Conventional blood tests in predicting influenza A (H1N1) rapidly.

Abstract

PURPOSE:

Although real-time reverse transcriptase-polymerase chain reactions (rRT-PCR) are gold standard for the diagnosis of influenza A (H1N1), the results can be delayed up to several days, which is problematic during a pandemic. Because of this limitation of rRT-PCR, clinicians have often had to set a treatment plan that was solely based on clinical suspicion. We investigated the hematological and biochemical factors that are associated with rRT-PCR results, in order to help clinicians deal with acute febrile patients during influenza pandemics.

METHODS:

We conducted a retrospective, cross-sectional study of 465 emergency department patients who underwent both rRT-PCR and blood tests at the same time. Hematological and biochemical findings were compared between the rRT-PCR-positive group and rRT-PCR-negative group.

RESULTS:

Levels of leukocytes, hemoglobin, platelets, blood urea nitrogen (BUN), total bilirubin, lactate dehydrogenase, serum glucose, C-reactive protein (CRP), and procalcitonin were significantly different between the two groups in the univariate analyses. In the multivariate analyses, leukocyte counts ≤ 10.8 (× 10(9))/L [odd ratio (OR) = 8.2, sensitivity = 93.7%, NPV = 85.3%], BUN levels ≤ 7.1 μmol/L (OR = 3.0, sensitivity = 93.7%, NPV = 85.3%), and CRP levels ≤ 60 mg/L (OR = 2.4, sensitivity = 93.7%, NPV = 85.3%) were independently associated with positive rRT-PCR results.

CONCLUSIONS:

Leukocyte counts, BUN levels and CRP levels were important predictors of rRT-PCR-positive results for 2009 influenza A (H1N1) in adults.

• Authors: Dong Hyuk Shin, Sang Kuk Han, Pil Cho Choi, Hee-Yeon Woo
• Journal: Scandinavian journal of clinical and laboratory investigation (Scand J Clin Lab Invest) Vol. 72 Issue 3 Pg. 197-203 (May 2012) ISSN: 1502-7686 [Electronic] England
• PMID: 22149383 (Publication Type: Journal Article)

Chemical References

• C-Reactive Protein

Topics

• Adolescent
• Adult
• Blood Urea Nitrogen
• C-Reactive Protein (analysis)
• Cross-Sectional Studies
• Female
• Fever (blood, etiology)
• Humans
• Influenza A Virus, H1N1 Subtype
• Influenza, Human (blood, diagnosis)
• Leukocyte Count
• Male
• Middle Aged
• Pandemics
• Retrospective Studies
• Reverse Transcriptase Polymerase Chain Reaction
• Sensitivity and Specificity