Lymphocytopenia as a marker for pandemic influenza A/H1N1 2009 virus infection in children
Lymphocytopenia has been reported in adults with pandemic influenza A/H1N1 2009 infection, but data in children are inconclusive. Data from 76 children presented with flu‐like symptoms between July and November 2009 and tested for pandemic influenza A/H1N1 2009 virus and white blood cell (WBC) count...
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| Veröffentlicht in: | Journal of medical virology 2011-01, Vol.83 (1), p.1-4 |
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| creator | Chiappini, Elena Galli, Luisa Azzi, Alberta Resti, Massimo Bonsignori, Francesca de Martino, Maurizio |
| description | Lymphocytopenia has been reported in adults with pandemic influenza A/H1N1 2009 infection, but data in children are inconclusive. Data from 76 children presented with flu‐like symptoms between July and November 2009 and tested for pandemic influenza A/H1N1 2009 virus and white blood cell (WBC) counts were analyzed. Samples from 37 (48.7%) children resulted in a positive PCR assay for pandemic influenza A/H1N1 2009 virus. When comparing data from these children with data from 39 (51.3%) children with uncomplicated flu‐like illness and negative PCR assay for pandemic influenza A/H1N1 2009 virus, no difference in disease duration, median age, red blood cell count, hemoglobin concentration, C reactive protein concentration, and absolute neutrophil count was observed, whereas significant differences were apparent when considering WBC count, relative and absolute lymphocyte count, absolute lymphocyte count z‐score, and platelet count. Receiver operating characteristic curve analysis revealed that the best absolute lymphocyte count and absolute lymphocyte count z‐score cut‐points that simultaneously maximized sensitivity and specificity were 2,256 cells/µl and −0.89, respectively, sensitivity being 0.81 (95% CI: 0.68-0.94), specificity 0.87 (95% CI: 0.77-0.98), positive predictive value 0.85 (95% CI: 0.74-0.97), and negative predictive value 0.83 (95% CI: 0.71-0.94). In conclusion, lymphocytopenia is a marker for influenza A/H1N1 2009 virus infection in children. Absolute lymphocyte count |
| doi_str_mv | 10.1002/jmv.21930 |
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Data from 76 children presented with flu‐like symptoms between July and November 2009 and tested for pandemic influenza A/H1N1 2009 virus and white blood cell (WBC) counts were analyzed. Samples from 37 (48.7%) children resulted in a positive PCR assay for pandemic influenza A/H1N1 2009 virus. When comparing data from these children with data from 39 (51.3%) children with uncomplicated flu‐like illness and negative PCR assay for pandemic influenza A/H1N1 2009 virus, no difference in disease duration, median age, red blood cell count, hemoglobin concentration, C reactive protein concentration, and absolute neutrophil count was observed, whereas significant differences were apparent when considering WBC count, relative and absolute lymphocyte count, absolute lymphocyte count z‐score, and platelet count. Receiver operating characteristic curve analysis revealed that the best absolute lymphocyte count and absolute lymphocyte count z‐score cut‐points that simultaneously maximized sensitivity and specificity were 2,256 cells/µl and −0.89, respectively, sensitivity being 0.81 (95% CI: 0.68-0.94), specificity 0.87 (95% CI: 0.77-0.98), positive predictive value 0.85 (95% CI: 0.74-0.97), and negative predictive value 0.83 (95% CI: 0.71-0.94). In conclusion, lymphocytopenia is a marker for influenza A/H1N1 2009 virus infection in children. Absolute lymphocyte count <2,556 cells/µl or absolute lymphocyte count z‐score < −0.89 may be useful cut‐offs to discriminate against children at higher risk of infection during epidemics. Considering that the pandemic virus is highly likely to continue to circulate in the coming winter season, these findings provide direct and practical implications for the near future. J. Med. Virol. 