Lower Respiratory Tract Virus Findings in Mechanically Ventilated Patients With Severe Community-Acquired Pneumonia

Karhu, Jaana; Ala‐Kokko, Tero; Vuorinen, Tytti; Ohtonen, Pasi; Syrjälä, Hannu

doi:10.1093/cid/ciu237

Cited by 123 publications

(176 citation statements)

References 39 publications

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“…Six studies reported that bronchoalveolar lavage was one of the diagnostic tools used to obtain a microbiological diagnosis [2,7,18,25,28,35]. However, only four of them reported the number of patients who had lower respiratory tract sampling [2,18,25,28].…”

Section: Resultsmentioning

confidence: 99%

“…However, only four of them reported the number of patients who had lower respiratory tract sampling [2,18,25,28]. In two of them, >50% of the patients had lower respiratory tract sampling [2,28]. Table 1 gives details of these studies.…”

Section: Resultsmentioning

confidence: 99%

“…=83.2%) in studies with mixed inpatients and outpatients [19,22,29,31,32]. In the two studies that obtained lower respiratory samples in >50% of the patients [2,28], it was 44.2% …”

Section: Primary Outcomementioning

confidence: 89%

“…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%).…”

Section: Individual Virusesmentioning

confidence: 99%

“…For the outcome short-term mortality, we pooled data from 13 studies [2,3,6,7,24,26,28,29,[31][32][33][34][35]. The odds of death were higher in patients with viral infection, but there was no statistical significance (OR 1.3, 95% CI 0.8-2.16; p=0.283; I 2 =44.1%) (figure 3).…”

Section: Short-term Mortalitymentioning

confidence: 99%

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

et al. 2016

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The advent of PCR has improved the identification of viruses in patients with communityacquired pneumonia (CAP). Several studies have used PCR to establish the importance of viruses in the aetiology of CAP.We performed a systematic review and meta-analysis of the studies that reported the proportion of viral infection detected via PCR in patients with CAP. We excluded studies with paediatric populations. The primary outcome was the proportion of patients with viral infection. The secondary outcome was short-term mortality.Our review included 31 studies. Most obtained PCR via nasopharyngeal or oropharyngeal swab. The pooled proportion of patients with viral infection was 24.5% (95% CI 21.5-27.5%). In studies that obtained lower respiratory samples in >50% of patients, the proportion was 44.2% (95% CI 35.1-53.3%). The odds of death were higher in patients with dual bacterial and viral infection (OR 2.1, 95% CI 1.32-3.31).Viral infection is present in a high proportion of patients with CAP. The true proportion of viral infection is probably underestimated because of negative test results from nasopharyngeal or oropharyngeal swab PCR. There is increased mortality in patients with dual bacterial and viral infection. @ERSpublications Viral infection is present in a high proportion of patients with community-acquired pneumonia

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…=83.2%) in studies with mixed inpatients and outpatients [19,22,29,31,32]. In the two studies that obtained lower respiratory samples in >50% of the patients [2,28], it was 44.2% …”

Section: Primary Outcomementioning

confidence: 89%

Section: Individual Virusesmentioning

confidence: 99%

Section: Short-term Mortalitymentioning

confidence: 99%

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

et al. 2016

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Coinfection with severe acute respiratory syndrome coronavirus‐2 and other respiratory viruses at a tertiary hospital in Korea

Kim

Lee

2021

Clinical Laboratory Analysis

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Background Studies have reported coinfection of severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2), the cause of coronavirus disease‐2019 (COVID‐19), with other viruses that cause respiratory tract infections (RTIs). We investigated the coinfection rate of SARS‐CoV‐2 and other RTI‐causing viruses, and whether the cycle threshold (Ct) value of a real‐time reverse transcriptase PCR (RT‐PCR) differed when the coinfection occurred during the first wave of COVID‐19 in Daegu, Republic of Korea, in 2020. Methods After performing PCR for SARS‐CoV‐2, we additionally tested for the presence of RTI‐causing viruses to check for coinfection. Subsequently, we identified the specific coexisting respiratory viruses and calculated the coinfection rate. In addition, based on the coinfection status, we compared the Ct values obtained from RT‐PCR for SARS‐CoV‐2 in patients who tested positive for COVID‐19 PCR. Results Of 13,717 patients, 123 had positive results on COVID‐19 PCR testing and six tested positive for an RTI‐causing virus. Thus, the coinfection rate was 4.9%. There were no statistically significant differences in the mean Ct values of SARS‐CoV‐2 RT‐PCR between coinfected and non‐coinfected patients. Conclusion This study computed the coinfection rate of SARS‐CoV‐2 and RTI‐causing viruses and revealed that the mean Ct values in SARS‐CoV‐2 real‐time RT‐PCR did not differ according to the coinfection status.

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Usefulness of national respiratory virus surveillance data for clinicians who manage adult patients

Cho

Choi

Chung

et al. 2018

Journal of Medical Virology

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The Korean Centers for Disease Control and Prevention (KCDC) provides weekly respiratory virus (RV) surveillance reports on its website (the KCDC data). Clinicians in clinical settings wherein the use of PCR for RVs is not a routine laboratory test for adult patients with acute respiratory illness (ARI) may question the clinical utility of such a national RV surveillance dataset in predicting RV outbreaks among their adult patients. We compared the KCDC data to the RV PCR data of adult patients who visited a tertiary care center. During a period of 108 weeks, a total of 6955 (5598 pediatric and 1257 adult) patients underwent RV PCR tests for ARI; most of these tests were administered while the patients were admitted (n = 6,920; 99.5%). From the KCDC website, we collected the RV PCR test results of 22 540 patients. Three graphs of weekly positivity rates were made for adults, children, and the KCDC data per each RV, and these graphs were then compared with one another. Whereas RV outbreaks were coincident between the KCDC and the adult graph with respect to influenza virus, respiratory syncytial virus, human metapneumovirus, and human coronavirus, the same was not true for human bocavirus, parainfluenza virus, rhinovirus, and adenovirus. However, a negative predictive value of the KCDC data in the prediction of the occurrence of an outbreak in the adult graph was high for the respective eight RVs (85-100%). A national RV surveillance dataset may be useful in identifying RV outbreaks in adult patients with severe ARI.

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Lower Respiratory Tract Virus Findings in Mechanically Ventilated Patients With Severe Community-Acquired Pneumonia

Cited by 123 publications

References 39 publications

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

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

Coinfection with severe acute respiratory syndrome coronavirus‐2 and other respiratory viruses at a tertiary hospital in Korea

Usefulness of national respiratory virus surveillance data for clinicians who manage adult patients

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