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Clinical and Laboratory Findings of Hospitalized Patients with Influenza in Hospitals of Golestan Province
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Bahman Aghcheli1    , Hila Moazzez2 , Alijan Tabarraei3 , Alireza Tahamtan *4 |
1- Assistant Professor of Medical Virology, Infectious Diseases Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.
2- General Physician, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
3- Professor of Medical Virology, School of Medicine, Department of Microbiology, Golestan University of Medical Sciences, Gorgan, Iran.
4- Associate Professor of Medical Virology, Infectious Diseases Research Center, School of Medicine, Department of Microbiology, Golestan University of Medical Sciences, Gorgan, Iran. , alireza.tmn@gmail.com |
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Keywords: Influenza, Human [MeSH], Respiration Disorders [MeSH], Iran [MeSH]
Article ID: Vol27-30 |
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Full-Text [PDF 437 kb]
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Type of Study: Letter to Editor |
Subject:
Health System
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Abstract: (9 Views) |
Extended Abstract
Letter to the Editor
The influenza virus, which has long been associated with humanity, annually causes seasonal epidemics and occasional global pandemics. This highly contagious respiratory virus has four types: A, B, C, and D, and is primarily transmitted via respiratory droplets. Among these, types A and B pose the most significant threat to public health. Influenza A virus, recognized as the most dangerous type, is known for its ability to cause a range of respiratory symptoms from mild to severe, as well as serious complications, such as pneumonia, respiratory failure, and myocarditis. The historical 1918 pandemic, with 50-100 million victims, and the 2009 (H1N1) pandemic, resulting in 100-400 thousand fatalities, attest to the devastating power of this virus. High-risk groups include the elderly, children, pregnant women, and individuals with underlying medical conditions, who collectively account for 10% of hospitalizations and 3% of deaths. Typical symptoms involve fever, cough, sore throat, and myalgia, and can lead to serious complications, such as acute respiratory distress syndrome (ARDS) and the exacerbation of chronic diseases. Influenza is characterized by the involvement of both the upper and lower respiratory tracts, accompanied by systemic symptoms like fever, headache, and myalgia.
In this cross-sectional retrospective study, conducted during 2021 on 993 samples collected from hospitalized patients (546 males and 447 females) with suspected acute viral respiratory infection in hospitals of Golestan Province, Iran, the clinical and laboratory findings of patients with influenza were evaluated. The study was approved by the Research Ethics Committee of Golestan University of Medical Sciences (IR.GOUMS.REC.1401.383). The samples were sent to the provincial molecular diagnostics laboratory for real-time polymerase chain reaction (PCR) molecular testing. All samples had also been tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Test results, along with demographic, clinical, and laboratory data, were collected using a standard questionnaire and analyzed with the statistical software SPSS-22.
Of the 993 samples tested for influenza, 174 were reported as positive. All but one of these positive cases were influenza A. From 993 tests for SARS-CoV-2, 271 cases were also reported as positive. Additionally, 11 patients had influenza and SARS-CoV-2 co-infection. The mean age of influenza patients hospitalized in the intensive care unit (ICU) was determined to be 55.60±15.11 years, while in other wards, it was 37.51±12.1 years (P<0.05). Regarding gender, the ICU-hospitalized male-to-female ratio was 3 times and 1.35 times in other wards (P<0.031). In ICU-hospitalized patients, the highest percentage of clinical symptoms belonged to fever, cough, chills, and anorexia, and in patients hospitalized in other wards, the highest percentage belonged to fever, followed by cough, chest pain, and chills. There was a statistically significant difference between ICU-hospitalized patients and those hospitalized in other wards for symptoms, such as anorexia, arthralgia, myalgia, sore throat, cough, nausea, headache, and chills (P<0.05). Blood factors, such as white blood cell (WBC) count, neutrophil and lymphocyte percentages, hemoglobin, erythrocyte sedimentation rate (ESR), and platelets, were evaluated, and no statistically significant difference was observed between the two patient groups. Biochemical factors, including blood urea nitrogen (BUN), creatinine, sodium, potassium, liver enzymes, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), creatine phosphokinase (CPK), and direct and indirect bilirubin, were also examined, and no significant difference was found between the two patient groups. Additionally, other factors, such as oxygen and carbon dioxide saturation percentages, bicarbonate, and blood pH, were assessed, and a statistically significant difference was found between the two groups for oxygen and carbon dioxide saturation percentages (P<0.05).
Based on the findings of this study, age and gender are effective factors in the severity of influenza. Men and older adults were at particular risk for ICU hospitalization. The high prevalence of influenza A and cases of SARS-CoV-2 co-infection also highlight the importance of accurate diagnosis and appropriate treatment. Given the increased risk of infection and disease severity among the elderly, implementing preventive programs, such as annual influenza and coronavirus disease 2019 (COVID-19) vaccination, is essential for this group. Additionally, attention to laboratory findings like blood oxygen levels can be effective in the early identification of high-risk patients.
Authors' Contributions
Bahman Aghcheli (Ph.D): Project administration and design, Project execution, Data collection, Data analysis, Interpretation of the results, Drafting of the initial manuscript, Approval of the final manuscript.
Hila Moazzez (M.D)
Project administration and design, Project execution, Data collection, Data analysis, Interpretation of the results, Drafting of the initial manuscript, Approval of the final manuscript.
Alijan Tabarraei (Ph.D)
Project administration and design, Project execution, Data collection, Data analysis, Interpretation of the results, Drafting of the initial manuscript, Approval of the final manuscript.
Alireza Tahamtan (Ph.D)
Project administration and design, Project execution, Data collection, Data analysis, Interpretation of the results, Drafting of the initial manuscript, Approval of the final manuscript.
Key Messgae: Age and gender are considered effective factors in the severity of influenza, and the implementation of preventive programs, such as annual influenza and COVID-19 vaccinations, is essential for elderly men. Furthermore, blood oxygen level assessment can be effective in the early identification of high-risk patients.
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| References |
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Aghcheli B, Moazzez H, Tabarraei A, Tahamtan A. Clinical and Laboratory Findings of Hospitalized Patients with Influenza in Hospitals of Golestan Province. J Gorgan Univ Med Sci 2025; 27 (3) :87-90 URL: http://goums.ac.ir/journal/article-1-4614-en.html
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