83:1-4, 2011.</description><identifier>ISSN: 0146-6615</identifier><identifier>EISSN: 1096-9071</identifier><identifier>DOI: 10.1002/jmv.21930</identifier><identifier>PMID: 21108332</identifier><identifier>CODEN: JMVIDB</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Adolescent ; Biological and medical sciences ; Biomarkers ; Child ; Child, Preschool ; children ; Female ; Fundamental and applied biological sciences. Psychology ; Human viral diseases ; Humans ; Infant ; Infectious diseases ; influenza A (H1N1) ; Influenza A Virus, H1N1 Subtype - isolation & purification ; Influenza A Virus, H1N1 Subtype - pathogenicity ; Influenza, Human - diagnosis ; Influenza, Human - immunology ; Influenza, Human - pathology ; Influenza, Human - virology ; Leukocyte Count ; lymphocytopenia ; Lymphopenia - diagnosis ; Male ; Medical sciences ; Microbiology ; Miscellaneous ; Predictive Value of Tests ; Reverse Transcriptase Polymerase Chain Reaction ; RNA, Viral - genetics ; ROC Curve ; Sensitivity and Specificity ; Viral diseases ; Virology</subject><ispartof>Journal of medical virology, 2011-01, Vol.83 (1), p.1-4</ispartof><rights>Copyright © 2010 Wiley‐Liss, Inc.</rights><rights>2015 INIST-CNRS</rights><rights>2010 Wiley-Liss, Inc.</rights><rights>Copyright © 2010 Wiley-Liss, Inc.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c6120-af221b90a2e2240ae8a57447260fa9c5277c166c0375ea009ea29cb5eb2930e03</citedby><cites>FETCH-LOGICAL-c6120-af221b90a2e2240ae8a57447260fa9c5277c166c0375ea009ea29cb5eb2930e03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjmv.21930$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjmv.21930$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23784245$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21108332$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-00599789$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Chiappini, Elena</creatorcontrib><creatorcontrib>Galli, Luisa</creatorcontrib><creatorcontrib>Azzi, Alberta</creatorcontrib><creatorcontrib>Resti, Massimo</creatorcontrib><creatorcontrib>Bonsignori, Francesca</creatorcontrib><creatorcontrib>de Martino, Maurizio</creatorcontrib><title>Lymphocytopenia as a marker for pandemic influenza A/H1N1 2009 virus infection in children</title><title>Journal of medical virology</title><addtitle>J. Med. Virol</addtitle><description>Lymphocytopenia has been reported in adults with pandemic influenza A/H1N1 2009 infection, but data in children are inconclusive. Data from 76 children presented with flu‐like symptoms between July and November 2009 and tested for pandemic influenza A/H1N1 2009 virus and white blood cell (WBC) counts were analyzed. Samples from 37 (48.7%) children resulted in a positive PCR assay for pandemic influenza A/H1N1 2009 virus. When comparing data from these children with data from 39 (51.3%) children with uncomplicated flu‐like illness and negative PCR assay for pandemic influenza A/H1N1 2009 virus, no difference in disease duration, median age, red blood cell count, hemoglobin concentration, C reactive protein concentration, and absolute neutrophil count was observed, whereas significant differences were apparent when considering WBC count, relative and absolute lymphocyte count, absolute lymphocyte count z‐score, and platelet count. Receiver operating characteristic curve analysis revealed that the best absolute lymphocyte count and absolute lymphocyte count z‐score cut‐points that simultaneously maximized sensitivity and specificity were 2,256 cells/µl and −0.89, respectively, sensitivity being 0.81 (95% CI: 0.68-0.94), specificity 0.87 (95% CI: 0.77-0.98), positive predictive value 0.85 (95% CI: 0.74-0.97), and negative predictive value 0.83 (95% CI: 0.71-0.94). In conclusion, lymphocytopenia is a marker for influenza A/H1N1 2009 virus infection in children. Absolute lymphocyte count <2,556 cells/µl or absolute lymphocyte count z‐score < −0.89 may be useful cut‐offs to discriminate against children at higher risk of infection during epidemics. Considering that the pandemic virus is highly likely to continue to circulate in the coming winter season, these findings provide direct and practical implications for the near future. J. Med. Virol. 