
(to)Tj
1.0261 0 Td
(Hospital)Tj
3.617 0 Td
(Universi-)Tj
-33.647 -1.2982 Td
(tario)Tj
2.0976 0 Td
(Miguel)Tj
3.0387 0 Td
(Servet,)Tj
2.897 0 Td
(Zaragoza)Tj
3.8778 0 Td
(\(Spain\))Tj
3.1407 0 Td
(with)Tj
2.0013 0 Td
(suspicion)Tj
3.9968 0 Td
(of)Tj
1.0148 0 Td
(influenza)Tj
3.9174 0 Td
(underwent)Tj
4.5751 0 Td
(PCR)Tj
2.0636 0 Td
(testing)Tj
2.88 0 Td
(of)Tj
1.0148 0 Td
(an)Tj
-36.5156 -1.3039 Td
(oropharyngeal)Tj
6.0264 0 Td
(swab)Tj
2.2053 0 Td
(for)Tj
1.389 0 Td
(influenza)Tj
3.9118 0 Td
(A\(H1N1\),)Tj
4.2689 0 Td
(A\(H3N2\))Tj
4.0365 0 Td
(or)Tj
1.0999 0 Td
(B)Tj
0.7993 0 Td
(infection.)Tj
4.0195 0 Td
(A)Tj
0.9014 0 Td
(retrospective)Tj
5.3632 0 Td
(observa-)Tj
-34.0212 -1.2983 Td
(tional)Tj
2.5171 0 Td
(study)Tj
2.3924 0 Td
(of)Tj
1.0148 0 Td
(those)Tj
2.3358 0 Td
(with)Tj
2.0012 0 Td
(positive)Tj
3.3108 0 Td
(test)Tj
1.6044 0 Td
(results)Tj
2.8063 0 Td
(was)Tj
1.7008 0 Td
(performed.)Tj
4.6941 0 Td
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1.2019 0 Td
(that)Tj
1.7802 0 Td
(time,)Tj
2.2563 0 Td
(a)Tj
0.652 0 Td
(hospital)Tj
3.3789 0 Td
(emer-)Tj
-33.647 -1.2983 Td
(gency)Tj
2.5341 0 Td
(protocol)Tj
3.6 0 Td
(was)Tj
1.6951 0 Td
(applied,)Tj
3.3789 0 Td
(and)Tj
1.7291 0 Td
(all)Tj
1.1509 0 Td
(those)Tj
2.3357 0 Td
(patients)Tj
3.3675 0 Td
(were)Tj
2.1203 0 Td
(subject)Tj
3.0217 0 Td
(to)Tj
1.0262 0 Td
(the)Tj
1.4683 0 Td
(same)Tj
2.2564 0 Td
(written)Tj
3.1124 0 Td
(diagnostic)Tj
-32.7966 -1.3039 Td
(and)Tj
1.7291 0 Td
(therapeutic)Tj
4.7338 0 Td
(management.)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 502.9795 cm
BT
/F0 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Definitions)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 485.9716 cm
BT
/F8 1 Tf
1 TL
-0.004 Tc
0 0 Td
(A)Tj
0.9014 0 Td
(case)Tj
1.8651 0 Td
(of)Tj
1.0148 0 Td
(influenza-associated)Tj
8.2998 0 Td
(hospitalization)Tj
6.1172 0 Td
(was)Tj
1.6951 0 Td
(defined)Tj
3.2314 0 Td
(as)Tj
1.0148 0 Td
(an)Tj
1.2019 0 Td
(adult)Tj
2.2507 0 Td
(\()Tj
/F13 1 Tf
0 Tc
(>)Tj
/F8 1 Tf
-0.004 Tc
(18)Tj
2.2847 0 Td
(years\))Tj
2.6022 0 Td
(who)Tj
1.9389 0 Td
(was)Tj
-34.418 -1.2982 Td
(admitted)Tj
3.8154 0 Td
(with)Tj
1.9955 0 Td
(suspected)Tj
4.0876 0 Td
(influenza)Tj
3.9118 0 Td
(and)Tj
1.7347 0 Td
