Derangement of blood chemistry specifically Liver function tests and Renal function tests in Influenza A/H1N1 Infection

Objective: To determine the multi-organ effects of influenza A/H1N1 virus, particularly focusing on the derangement of hepatic and renal function during the course of the infection. Design: Cross sectional study Place and duration of study: Department of Chemical Pathology and Endocrinology Combined Military Hospital, Multan, from Nov 2017 to Jan 2018. Patients and Methods: All suspected cases with clinical features of influenza flu, who were admitted in Combined Military Hospital Multan, from Nov 2017 to Jan 2018 were closely observed for the purpose of investigating the multi-systemic effects of the disease.PCR for influenza virus was conducted. Liver function tests and renal function tests were performed in all suspected cases. In A/H1N1 positive cases LFTs and RFTs were repeated after completion of treatment with oseltamavir and azithromycin. A/H1N1 positive and negative groupswere compared.A total of 145 cases were analyzed. Results: Out of the 145(100%) cases that had been reviewed, 72 (49.65%) cases were positive for influenza A/H1N1 infection, 73 (50.35%) patients had negative results for influenza virus. Out of the positive 72(100%) cases, 18(25.1%) had deranged LFT’S, 15(20.83%) had deranged RFT’s and 10(13.8%) had both LFT’S and RFT’S deranged, and the remaining 29(40.27%) patients had normal chemistry. While the 73 patients with negative results for H1N1 virus had normal chemistry and no derangement of LFT’S and RFT’S. Our patients were treated for H1N1 infection, and the liver and kidney function reverted back to a normal level in 72 hours. Conclusion: Our study showed that significant number of patients with influenza A/H1N1 infection had derangement in LFTS and RFTS as compared to non –influenza flu cases indicating that it is a multi-organ effecting virus. Early initiation of treatment resulted in reversion of deranged LFTs and RFTs