83:1-4, 2011.</description><subject>Adolescent</subject><subject>Biological and medical sciences</subject><subject>Biomarkers</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>children</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infant</subject><subject>Infectious diseases</subject><subject>influenza A (H1N1)</subject><subject>Influenza A Virus, H1N1 Subtype - isolation & purification</subject><subject>Influenza A Virus, H1N1 Subtype - pathogenicity</subject><subject>Influenza, Human - diagnosis</subject><subject>Influenza, Human - immunology</subject><subject>Influenza, Human - pathology</subject><subject>Influenza, Human - virology</subject><subject>Leukocyte Count</subject><subject>lymphocytopenia</subject><subject>Lymphopenia - diagnosis</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Microbiology</subject><subject>Miscellaneous</subject><subject>Predictive Value of Tests</subject><subject>Reverse Transcriptase Polymerase Chain Reaction</subject><subject>RNA, Viral - genetics</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><subject>Viral diseases</subject><subject>Virology</subject><issn>0146-6615</issn><issn>1096-9071</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90s1uEzEQAOAVAtFQOPACsBJCwGHbGa_tXR9DoQ0QChJtkbhYE8dLHPYn2NlAeHockqYSEpxs2Z89Mx4nyUOEIwRgx_NmdcRQ5XArGSAomSko8HYyAOQykxLFQXIvhDkAlIqxu8kBQ4Qyz9kg-TJeN4tZZ9bLbmFbRymFlNKG_Dfr06rz6YLaqW2cSV1b1b1tf1E6PB7hOaYMQKUr5_uw2bNm6bo2zlIzc_XU2_Z-cqeiOtgHu_EwuTx9fXEyysYfzt6cDMeZkcggo4oxnCggZhnjQLYkUXBeMAkVKSNYURiU0kBeCEsxpiWmzETYCYsVW8gPkxfbe2dU64V3Mfm17sjp0XCsN2sAQqmiVCuM9tnWLnz3vbdhqRsXjK1ram3XB10i5zLnsojy-X8lCgmI8aFlpE_-ovOu922sOSouoBRSsps0je9C8Lba54qgN23UsY36TxujfbS7sZ80drqX132L4OkOUDBUV55a48KNy4uSMy6iO966H662639H1G_fX12HzrYnXFjan_sT8UPo-CqF0J_Pz_TFq48vxbursT6N_vHWV9Rp-upjFpefGGAOqJDnvMx_A7M1x2g</recordid><startdate>201101</startdate><enddate>201101</enddate><creator>Chiappini, Elena</creator><creator>Galli, Luisa</creator><creator>Azzi, Alberta</creator><creator>Resti, Massimo</creator><creator>Bonsignori, Francesca</creator><creator>de Martino, Maurizio</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley</general><general>Wiley Subscription Services, Inc</general><general>Wiley-Blackwell</general><scope>FBQ</scope><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7TK</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>RC3</scope><scope>7T2</scope><scope>7T5</scope><scope>7U1</scope><scope>7U2</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope></search><sort><creationdate>201101</creationdate><title>Lymphocytopenia as a marker for pandemic influenza A/H1N1 2009 virus infection in children</title><author>Chiappini, Elena ; Galli, Luisa ; Azzi, Alberta ; Resti, Massimo ; Bonsignori, Francesca ; de Martino, Maurizio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c6120-af221b90a2e2240ae8a57447260fa9c5277c166c0375ea009ea29cb5eb2930e03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adolescent</topic><topic>Biological and medical sciences</topic><topic>Biomarkers</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>children</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infant</topic><topic>Infectious diseases</topic><topic>influenza A (H1N1)</topic><topic>Influenza A Virus, H1N1 Subtype - isolation & purification</topic><topic>Influenza A Virus, H1N1 Subtype - pathogenicity</topic><topic>Influenza, Human - diagnosis</topic><topic>Influenza, Human - immunology</topic><topic>Influenza, Human - pathology</topic><topic>Influenza, Human - virology</topic><topic>Leukocyte Count</topic><topic>lymphocytopenia</topic><topic>Lymphopenia - diagnosis</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Microbiology</topic><topic>Miscellaneous</topic><topic>Predictive Value of Tests</topic><topic>Reverse Transcriptase Polymerase Chain Reaction</topic><topic>RNA, Viral - genetics</topic><topic>ROC