(positive)Tj
3.3166 0 Td
(PCR)Tj
2.0636 0 Td
(test.)Tj
1.8255 0 Td
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4.1159 0 Td
(of)Tj
1.0147 0 Td
(influenza)Tj
3.9118 0 Td
(included)Tj
3.7134 0 Td
(at)Tj
-35.5065 -1.2983 Td
(least)Tj
1.9842 0 Td
(one)Tj
1.6951 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(IDSA)Tj
2.4605 0 Td
(conditions)Tj
4.473 0 Td
([)Tj
0.83 0.64 0.02 0 k
(29)Tj
0 g
(]:)Tj
2.075 0 Td
(a\))Tj
0.9978 0 Td
(fever)Tj
2.1826 0 Td
(and)Tj
1.7292 0 Td
(acute)Tj
2.3243 0 Td
(onset)Tj
2.3585 0 Td
(of)Tj
1.0148 0 Td
(respiratory)Tj
4.5977 0 Td
(symptoms;)Tj
4.5864 0 Td
(b\))Tj
-34.9622 -1.2982 Td
(fever)Tj
2.1769 0 Td
(and)Tj
1.7348 0 Td
(exacerbation)Tj
5.3235 0 Td
(of)Tj
1.0148 0 Td
(underlying)Tj
4.5977 0 Td
(chronic)Tj
3.2882 0 Td
(lung)Tj
2.0069 0 Td
(disease;)Tj
3.2428 0 Td
(c\))Tj
0.9865 0 Td
(elderly)Tj
2.914 0 Td
(with)Tj
1.9956 0 Td
(new)Tj
1.8765 0 Td
(or)Tj
1.0998 0 Td
(worsening)Tj
-32.258 -1.304 Td
(respiratory)Tj
4.5977 0 Td
(symptoms,)Tj
4.5808 0 Td
(including)Tj
4.0422 0 Td
(exacerbation)Tj
5.3234 0 Td
(of)Tj
1.0148 0 Td
(congestive)Tj
4.3937 0 Td
(heart)Tj
2.2733 0 Td
(failure)Tj
2.778 0 Td
(or)Tj
1.0998 0 Td
(altered)Tj
2.9423 0 Td
(mental)Tj
2.9934 0 Td
(sta-)Tj
-36.0394 -1.2982 Td
(tus,)Tj
1.6327 0 Td
(with)Tj
1.9956 0 Td
(or)Tj
1.0998 0 Td
(without)Tj
3.3279 0 Td
(fever;)Tj
2.4094 0 Td
(d\))Tj
1.0885 0 Td
(severely)Tj
3.3732 0 Td
(ill)Tj
0.9808 0 Td
(persons)Tj
3.3108 0 Td
(with)Tj
1.9956 0 Td
(fever)Tj
2.1827 0 Td
(or)Tj
1.0998 0 Td
(hyponatremia.)Tj
6.0491 0 Td
(Hospitalized)Tj
-30.5459 -1.2983 Td
(adults)Tj
2.6135 0 Td
(admitted)Tj
3.8154 0 Td
(without)Tj
3.3335 0 Td
(fever)Tj
2.177 0 Td
(and)Tj
1.7348 0 Td
(acute)Tj
2.3244 0 Td
(respiratory)Tj
4.5978 0 Td
(symptoms)Tj
4.3596 0 Td
(that)Tj
1.7745 0 Td
(developed)Tj
4.2746 0 Td
(febrile)Tj
2.7439 0 Td
(respira-)Tj
-33.749 -1.3039 Td
(tory)Tj
1.8481 0 Td
(illness)Tj
2.6759 0 Td
(after)Tj
2.0353 0 Td
(hospital)Tj
3.3789 0 Td
(admission)Tj
4.3143 0 Td
(were)Tj
2.1203 0 Td
(not)Tj
1.576 0 Td
(included.)Tj
-16.7526 -1.2983 Td
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1.7858 0 Td
(protocol)Tj
3.5943 0 Td
(included)Tj
3.7133 0 Td
(a)Tj
0.6577 0 Td
(pharyngeal)Tj
4.6374 0 Td
(swab)Tj
