Disease Severity and Clinical Outcomes of Community Acquired Pneumonia Caused by Non-Influenza Respiratory Viruses: A Multicenter Prospective Registry Study from CAP-China Network

Zhou, Fei; Wang, Y.; Liu, Y.; Liu, X.; Gu, Li; Zhang, X.; Pu, Zenghui; Yang, Guoru; Liu, B.; Mie, Q.; Xue, Bing; Feng, Jing; Guo, Qiang; Wang, Chen; Cao, Bin

doi:10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a4212

Cited by 15 publications

(11 citation statements)

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“…We mainly focus on respiratory viruses related to sepsis. Our study results from CAP-China found the risk of sepsis during hospitalisation between CAP patients with influenza and those with non-influenza respiratory virus infection were not statistically different (OR 1.00 (95% CI) 0.63-1.58) [18]. Previous studies showed diverse positive rates of non-influenza virus for patients with different clinical characteristics.…”

Section: Coronavirus-related Sepsiscontrasting

confidence: 44%

“…In both these studies, conducted in three middle-income countries from Southeast Asia and in a rural area of a high-income country (Sweden), viruses were detected in around one-third of adult patients with sepsis. The viruses, which can cause severe disease, included influenza A and B, respiratory syncytial virus, coronavirus, human metapneumovirus, parainfluenza virus types 1-3, adenovirus, enteroviruses, and rhinovirus [18][19][20]. Our CAP-China study, which was conducted in 34 hospitals from 10 provinces of mainland China, showed that the proportions of patients with community-acquired pneumonia (CAP) who developed sepsis during hospitals were 40.1 and 39.6% among those with influenza and non-influenza viral infections, respectively [18].…”

Section: Introductionmentioning

confidence: 99%

“…The viruses, which can cause severe disease, included influenza A and B, respiratory syncytial virus, coronavirus, human metapneumovirus, parainfluenza virus types 1-3, adenovirus, enteroviruses, and rhinovirus [18][19][20]. Our CAP-China study, which was conducted in 34 hospitals from 10 provinces of mainland China, showed that the proportions of patients with community-acquired pneumonia (CAP) who developed sepsis during hospitals were 40.1 and 39.6% among those with influenza and non-influenza viral infections, respectively [18]. As well as for commonly detected viruses, emerging novel virus infections can also result in sepsis and have raised global health concerns [20], these include: severe acute respiratory syndrome-coronavirus (SARS-CoV) [21]; Middle East Respiratory Syndrome-coronavirus (MERS-CoV) [22]; and SARS-CoV-2 which caused the recent outbreak of the coronavirus disease 2019 (COVID- 19) in China and in many other countries all over the world.…”

Section: Introductionmentioning

confidence: 99%

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Respiratory viral sepsis: epidemiology, pathophysiology, diagnosis and treatment

Zhou

Wang

et al. 2020

Eur Respir Rev

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According to the Third International Consensus Definition for Sepsis and Septic Shock, sepsis is a life-threatening organ dysfunction resulting from dysregulated host responses to infection. Epidemiological data about sepsis from the 2017 Global Burden of Diseases, Injuries and Risk Factor Study showed that the global burden of sepsis was greater than previously estimated. Bacteria have been shown to be the predominant pathogen of sepsis among patients with pathogens detected, while sepsis caused by viruses is underdiagnosed worldwide. The coronavirus disease that emerged in 2019 in China and now in many other countries has brought viral sepsis back into the vision of physicians and researchers worldwide. Although the current understanding of the pathophysiology of sepsis has improved, the differences between viral and bacterial sepsis at the level of pathophysiology are not well understood. Diagnosis methods that can broadly differentiate between bacterial and viral sepsis at the initial stage after the development of sepsis are limited. New treatments that can be applied at clinics for sepsis are scarce and this situation is not consistent with the growing understanding of pathophysiology. This review aims to give a brief summary of current knowledge of the epidemiology, pathophysiology, diagnosis and treatment of viral sepsis.

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Section: Coronavirus-related Sepsiscontrasting

confidence: 44%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Respiratory viral sepsis: epidemiology, pathophysiology, diagnosis and treatment

Zhou

Wang

et al. 2020

Eur Respir Rev

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“…The disease severity, complications, and outcomes in immunocompetent patients with CAP were similar between IFV and non-IFV related respiratory diseases [29][30][31]. We found that the in-hospital mortality was signi cantly higher in immunocompromised patients with CMV or two-or-more viruses infections.…”

Section: Discussionmentioning

confidence: 71%

Characteristics of Viral Pneumonia in Immunocompromised and Immunocompetent Patients: A Retrospective Cohort Study

Hsu

Wang

et al. 2020

Preprint

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Background: Viral pneumonia has a high incidence and mortality and often presents with bacterial or fungal infections. However, only a few studies have examined viral infection in immunocompromised patients. In this study, we compared the clinical and etiologic characteristics of viral pneumonia in immunocompetent and immunocompromised patients.Methods: We retrospectively recruited patients hospitalized with viral pneumonia from 6 academic hospitals in China between August 2016 and December 2019. We measured the prevalence of comorbidities, coinfections, nosocomial infections, and in-hospital mortalities.Results: Of the 806 patients, 370 were immunocompromised and 436 were immunocompetent. Cytomegalovirus (CMV) was most common (58.1%) in immunocompromised patients, followed by influenza A virus (IFV-A, 21.4%), respiratory syncytial virus (RSV, 19.2%), and parainfluenza virus (PIV, 7.3%). IFV-A (46.1%) was the most common in immunocompetent patients, followed by RSV (20.6%), adenovirus (AdV, 10.6%), PIV (10.1%), and rhinovirus (HRV, 9.2%). Disease severity and in-hospital mortality of immunocompromised patients were higher than those of immunocompetent patients. Pneumocystis jirovecii pneumonia (PCP) (22.4%), Aspergillus (14.1%) and bacteria (13.8%) were most frequent coinfections in immunocompromised patients as to Aspergillus (10.8%), bacteria (7.1%) and mycoplasma (5.3%) in immunocompetent patients. Viral shedding was significantly longer in immunocompromised patients.Conclusions: Immunocompromised patients have a high frequency of coinfections, and persistent viral shedding makes them contagious for prolonged periods. Most deaths were reported among those with CMV and two-or-more viruses, and we found the same disease severity and prognosis for IFV and non-IFV.

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“…2). The outcomes were similar between patients with CAP due to influenza virus and those with CAP due to non-influenza viruses, although in patients with CAP due to non-influenza viruses the incidence of complications was higher 74 . In another study, 3% of all patients with a diagnosis of CAP admitted to the emergency department had pure viral sepsis 75 .…”

Section: Capmentioning

confidence: 76%

Pneumonia

Torres

Niederman

Menéndez

et al. 2021

Nat Rev Dis Primers

391

261

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Pneumonia is a common acute respiratory infection that affects the alveoli and distal bronchial tree of the lungs. The disease is broadly divided into community-acquired pneumonia (CAP) or hospital-acquired pneumonia (HAP, which includes ventilation-associated pneumonia (VAP)) (Box 1). Aspiration pneumonia represents 5-15% of all cases of CAP; however, its prevalence amongst patients with HAP is not known 1 . The lack of robust diagnostic criteria for aspiration pneumonia may explain why the true burden of this type of pneumonia remains unknown 1 .The causative microorganisms for CAP and HAP differ substantially. The most common causal microorganisms in CAP are Streptococcus pneumoniae, respiratory viruses, Haemophilus influenzae and other bacteria such as Mycoplasma pneumoniae and Legionella pneumophila. Conversely, the most frequent microorganisms in HAP are Staphylococcus aureus (including both methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA)), Enterobacterales, non-fermenting gram-negative bacilli (for example, Pseudomonas aeruginosa), and Acinetobacter spp. 2,3 . In health-care-associated pneumonia (HCAP), owing to patient risk factors, the microbial aetiology is more similar to that in HAP than to that in CAP. However, difficulties in standardizing risk factors for this population, coupled with the heterogeneity of post-hospital health care worldwide, suggest that the concept of HCAP has little usefulness, and indeed, HCAP was not included in recent guidelines for CAP and HAP [3][4][5] .Differences in microbiology between CAP and HAP depend on whether pneumonia was acquired in the community or health care environment and on host risk factors, including abnormal gastric and oropharyngeal colonization. In addition, the aetiopathogenesis of CAP is different from that of HAP. In general, mild CAP is treated on an outpatient basis, moderately severe CAP in hospital wards, and severe CAP in intensive care units (ICUs) with or without mechanical ventilation 6 . The need for mechanical ventilation is used as a sub-classification of interest for prognosis and stratification in randomized clinical trials.Both CAP 7 and HAP 4 can occur in either immunosuppressed or immunocompetent patients. To date, most research data have been based on studies of immunocompetent patients and, therefore, we rely on such sources in this Primer. However, CAP, HAP and VAP in immunosuppressed patients have attracted the attention of researchers, and more investigation is to come.In this Primer, we cover and summarize the most important and recent updates related to epidemiology, pathophysiology, diagnostic screening, prevention, management, quality of life, and research perspectives. Additionally, owing to the profound impact of the coronavirus disease 2019 (COVID-19) pandemic caused by

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Disease Severity and Clinical Outcomes of Community Acquired Pneumonia Caused by Non-Influenza Respiratory Viruses: A Multicenter Prospective Registry Study from CAP-China Network

Cited by 15 publications

References 0 publications

Respiratory viral sepsis: epidemiology, pathophysiology, diagnosis and treatment

Respiratory viral sepsis: epidemiology, pathophysiology, diagnosis and treatment

Characteristics of Viral Pneumonia in Immunocompromised and Immunocompetent Patients: A Retrospective Cohort Study

Pneumonia

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