Curve</topic><topic>Sensitivity and Specificity</topic><topic>Viral diseases</topic><topic>Virology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chiappini, Elena</creatorcontrib><creatorcontrib>Galli, Luisa</creatorcontrib><creatorcontrib>Azzi, Alberta</creatorcontrib><creatorcontrib>Resti, Massimo</creatorcontrib><creatorcontrib>Bonsignori, Francesca</creatorcontrib><creatorcontrib>de Martino, Maurizio</creatorcontrib><collection>AGRIS</collection><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><jtitle>Journal of medical virology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chiappini, Elena</au><au>Galli, Luisa</au><au>Azzi, Alberta</au><au>Resti, Massimo</au><au>Bonsignori, Francesca</au><au>de Martino, Maurizio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lymphocytopenia as a marker for pandemic influenza A/H1N1 2009 virus infection in children</atitle><jtitle>Journal of medical virology</jtitle><addtitle>J. Med. Virol</addtitle><date>2011-01</date><risdate>2011</risdate><volume>83</volume><issue>1</issue><spage>1</spage><epage>4</epage><pages>1-4</pages><issn>0146-6615</issn><eissn>1096-9071</eissn><coden>JMVIDB</coden><abstract>Lymphocytopenia has been reported in adults with pandemic influenza A/H1N1 2009 infection, but data in children are inconclusive. Data from 76 children presented with flu‐like symptoms between July and November 2009 and tested for pandemic influenza A/H1N1 2009 virus and white blood cell (WBC) counts were analyzed. Samples from 37 (48.7%) children resulted in a positive PCR assay for pandemic influenza A/H1N1 2009 virus. When comparing data from these children with data from 39 (51.3%) children with uncomplicated flu‐like illness and negative PCR assay for pandemic influenza A/H1N1 2009 virus, no difference in disease duration, median age, red blood cell count, hemoglobin concentration, C reactive protein concentration, and absolute neutrophil count was observed, whereas significant differences were apparent when considering WBC count, relative and absolute lymphocyte count, absolute lymphocyte count z‐score, and platelet count. Receiver operating characteristic curve analysis revealed that the best absolute lymphocyte count and absolute lymphocyte count z‐score cut‐points that simultaneously maximized sensitivity and specificity were 2,256 cells/µl and −0.89, respectively, sensitivity being 0.81 (95% CI: 0.68-0.94), specificity 0.87 (95% CI: 0.77-0.98), positive predictive value 0.85 (95% CI: 0.74-0.97), and negative predictive value 0.83 (95% CI: 0.71-0.94). In conclusion, lymphocytopenia is a marker for influenza A/H1N1 2009 virus infection in children. Absolute lymphocyte count <2,556 cells/µl or absolute lymphocyte count z‐score < −0.89 may be useful cut‐offs to discriminate against children at higher risk of infection during epidemics. Considering that the pandemic virus is highly likely to continue to circulate in the coming winter season, these findings provide direct and practical implications for the near future. J. Med. Virol. 83:1-4, 2011.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>21108332</pmid><doi>10.1002/jmv.21930</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Biological and medical sciences Biomarkers Child Child, Preschool children Female Fundamental and applied biological sciences. Psychology Human viral diseases Humans Infant Infectious diseases influenza A (H1N1) Influenza A Virus, H1N1 Subtype - isolation & purification Influenza A Virus, H1N1 Subtype - pathogenicity Influenza, Human - diagnosis Influenza, Human - immunology Influenza, Human - pathology Influenza, Human - virology Leukocyte Count lymphocytopenia Lymphopenia - diagnosis Male Medical sciences Microbiology Miscellaneous Predictive Value of Tests Reverse Transcriptase Polymerase Chain Reaction RNA, Viral - genetics ROC Curve Sensitivity and Specificity Viral diseases Virology |
| title | Lymphocytopenia as a marker for pandemic influenza A/H1N1 2009 virus infection in children |
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