Participación de los virus respiratorios en la neumonía del adulto inmunocompetente adquirida en la comunidad

Peñafiel, Fernando Saldías; Gutiérrez, Marcos Ortega; López, Gino Fuentes; Aránguiz, José Manuel Elola; Monasterio, Javier Uribe; Soto, Arturo Morales; Patiño, Orlando Díaz

doi:10.4067/s0034-98872016001200002

Cited by 6 publications

(3 citation statements)

References 28 publications

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“…With the development of the molecular diagnostic techniques and wide clinical applications, respiratory viruses (RVs), including the influenza virus (IFV), human rhinovirus (hRV), respiratory syncytial virus (RSV), human metapneumovirus (hMPV), human parainfluenza virus (hPIV), human adenovirus (hAdV), enterovirus (EV) and human coronaviruses (hCoV), have been increasingly recognized to play an important role in the occurrence of CAP. 3 Previous research reported the prevalence of RVs in CAP to be about 20–50%, 4 , 5 sometimes even higher than that of Streptococcus pneumoniae , 6 which was regarded as the most common pathogen in the patients with CAP. A meta-analysis including 31 studies indicated that the pooled proportion of patients with viral infection was 24.5% (95% confidence interval (CI) 21.5–27.5%); while the studies that obtained lower respiratory samples in >50% of the patients reported the proportion to be 44.2% (95% CI 35.1–53.3%).…”

Section: Introductionmentioning

confidence: 97%

<p>Comparison of the Clinical Characteristics and Severity of Influenza and Non-influenza Respiratory Virus-Related Pneumonia in China: A Multicenter, Real-World Study</p>

Chen

Han

et al. 2020

IDR

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Purpose: Respiratory viruses are important etiologies of community-acquired pneumonia (CAP). However, the impact of different RVs on the outcomes of CAP is not well elucidated. This study aims to compare the clinical features and severity of influenza (Flu-p) and non-influenza respiratory viruses-related pneumonia (NIRVs-p) onset in the community among immunocompetent adults. Methods: The data of the patients hospitalized with laboratory-confirmed RVs-p were retrospectively reviewed from five teaching hospitals in China from January 2013 to May 2019. Univariate and multivariate logistic regressions were performed to compare the clinical characteristics and outcomes between Flu-p and NIRVs-p. Results: A total of 1079 patients with Flu-p and 341 patients with NIRVs-p were included in this study. A multivariate logistic regression model revealed chronic pulmonary disease [odd ratio (OR) 0.341, 95% confidence interval (CI) 0.225-0.515, p < 0.001], solid malignant tumor (OR 0.330, 95% CI 0.163-0.668, p = 0.002), myalgia (OR 1.697, 95% CI 1.236-2.330, p < 0.001), lymphocytes <0.8×10 9 /L (OR 10.811, 95% CI 6.949-16.818, p < 0.001) and blood albumin <35 g/L (OR 0.327, 95% CI 0.242-0.442, p < 0.001) were predictors for Flu-p. After adjusting for confounders, the multivariate logistic regression analysis confirmed that influenza B-related pneumonia (FluB-p) (OR 0.419, 95% CI 0.272-0.646, p < 0.001) and NIRVs-p (OR 0.260, 95% CI 0.158-0.467, p < 0.001) were associated with a decreased risk of 30-day mortality compared with the influenza A-related pneumonia (FluA-p). Conclusion: Our results showed that patients with FluA-p experience a more severe disease than those with FluB-p and NIRVs-p. Some clinical features are helpful to distinguish between NIRVs-p and Flu-p.

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Section: Introductionmentioning

confidence: 97%

<p>Comparison of the Clinical Characteristics and Severity of Influenza and Non-influenza Respiratory Virus-Related Pneumonia in China: A Multicenter, Real-World Study</p>

Chen

Han

et al. 2020

IDR

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“…Dentro do espectro infeccioso do trato respiratório, os agentes virais apresentam maior importância clínica, principalmente pela possibilidade gerarem epidemias extensas e pandemias recentes (Rodrigues et al, 2019). No Chile, estudo clínico prospectivo descritivo realizado com 240 pacientes adultos internados por um episódio de pneumonia adquirida na comunidade demonstrou que os virus foram responsáveis em causar pneumonia nesse grupo, ocorrendo em indivíduos que apresentaram múltiplas comorbidades, com incremento de internação na Unidade de Terapia Intensiva (UTI) e mortalidade hospitalar (Peñafiel et al, 2016).…”

Section: Discussionunclassified

Impacto dos determinantes sociais da saúde no adoecimento respiratório por Covid e outros virus

