Remember when there was talk about how SARS might disproportionately hit Chinese in comparison to other populations? Here’s a new paper on how Swine Flu may progress in different populations, Clinical Findings and Demographic Factors Associated With ICU Admission in Utah Due to Novel 2009 Influenza A(H1N1) Infection:
The ICU cohort of 47 influenza patients had a median age of 34 years, Acute Physiology and Chronic Health Evaluation II score of 21, and BMI of 35 kg/m2. Mortality was 17% (8/47). All eight deaths occurred among the 64% of patients (n = 30) with ARDS, 26 (87%) of whom also developed multiorgan failure. Compared with the Salt Lake County population, patients with novel A(H1N1) were more likely to be obese (22% vs 74%; P < .001), medically uninsured (14% vs 45%; P < .001), and Hispanic (13% vs 23%; P < .01) or Pacific Islander (1% vs 26%; P < .001). Observed ICU admissions were 15-fold greater than expected for those with BMI ≥ 40 kg/m2 (standardized morbidity ratio 15.8, 95% CI, 8.3-23.4) and 1.5-fold greater than expected among those with BMI of 30 to 39 kg/m2 for age-adjusted and sex-adjusted rates for Salt Lake County.
Remember that these are 47 intensive care patients, the most extreme cases. Here’s a table with N’s & odds ratios:
I’m struck by the Pacific Islander results. Obviously there are some confounds here, Pacific Islanders are heavier and have lower socioeconomic status from what I know. But the odds ratio is so high. Unfortunately I don’t see the obesity levels of the Pacific Islanders broken out, rather, they controlled for ethnicity by looking only at the white population (and obesity, smoking, etc., still mattered). I wonder how much more susceptible groups from low density or isolated societies, like Pacific Islanders, are to endemic infectious diseases.
Citation: doi: 10.1378/chest.09-2517, CHEST April 2010 vol. 137 no. 4 752-758
