Clinical characteristics and outcomes during a severe influenza season in China during 2017-2018

Xiaofang Fu, Yuqing Zhou, Jie Wu, Xiaoxiao Liu, Cheng Ding, Chenyang Huang, Shufa Zheng, Dhanasekaran Vijaykrishna, Yu Chen, Lanjuan Li, Shigui Yang

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8 Citations (Scopus)


Background: A severe seasonal influenza epidemic was observed during 2017-2018 in China, prompting questions on clinical characteristics and outcomes of severe cases with influenza. Methods: We retrospectively collected clinical data and outcomes of laboratory-confirmed hospitalized patients (severe to critical) during Jan-2011 to Feb-2018 from five hospitals, followed by a systematic analysis of cases from 2017 to 2018 (n = 289) and all previous epidemics during 2011-2017 (n = 169). Results: In-hospital fatality was over 5-folds higher during the 2017-2018 (p < 0.01) in which 19 patients died (6.6%), whereas only 2 mortalities (1.2%) were observed during 2011-2017. Of the 289 hospitalized in 2017-2018, 153 were confirmed with influenza B virus, 110 with A/H1N1pdm09, and 26 A/H3N2, whereas A/H1N1pdm09 was the predominant cause of hospitalization in previous seasons combined (45%). Fatal cases in 2017-2018 were exclusively associated with either influenza B or A/H1N1pdm09. Our results show that a significant lower proportion of patients aged 14 or greater were treated with oseltamivir, during the 2017-2018 epidemic, and exhibited higher levels of clinical severity. Conclusions: In-hospital fatality rate might be significantly higher in the 2017-2018 season in China. A sufficient supply of oseltamivir and antiviral therapy within 48 h from onset could reduce fatality rates.

Original languageEnglish
Article number668
Number of pages10
JournalBMC Infectious Diseases
Issue number1
Publication statusPublished - 29 Jul 2019


  • Antiviral therapy
  • Clinical characteristics
  • In-hospital fatality rates
  • Subtype
  • The 2017-2018 influenza

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