2.211 0 Td
(at)Tj
0.9525 0 Td
(the)Tj
1.4683 0 Td
(ED)Tj
1.525 0 Td
(within)Tj
2.812 0 Td
(6)Tj
0.6973 0 Td
(hours)Tj
2.5115 0 Td
(of)Tj
1.0148 0 Td
(arrival,)Tj
3.0274 0 Td
(and)Tj
1.7291 0 Td
(initiation)Tj
-0.01 Tc
-33.5336 -1.2982 Td
(of)Tj
0.9977 0 Td
(Oseltamivir)Tj
4.8416 0 Td
(therapy)Tj
3.2031 0 Td
(as)Tj
0.9978 0 Td
(soon)Tj
2.1146 0 Td
(as)Tj
1.0035 0 Td
(influenza)Tj
3.8608 0 Td
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1.6781 0 Td
(suspected.)Tj
4.2462 0 Td
(Laboratory)Tj
4.5751 0 Td
(confirmation)Tj
5.4255 0 Td
(was)Tj
1.6781 0 Td
(defined)Tj
-34.6221 -1.304 Td
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1.0034 0 Td
(a)Tj
0.6463 0 Td
(positive)Tj
3.2655 0 Td
(reverse)Tj
3.0104 0 Td
(transcription)Tj
5.3574 0 Td
(polymerase)Tj
4.7168 0 Td
(chain)Tj
2.3925 0 Td
(reaction)Tj
3.4412 0 Td
(\(PCR\))Tj
2.7156 0 Td
(result.)Tj
2.6305 0 Td
(We)Tj
1.5987 0 Td
(used)Tj
2.0353 0 Td
(a)Tj
0.6463 0 Td
(rapid)Tj
-33.4599 -1.2982 Td
(commercial)Tj
4.8925 0 Td
(real-time)Tj
3.8041 0 Td
(PCR)Tj
2.0466 0 Td
(test)Tj
1.576 0 Td
(\(GeneXpert)Tj
4.8756 0 Td
(Xpert)Tj
2.4491 0 Td
(Flu)Tj
1.508 0 Td
(assay,)Tj
2.4492 0 Td
(Cepheid,)Tj
3.753 0 Td
(Sunnyvale,)Tj
4.4957 0 Td
(CA,)Tj
1.7745 0 Td
(USA\).)Tj
-0.004 Tc
-32.4281 -1.2983 Td
(The)Tj
1.7858 0 Td
(protocol)Tj
3.5943 0 Td
(included)Tj
3.7133 0 Td
(information)Tj
5.0797 0 Td
(on)Tj
1.2756 0 Td
(demographic)Tj
5.4992 0 Td
(characteristics,)Tj
6.1341 0 Td
(comorbidities,)Tj
5.9924 0 Td
(medical)Tj
-34.2706 -1.2982 Td
(history,)Tj
3.2314 0 Td
(influenza)Tj
3.9118 0 Td
(vaccination)Tj
4.8245 0 Td
(status,)Tj
2.7213 0 Td
(clinical)Tj
3.0784 0 Td
(course,)Tj
3.0557 0 Td
(laboratory)Tj
4.3483 0 Td
(analysis,)Tj
3.549 0 Td
(chest)Tj
2.2507 0 Td
(X-ray,)Tj
2.7099 0 Td
(treatment)Tj
-33.681 -1.304 Td
(and)Tj
1.7291 0 Td
(outcomes.)Tj
4.3143 0 Td
(If)Tj
0.8447 0 Td
(any)Tj
1.6611 0 Td
(information)Tj
5.074 0 Td
(was)Tj
1.7007 0 Td
(not)Tj
1.5704 0 Td
(available)Tj
3.668 0 Td
(in)Tj
1.0375 0 Td
(the)Tj
1.4684 0 Td
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5.3631 0 Td
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2.6135 0 Td
(it)Tj
0.7824 0 Td
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1.7007 0 Td
(collected)Tj
