The study population comprised 288 cases who were hospitalized with influenza A (H7N9) viral pneumonia. The median age of the study population was 58 years, % of the cohort comprised male patients, and % had at least one type of underlying diseases. The in-hospital mortality was %. Two hundred and four patients (%) received adjuvant corticosteroids; among them, 193 had hypoxemia and lung infiltrates, 11 had chronic obstructive pulmonary disease, and 11 had pneumonia only. Corticosteroids were initiated within 7 days (interquartile range, - d) of the onset of illness and the maximum dose administered was equivalent to 80-mg methylprednisolone (interquartile range, 40-120 mg). The patients were treated with corticosteroids for a median duration of 7 days (interquartile range, - d). Cox regression analysis showed that compared with the patients who did not receive corticosteroid, those who received corticosteroid had a significantly higher 60-day mortality (adjusted hazards ratio, ; 95% CI, -; p = ). Subgroup analysis showed that high-dose corticosteroid therapy (> 150 mg/d methylprednisolone or equivalent) significantly increased both 30-day and 60-day mortality, whereas no significant impact was observed for low-to-moderate doses of corticosteroids (25-150 mg/d methylprednisolone or equivalent). The propensity score-matched case-control analysis showed that the median viral shedding time was much longer in the group that received high-dose corticosteroids (15 d), compared with patients who did not receive corticosteroids (13 d; p = ).
Symptoms of pneumonia can often be confusing and it can be impossible to diagnose the condition conclusively at home. For this reason if you notice any of the warning signs or have any reason to suspect pneumonia, make it a point to consult with your doctor for an accurate medical diagnosis immediately. The symptoms of pneumonia can vary depending on the cause, and they can also be very subtle or go unnoticed in older individuals. Typically, the symptoms of pneumonia closely resemble those of a flu, starting with a cough and fever. This is why the condition often goes unrecognized until in a more advanced stage. The most common signs of pneumonia include the following: