Clinical characteristics and outcomes of patients with severe acute respiratory infections (SARI): results from the Egyptian surveillance study 2010–2014

Abstract

Background Respiratory viral and atypical bacterial infections data in Egyptian patients are sparse. This study describes the clinical features and outcomes of patients with severe acute respiratory infections (SARI) in hospitalized patients in Egypt. Methods SARI surveillance was implemented at Cairo University Hospital (CUH) during the period 2010–2014. All hospitalized patients meeting the WHO case definition for SARI were enrolled. Nasopharyngeal/oropharyngeal (NP/OP) swabs were collected and samples were tested using RT-PCR for influenza A, B, respiratory syncytial virus (RSV), human metapneumovirus (hMPV), parainfluenza virus (PIV 1,2,3,4), adenovirus, bocavirus, coronavirus, enterovirus, rhinovirus, and atypical bacteria. Data were analyzed to calculate positivity rates for viral pathogens and determine which pathogens related to severe outcomes or resulted in death. Results Overall, 1,075/3,207 (33.5%) cases had a viral etiology, with a mean age of 5.74 (±13.87) years. The highest rates were reported for RSV (485 cases, 45.2%), PIV (125, 11.6%), and adenovirus (105, 9.8%). Children had a higher viral rate (981, 91.2%) compared to 94 (8.8%) cases in adults. Patients with identified viruses had significantly lower rates for ICU admission, hospital stay, mechanical ventilation, and overall mortality than those without identified viruses. No infections were independently associated with severe outcomes. Conclusions Viral pathogens were encountered in one-third of hospitalized adult and pediatric Egyptian patients with SARI, while atypical bacteria had a minor role. Highest rates of viral infections were reported for RSV, PIV, and adenovirus. Viral infections had neither negative impacts on clinical features nor outcomes of patients with SARI in our locality.

Outcomes of patients with Severe Acute Respiratory Infections (SARI) admitted to the intensive care unit: Results from the Egyptian Surveillance Study 2010-2014

“…One might expect that the presence of medical comorbidities will put SARI patients into higher risk for severe disease and ICU admission. In this respect, it was also disappointing and contradicting other studies [11,15,17], as it was observed that-in terms of comorbidities-there were no significant differences between ICU and non-ICU SARI patients. Definitely, studies with larger numbers of patients are needed to clarify these associations.…”

“…We have recently published the largest surveillance Egyptian study that addressed the epidemiological patterns of SARI due to viruses in both children and adult population and their relation to the clinical characteristics and outcomes of those patients [11]. Despite that viral pathogens were encountered in one-third of SARI patients, these infections had no negative impacts on clinical features, clinical course, and outcomes of those patients [11]. In this related study, we aimed to address the impacts of SARI on the clinical outcomes of patients admitted to the ICU, in terms of morbidity and mortality.…”

“…In our previous work [11], we had addressed the clinical characteristics and outcomes of Egyptian adult and pediatric patients with SARI prospectively enrolled at Cairo University Hospitals (CUH) from 2010 to 2014. In the current study, we analyze data of those SARI patients admitted to the ICU.…”

Laboratory based Retrospective Study to determine the start of SARS-CoV-2 in Patients with Severe Acute Respiratory Illness in Egypt at El-Demerdash tertiary hospitals

“…Also a study conducted in Chilie found that adults are more prone to SARI when they suffered from cardiac and respiratory illnesses (5). An Egyptian study survey was conducted recently in Assuit and included pediatric and adult groups from 2010-2014 by Hatem et al,they found that 53% of patients had co-morbidities mostly in adults not children, and in the form of chronic lung diseases 43% (21).…”

Circulating Pattern of Respiratory Viruses, in Egypt, Season 2013-2014

“…The second study, which was published 2019 and was done from the period 2010-2014, at Cairo University Hospital, showed an incidence rate viral respiratory viruses in Egypt of 33.5% in hospitalized adult and paediatric Egyptian patients with SARI 63 .…”