Incidence and characteristics of viral community-acquired pneumonia in adults

Abstract

Background: In adults, viral causes of communityacquired pneumonia (CAP) are poorly characterised. The aims of this study were to characterise the viral aetiology of CAP in adults by using an extensive array of viral diagnostic tests and to compare the characteristics of viral pneumonia with those of pneumococcal pneumonia. Methods: Adults admitted to Christchurch Hospital over a 1-year period with CAP were included in the study. Microbiological testing methods included blood and sputum cultures, urinary antigen testing for Streptococcus pneumoniae and Legionella pneumophila, antibody detection in paired sera and detection of respiratory viruses in nasopharyngeal swabs by immunofluorescence, culture and PCR.

Viral infection in community-acquired pneumonia: a systematic review and meta-analysis

“…They were observational cohort studies except for one case-control study [34]. They were published between 2005 and 2015 and carried out in Europe (n=14) [1, 3, 5, 18-24, 26, 28, 33, 35], Asia (n=9) [2, 6, 10, 29-32, 34, 36], North America (n=4) [11,12,25,27], Oceania (n=3) [7,8,17] and South America (n=1) [9]. These studies enrolled a predominantly adult population although two of them used a cut-off of age >14 years for inclusion [3,31].…”

“…The most commonly identified viruses were influenza in 18 studies [3, 6, 7, 10, 11, 17-19, 21, 23, 26, 27, 29, 31, 32, 34-36], rhinovirus in eight studies [1,5,8,12,22,24,25,28], respiratory syncytial virus in three studies [2,9,33] and coronavirus in two studies [20,30]. Meta-analyses revealed that the proportion of infection by influenza (31 studies) was 8% (95% CI 6.3-9.6%; I 2 =91.9%), by rhinovirus (25 studies) was 5.7% (95% CI 4.3-7.1%; I 2 =90.3%), by respiratory syncytial virus (29 studies) was 2.2% (95% CI 1.6-2.8%; I 2 =80%) and by coronavirus (18 studies) was 3.3% (95% CI 2.3-4.2%; I 2 =80.2%).…”

“…In patients with dual bacterial and viral infection (10 studies), the odds of death were significantly higher compared with patients without dual infection (OR 2. [3] SAITO [32] HOLM [22] JENNINGS [8] HOHENTHAL [21] CHARLES [17] JOHNSTONE [27] DIEDEREN [20] MERMOND [7] SHIBLI [34] JOHANSSON [26] LIEBERMAN [30] HARA [6] CILLÓNIZ [18] CHOI [2] SANGIL [33] YIN [36] VAN GAGELDONK-LAFEBER [5] LUCHSINGER [9] TAKAHASHI [10] WIEMKEN [11] MUSHER [12] VIASUS [35] HUIJSKENS [24] KIM [29] KARHU [28] HOLTER [23] QU [31] DAS [19] JAIN [25] …”

“…The advent of PCR has greatly improved the identification of viruses in patients with CAP [1]. Over the last decade, several studies have used PCR to establish the importance of viruses in the aetiology of CAP [1][2][3][4][5][6][7][8][9][10][11][12]. An updated and objective literature review that quantitatively summarises and critically appraises the results of these studies is warranted.…”

Clinical Approach to Nonresponsive Pneumonia in Adults Diagnosed by a Primary Care Clinician: A Retrospective Study

“…Intriguingly, myalgia was associated with pneumonia caused by a respiratory virus and with influenza pneumonia. 32 Perhaps our study population of CAP patients initially evaluated by primary care clinicians in ambulatory settings includes a significant proportion of patients with primary viral pneumonia. Such individuals would be expected to have a slow or nonresponsive course following onset of antibiotic treatment (i.e.…”