单位:[1]Capital Med Univ, Xuanwu Hosp, Beijing, Peoples R China首都医科大学宣武医院[2]Capital Med Univ, Natl Clin Res Ctr Resp Dis, China Japan Friendship Hosp, Dept Pulm & Crit Care Med,Ctr Resp Dis, Beijing, Peoples R China[3]Capital Med Univ, Dept Resp Med, Beijing, Peoples R China[4]Peking Union Med Coll, Chinese Acad Med Sci, Beijing, Peoples R China[5]Soochow Univ, Affiliated Hosp 1, Dept Resp Emergency & Crit Care Med, Suzhou, Peoples R China[6]Fifth Peoples Hosp Suzhou, Suzhou, Peoples R China[7]Suzhou Municipal Hosp, Intens Care Unit, Suzhou, Peoples R China[8]Wuxi Peoples Hosp, Intens Care Unit, Wuxi, Peoples R China[9]Taizhou Peoples Hosp, Intens Care Unit, Taizhou, Peoples R China[10]Nanchang Univ, Affiliated Hosp 1, Nanchang, Jiangxi, Peoples R China[11]Soochow Univ, First Peoples Hosp Changzhou, Affiliated Hosp 1, Dept Crit Care Med, Changzhou, Peoples R China[12]Wenzhou Med Univ, Affiliated Hosp 1, Dept Pulm & Crit Care Med, Wenzhou, Peoples R China[13]Shenzhen Third Peoples Hosp, Infect Dis Dept, Shenzhen, Peoples R China[14]Wuhan Med Treatment Ctr Hosp, Intens Care Unit, Wuhan, Hubei, Peoples R China[15]Anhui Med Univ, Affiliated Hosp 2, Dept Resp Med, Hefei, Anhui, Peoples R China[16]Anhui 2 Prov Peoples Hosp, Intens Care Unit, Hefei, Anhui, Peoples R China[17]Binhu Hosp Hefei, Intens Care Unit, Hefei, Anhui, Peoples R China[18]Second Peoples Hosp Hefei, Dept Crit Care Med, Hefei, Anhui, Peoples R China[19]Henan Prov Peoples Hosp, Infect Dis Dept, Zhengzhou, Henan, Peoples R China[20]Suining Cent Hosp, Ctr Resp Dis, Suining, Peoples R China[21]Southeast Univ, Zhongda Hosp, Dept Crit Care Med, Nanjing, Jiangsu, Peoples R China[22]Nantong Univ, Affiliated Hosp, Intens Care Unit, Nantong, Peoples R China[23]Nanjing Med Univ, Huaian Peoples Hosp 1, Dept Pulm & Crit Care Med, Huaian, Peoples R China江苏省人民医院[24]Jieyang Peoples Hosp, Intens Care Unit, Jieyang, Peoples R China[25]Lishui Municipal Cent Hosp, Lishui, Peoples R China[26]Suichang Cty Peoples Hosp, Dept Resp Med, Lishui, Peoples R China[27]Guangzhou 8 Peoples Hosp, Intens Care Unit, Guangzhou, Guangdong, Peoples R China[28]Yancheng First Peoples Hosp, Yancheng, Peoples R China[29]Dongguan Peoples Hosp, Intens Care Unit, Dongguan, Peoples R China[30]Yijishan Hosp, Wannan Med Coll, Affiliated Hosp 1, Intens Care Unit, Wuhu, Peoples R China[31]Anqing Municipal Hosp, Dept Resp Med, Anqing, Peoples R China[32]Cent S Univ, Xiangya Hosp 2, Dept Pulm & Crit Care Med, Changsha, Hunan, Peoples R China[33]China Med Univ, Hosp 1, Infect Dis Dept, Shenyang, Liaoning, Peoples R China[34]Fuzhou Pulm Hosp Fujian, Dept Pulm & Crit Care Med, Fuzhou, Fujian, Peoples R China[35]Bozhou Peoples Hosp, Bozhou, Peoples R China[36]Gen Hosp, Wanbei Coal Elect Grp, Infect Dis Dept, Suzhou, Peoples R China[37]Zhaoqing First Peoples Hosp, Infect Dis Dept, Zhaoqing, Peoples R China[38]Xiaolan Peoples Hosp Zhongshan, Dept Crit Care Med, Zhongshan, Peoples R China[39]Putian Municipal Hosp, Infect Dis Dept, Putian, Peoples R China[40]First Peoples Hosp Xiangtan City, Intens Care Unit, Xiangtan, Peoples R China[41]Luan Peoples Hosp, Infect Dis Dept, Luan, Peoples R China[42]Yunnan Prov Infect Dis Hosp, Kunming, Yunnan, Peoples R China[43]Wenzhou Med Univ, Yueqing Peoples Hosp 1, Dept Crit Care Med, Yueqing, Peoples R China[44]Beilun Dist Peoples Hosp, Dept Resp Med, Ruian, Peoples R China[45]Ningbo First Hosp, Dept Resp Med, Ningbo, Zhejiang, Peoples R China[46]Wenzhou Med Univ, Affiliated Hosp 3, Ruian, Peoples R China[47]Huzhou Cent Hosp, Dept Resp Med, Huzhou, Peoples R China[48]Ctr Dis Control & Prevent, Natl Ctr Immunizat & Resp Dis, Influenza Div, Atlanta, GA USA
Background. Data are limited on the impact of neuraminidase inhibitor (NAI) treatment on avian influenza A(H7N9) virus RNA shedding. Methods. In this multicenter, retrospective study, data were collected from adults hospitalized with A(H7N9) infection during 2013-2017 in China. We compared clinical features and A(H7N9) shedding among patients with different NAI doses and combination therapies and evaluated factors associated with A(H7N9) shedding, using Cox proportional hazards regression. Results. Among 478 patients, the median age was 56 years, 71% were male, and 37% died. The median time from illness onset to NAI treatment initiation was 8 days (interquartile range [IQR], 6-10 days), and the median duration of A(H7N9) RNA detection from onset was 15.5 days (IQR, 12-20 days). A(H7N9) RNA shedding was shorter in survivors than in patients who died (P < .001). Corticosteroid administration (hazard ratio [HR], 0.62 [95% confidence interval {CI},.50-.77]) and delayed NAI treatment (HR, 0.90 [95% CI,.91-.96]) were independent risk factors for prolonged A(H7N9) shedding. There was no significant difference in A(H7N9) shedding duration between NAI combination treatment and monotherapy (P = .65) or between standard-dose and double-dose oseltamivir treatment (P = .70). Conclusions. Corticosteroid therapy and delayed NAI treatment were associated with prolonged A(H7N9) RNA shedding. NAI combination therapy and double-dose oseltamivir treatment were not associated with a reduced A(H7N9) shedding duration as compared to standard-dose oseltamivir.
基金:
National Science Fund for Distinguished Young ScholarsNational Natural Science Foundation of China (NSFC)National Science Fund for Distinguished Young Scholars [81425001/H0104]; National Science and Technology Emergency Project [10600100000015001206]; National Key Technology Support Program from Ministry of Science and Technology [2015BAI12B11]
第一作者单位:[1]Capital Med Univ, Xuanwu Hosp, Beijing, Peoples R China[2]Capital Med Univ, Natl Clin Res Ctr Resp Dis, China Japan Friendship Hosp, Dept Pulm & Crit Care Med,Ctr Resp Dis, Beijing, Peoples R China[3]Capital Med Univ, Dept Resp Med, Beijing, Peoples R China
通讯作者:
通讯机构:[2]Capital Med Univ, Natl Clin Res Ctr Resp Dis, China Japan Friendship Hosp, Dept Pulm & Crit Care Med,Ctr Resp Dis, Beijing, Peoples R China[3]Capital Med Univ, Dept Resp Med, Beijing, Peoples R China
推荐引用方式(GB/T 7714):
Wang Yeming,Guo Qiang,Yan Zheng,et al.Factors Associated With Prolonged Viral Shedding in Patients With Avian Influenza A(H7N9) Virus Infection[J].JOURNAL of INFECTIOUS DISEASES.2018,217(11):1708-1717.doi:10.1093/infdis/jiy115.
APA:
Wang, Yeming,Guo, Qiang,Yan, Zheng,Zhou, Daming,Zhang, Wei...&Cao, Bin.(2018).Factors Associated With Prolonged Viral Shedding in Patients With Avian Influenza A(H7N9) Virus Infection.JOURNAL of INFECTIOUS DISEASES,217,(11)
MLA:
Wang, Yeming,et al."Factors Associated With Prolonged Viral Shedding in Patients With Avian Influenza A(H7N9) Virus Infection".JOURNAL of INFECTIOUS DISEASES 217..11(2018):1708-1717