-33.5279 -1.2982 Td
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1.1792 0 Td
(reviewing)Tj
4.1272 0 Td
(patients')Tj
3.5829 0 Td
(medical)Tj
3.3619 0 Td
(charts)Tj
2.6362 0 Td
(and)Tj
1.7291 0 Td
(medical)Tj
3.3619 0 Td
(records,)Tj
3.4299 0 Td
(and)Tj
1.7291 0 Td
(by)Tj
1.1849 0 Td
(contacting)Tj
4.4334 0 Td
(patients)Tj
3.3675 0 Td
(or)Tj
1.0998 0 Td
(their)Tj
-35.223 -1.2983 Td
(family)Tj
2.7269 0 Td
(members)Tj
3.9458 0 Td
(by)Tj
1.1848 0 Td
(telephone)Tj
4.1329 0 Td
(after)Tj
2.0353 0 Td
(discharge.)Tj
4.2463 0 Td
(CRP)Tj
2.0636 0 Td
(and)Tj
1.7291 0 Td
(PCT)Tj
2.0579 0 Td
(levels)Tj
2.3755 0 Td
(were)Tj
2.1203 0 Td
(obtained)Tj
3.7303 0 Td
(in)Tj
1.0375 0 Td
(the)Tj
1.4683 0 Td
(first)Tj
-34.8545 -1.3039 Td
(blood)Tj
2.5114 0 Td
(sample.)Tj
-1.3152 -1.2983 Td
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3.2825 0 Td
(was)Tj
1.6951 0 Td
(defined)Tj
3.2258 0 Td
(as)Tj
1.0148 0 Td
(a)Tj
0.6576 0 Td
(body)Tj
2.2167 0 Td
(mass)Tj
2.194 0 Td
(index)Tj
2.4548 0 Td
(of)Tj
1.0148 0 Td
(over)Tj
1.9729 0 Td
(30)Tj
1.1735 0 Td
(Kg/m)Tj
ET
Q
q
1 j
1 J
0 w
7.4999 0 0 6.6659 443.8488 256.422 cm
BT
/F8 1 Tf
1 TL
-0.0053 Tc
0 0 Td
(2)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 447.4204 252 cm
BT
/F8 1 Tf
1 TL
-0.004 Tc
0 0 Td
(.)Tj
0.4478 0 Td
(Immunosuppression)Tj
8.5436 0 Td
(included)Tj
-33.732 -1.2982 Td
(immunoglobulin)Tj
7.0242 0 Td
(deficiency,)Tj
4.4901 0 Td
(current)Tj
3.1861 0 Td
(therapy)Tj
3.2485 0 Td
(associated)Tj
4.2576 0 Td
(with)Tj
1.9956 0 Td
(neoplasia,)Tj
4.1838 0 Td
(transplant,)Tj
4.5014 0 Td
(human)Tj
-32.8873 -1.3039 Td
(immunodeficiency)Tj
7.7556 0 Td
(virus)Tj
2.1996 0 Td
(infection/AIDS,)Tj
6.5877 0 Td
(or)Tj
1.0942 0 Td
(chronic)Tj
3.2881 0 Td
(treatment)Tj
4.1385 0 Td
(with)Tj
1.9956 0 Td
(oral)Tj
1.7801 0 Td
(corticosteroids)Tj
6.1342 0 Td
(\()Tj
/F12 1 Tf
0 Tc
()Tj
/F8 1 Tf
-0.004 Tc
(20)Tj
-34.9736 -1.2983 Td
(mg)Tj
1.5024 0 Td
(prednisone/day\).)Tj
7.0298 0 Td
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1.7802 0 Td
(date)Tj
1.9049 0 Td
(of)Tj
1.0148 0 Td
(influenza)Tj
3.9174 0 Td
(vaccination)Tj
4.8246 0 Td
(was)Tj
1.7007 0 Td
(obtained)Tj
3.7303 0 Td
(from)Tj
2.2053 0 Td
(the)Tj
1.474 0 Td
(medical)Tj
3.3619 0 Td
(record)Tj
