Influenza A virus H1N1 associated pneumonia - acute and late aspects evaluated with tomography high resolution in hospitalized patients

  • Cristina Asvolinsque Pantaleão Fontes | cfontes@id.uff.br Radiology Service, Department of Radiology, Faculty of Medicine, Antônio Pedro University Hospital, Federal Fluminense University, Niterói , Brazil. https://orcid.org/0000-0002-9668-5387
  • Alair Augusto Sarmet Moreira Damas dos Santos Radiology Service, Department of Radiology, Faculty of Medicine, Antônio Pedro University Hospital, Federal Fluminense University; Imaging Center of the Complex Hospital of Niterói, Brazil.
  • Solange Artimos de Oliveira Department of Clinical Medicine, Faculty of Medicine, Antônio Pedro University Hospital, Federal Fluminense University, Niterói , Brazil.
  • Miquel Abdon Aidê Department of Clinical Medicine, Faculty of Medicine, Antônio Pedro University Hospital, Federal Fluminense University, Niterói , Brazil.

Abstract

Background: Influenza A (H1N1) virus often compromises the respiratory tract, leading to pneumonia, which is the principal cause of death in these patients. The purpose of this study was to review the acute and late phase pulmonary findings in influenza A(H1N1) associated pneumonia using high resolution computed tomography (HRCT), and to determine the importance of performing end expiration series. 
Methods: Between July and August 2009, 140 patients presented with influenza A (H1N1) confirmed by real-timepolymerase chain reaction. Out of these, 27 patients underwent HRCT in the acute and late phases of pneumonia, allowing for a comparative study. Late phase exams were performed due to clinical worsening and up to 120 days later in patients with persistent complaints of dyspnea.
Results: Ground glass opacities, consolidations, and the combination of both were associated with the acute phase, whereas persistence or worsening of the lesions, lesion improvement, and air trapping in the end expiration series (as seen using HRCT, n=6) were observed in the late phase.
Conclusions: In the HRCT end expiration series, air trapping was found in the late phase of H1N1 associated pneumonia. Generally, these exams are not evaluated in research articles, and air trapping has not previously been studied using the end expiration series. Our study brings more scientific knowledge about aspects of pulmonary involvement by influenza A (H1N1), through evaluation with end expiration series, which makes the CT exam dynamic, translating the respiratory movement, and showing bronchial alteration.

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Published
2020-09-30
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Original Research Articles
Keywords:
Influenza A(H1N1), viral pneumonia, HRCT, HRCT end expiration, air trapping, small distal airways
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How to Cite
Asvolinsque Pantaleão Fontes, C., Sarmet Moreira Damas dos Santos, A. A., Artimos de Oliveira, S., & Abdon Aidê, M. (2020). Influenza A virus H1N1 associated pneumonia - acute and late aspects evaluated with tomography high resolution in hospitalized patients. Multidisciplinary Respiratory Medicine, 15. https://doi.org/10.4081/mrm.2020.692