Follow-up study of discharged patients infected with novel recombinant avian-origin influenza A H7N9

Objective: To analyze the laboratory results and chest CT appearances of novel recombinant avian-origin influenza A (H7N9) in discharged patients for understanding the imaging changes. Methods: The clinical and imaging data of 4 patients with novel recombinant avian-origin influenza A (H7N9) were collected. The imaging changes and laboratory results were analyzed. Results: All patients underwent chest CT examination 2 to 5 times from admission to discharge. The lesions primarily presented as ground-glass opacity (GGO) and mainly located in the inferior lobe of the left lung in 3 cases, in the inferior lobe of the right lung in 1 case, alternating between absorption and progress. GGO was absorbed obviously in about 3 days after treatment and consolidation was progressed after treatment. Consolidation absorption was observed with continue treatment in 1 case. The pulmonary lesions were absorbed obviously in 1 case 7 days after discharge. Synchronous reduction of the absolute values of CD3, CD8, CD4, CD45 were observed in 3 cases and the ratio of CD4/CD8 was normal. Conclusions: (1) The areas of pulmonary involvement are large and variable in H7N9. The lesion area and imaging patterns are important for disease prognosis. (2) H7N9 virus infection may causes immunosuppression, decrease of CRP value can predict the improvement of the disease. (authors)