-34.4463 -1.2983 Td
(or)Tj
1.0942 0 Td
(by)Tj
1.1849 0 Td
(phone.)Tj
-1.0829 -1.3039 Td
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4.3767 0 Td
(of)Tj
1.0148 0 Td
(CAP)Tj
2.126 0 Td
(was)Tj
1.6951 0 Td
(based)Tj
2.4774 0 Td
(on)Tj
1.2699 0 Td
(current)Tj
3.1862 0 Td
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4.2066 0 Td
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3.2257 0 Td
(Society)Tj
3.067 0 Td
(of)Tj
1.0148 0 Td
(America)Tj
3.6454 0 Td
(\(IDSA\)/)Tj
-32.5018 -1.2982 Td
(American)Tj
4.1896 0 Td
(Thoracic)Tj
3.7871 0 Td
(Society)Tj
3.067 0 Td
(\(ATS\))Tj
2.6702 0 Td
(guidelines,)Tj
4.5071 0 Td
(and)Tj
1.7291 0 Td
(pneumonia)Tj
4.8131 0 Td
(severity)Tj
3.2769 0 Td
(was)Tj
1.6951 0 Td
(assessed)Tj
3.4752 0 Td
(using)Tj
2.3868 0 Td
(the)Tj
-35.5972 -1.2983 Td
(PSI)Tj
1.5931 0 Td
(and)Tj
1.7291 0 Td
(CURB65)Tj
3.7757 0 Td
(scores.)Tj
-5.9017 -1.2983 Td
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2.795 0 Td
(disease)Tj
3.016 0 Td
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1.7008 0 Td
(defined)Tj
3.2258 0 Td
(as)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(presence)Tj
3.7134 0 Td
(at)Tj
0.9524 0 Td
(least)Tj
1.9843 0 Td
(of)Tj
1.0148 0 Td
(one)Tj
1.6951 0 Td
(of)Tj
1.0147 0 Td
(the)Tj
1.474 0 Td
(following)Tj
3.9798 0 Td
(variables:)Tj
3.9401 0 Td
(multilo-)Tj
-34.1855 -1.3039 Td
(bar)Tj
1.5307 0 Td
(or)Tj
1.0999 0 Td
(bilateral)Tj
3.4469 0 Td
(pneumonia,)Tj
5.0399 0 Td
(septic)Tj
2.5115 0 Td
(shock,)Tj
2.7609 0 Td
(ICU)Tj
1.9559 0 Td
(stay,)Tj
1.9956 0 Td
(need)Tj
2.143 0 Td
(for)Tj
1.3833 0 Td
(invasive)Tj
3.4298 0 Td
(mechanical)Tj
4.7678 0 Td
(ventilation)Tj
-32.0652 -1.2983 Td
(\(IMV\),)Tj
3.0501 0 Td
(acute)Tj
2.33 0 Td
(respiratory)Tj
4.5978 0 Td
(distress)Tj
3.1861 0 Td
(syndrome)Tj
4.235 0 Td
(\(ARDS\))Tj
3.4185 0 Td
(and)Tj
1.7291 0 Td
(intra-hospital)Tj
5.6522 0 Td
(death.)Tj
2.6532 0 Td
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-30.852 -1.2982 Td
(complication)Tj
5.4765 0 Td
(was)Tj
1.7008 0 Td
(defined)Tj
3.2258 0 Td
(as)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(presence)Tj
3.7134 0 Td
(of)Tj
1.0148 0 Td
(one)Tj
1.7008 0 Td
(or)Tj
1.0941 0 Td
(more)Tj
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