Silva Junior,

Ramalho,

Reis

et al. 2024

CLCS

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A ocorrência da Síndrome Respiratória Aguda Grave assumiu proporções pandêmicas após o incremento do SARS-CoV-2, afetando mais de 100 países em poucas semanas no início de 2020, apontando a necessidade de resposta global imediata. Nesse escopo, foi desenvolvida investigação com objetivo de analisar quais fatores socioepidemiológicos e ambientais influenciam o adoecimento respiratório viral. Pesquisa quantitativa, epidemiológica, descritiva e espacial. A coleta de dados ocorreu por meio do Sistema de Informação de Vigilância Epidemiológica da Gripe. Os dados meteorológicos foram coletados a partir do Instituto Nacional de Meteorologia (INMET) e os dados sociodemográficos dos municípios no portal de domínio público do Instituto Brasileiro de Geografia e Estatística (IBGE). Foram realizados testes estatísticos para verificar a associação entre os fatores socioepidemiológicos, ambientais e o adoecimento respiratório viral humano decorrente da SRAG. Observa-se que houve aumento em 2020 de 817,3% de SRAG em relação ao ano de 2019. Os vírus Influenza A e B, Vírus Sincicial Respiratório, Parainflenza, Adenovírus, Metapneumovírus e Bocavírus tiveram maiores registros no ano de 2019. O Rinovírus teve um aumento substancial no ano de 2020 (relatou-se 365 casos em 2019 e 1195 casos em 2020). Em 2020 foram registrados 27961 casos de SRAG ocasionada pelo Sars-CoV-2. Por meio do método Scan espacial, em 2019 formaram-se seis conglomerados de cidades no estado do Paraná e em 2020 formaram-se dezoito conglomerados de cidades no estado. A maioria dos pacientes acometidos pela SRAG é do sexo masculino, de cor branca, e ensino fundamental 1° ciclo e provenientes da zona urbana. No que se refere à hospitalização a maioria precisou de tratamento em ambiente hospitalar sendo que 64,66% dos pacientes necessitaram de suporte ventilatório com presença de tosse (93,53%), febre (86,74%) e desconforto respiratório (82,66%) dentre outros. Concernente a correlação entre adoecimento respiratório viral e o meio ambiente, a temperatura mínima para o ano de 2020 apresentou correlação positiva significativa com a taxa de SRAG (0,56), não sendo detectada para as demais variáveis correlação significativa. as afecções virais do sistema respiratório constituem vasto espectro de adoecimento, apresentando-se desde um resfriado comum até complicações com sério risco de morte devido sua letalidade como ocorre na infecção pelo SARS-CoV-2. Esta característica aponta para necessidade de aprofundamento de estudos que possam compreender o adoecimento respiratório viral e os fatores envolvidos na vida das pessoas adoecidas.

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“… 1 , 2 As a result of advances in nucleic acid diagnostics and its clinical applications, respiratory viruses (RVs) have been increasingly recognized as a major player in the occurrence of CAP. 3 , 4 Previous research has indicated that the prevalence of RVs in CAP ranges from 20% to 50%, 5 , 6 which is eventually higher than that of Streptococcus pneumoniae , 7 the most common pathogen in patients with CAP. One European meta-analysis, comprising 21 studies, has indicated that the pooled proportion of RVs in patients with CAP is 22% [95% confidence interval (CI) of 18–27%].…”

Section: Introductionmentioning

confidence: 99%

Derivation and validation of a prediction rule for mortality of patients with respiratory virus-related pneumonia (RV-p score)

Chen

Han

et al. 2020

Ther Adv Respir Dis

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Background: Respiratory viruses are important etiologies of community-acquired pneumonia. However, current knowledge on the prognosis of respiratory virus-related pneumonia (RV-p) is limited. Thus, here we aimed to establish a clinical predictive model for mortality of patients with RV-p. Methods: A total of 1431 laboratory-confirmed patients with RV-p, including 1169 and 262 patients from respective derivation and validation cohorts from five teaching hospitals in China were assessed between January 2010 and December 2019. A prediction rule was established on the basis of risk factors for 30-day mortality of patients with RV-p from the derivation cohort using a multivariate logistic regression model. Results: The 30-day mortality of patients with RV-p was 16.8% (241/1431). The RV-p score was composed of nine predictors (including respective points of mortality risk): (a) age ⩾65 years (1 point); (b) chronic obstructive pulmonary disease (1 point); (c) mental confusion (1 point); (d) blood urea nitrogen (1 point); (e) cardiovascular disease (2 points); (f) smoking history (2 points); (g) arterial pressure of oxygen/fraction of inspiration oxygen (PaO2/FiO2) < 250 mmHg (2 points); (h) lymphocyte counts <0.8 × 109/L (2 points); (i) arterial PH < 7.35 (3 points). A total of six points was used as the cut-off value for mortality risk stratification. Our model showed a sensitivity of 0.831 and a specificity of 0.783. The area under the receiver operating characteristic curve was more prominent for RV-p scoring [0.867, 95% confidence interval (CI)0.846–0.886] when compared with both pneumonia severity index risk (0.595, 95% CI 0.566–0.624, p < 0.001) and CURB-65 scoring (0.739, 95% CI 0.713–0.765, p < 0.001). Conclusion: RV-p scoring was able to provide a good predictive accuracy for 30-day mortality, which accounted for a more effective stratification of patients with RV-p into relevant risk categories and, consequently, help physicians to make more rational clinical decisions. The reviews of this paper are available via the supplemental material section.

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Participación de los virus respiratorios en la neumonía del adulto inmunocompetente adquirida en la comunidad

Abstract: The use of molecular diagnostic techniques expanded the detection of respiratory viruses in immunocompetent adults hospitalized with CAP.

Cited by 6 publications

References 28 publications

<p>Comparison of the Clinical Characteristics and Severity of Influenza and Non-influenza Respiratory Virus-Related Pneumonia in China: A Multicenter, Real-World Study</p>

<p>Comparison of the Clinical Characteristics and Severity of Influenza and Non-influenza Respiratory Virus-Related Pneumonia in China: A Multicenter, Real-World Study</p>

Impacto dos determinantes sociais da saúde no adoecimento respiratório por Covid e outros virus

Derivation and validation of a prediction rule for mortality of patients with respiratory virus-related pneumonia (RV-p score)

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