Epidemiology, Co-Infections, and Outcomes of Viral Pneumonia in Adults: An Observational Cohort Study
- PMID: 26683973
- PMCID: PMC5058945
- DOI: 10.1097/MD.0000000000002332
Epidemiology, Co-Infections, and Outcomes of Viral Pneumonia in Adults: An Observational Cohort Study
Abstract
Advanced technologies using polymerase-chain reaction have allowed for increased recognition of viral respiratory infections including pneumonia. Co-infections have been described for several respiratory viruses, especially with influenza. Outcomes of viral pneumonia, including cases with co-infections, have not been well described. This was observational cohort study conducted to describe hospitalized patients with viral pneumonia including co-infections, clinical outcomes, and predictors of mortality. Patients admitted from March 2013 to November 2014 with a positive respiratory virus panel (RVP) and radiographic findings of pneumonia within 48 h of the index RVP were included. Co-respiratory infection (CRI) was defined as any organism identification from a respiratory specimen within 3 days of the index RVP. Predictors of in-hospital mortality on univariate analysis were evaluated in a multivariate model. Of 284 patients with viral pneumonia, a majority (51.8%) were immunocompromised. A total of 84 patients (29.6%) were found to have a CRI with 48 (57.6%) having a bacterial CRI. Viral CRI with HSV, CMV, or both occurred in 28 patients (33.3%). Fungal (16.7%) and other CRIs (7.1%) were less common. Many patients required mechanical ventilation (54%) and vasopressor support (36%). Overall in-hospital mortality was high (23.2%) and readmissions were common with several patients re-hospitalized within 30 (21.1%) and 90 days (36.7%) of discharge. Predictors of in-hospital mortality on multivariate regression included severity of illness factors, stem-cell transplant, and identification of multiple respiratory viruses. In conclusion, hospital mortality is high among adult patients with viral pneumonia and patients with multiple respiratory viruses identified may be at a higher risk.
Conflict of interest statement
All authors have declared no competing interests.
Figures
Similar articles
-
Impact of antibacterials on subsequent resistance and clinical outcomes in adult patients with viral pneumonia: an opportunity for stewardship.Crit Care. 2015 Nov 18;19:404. doi: 10.1186/s13054-015-1120-5. Crit Care. 2015. PMID: 26577540 Free PMC article.
-
Clinical characteristics and outcomes in hospitalized patients with respiratory viral co-infection during the 2009 H1N1 influenza pandemic.PLoS One. 2013 Apr 9;8(4):e60845. doi: 10.1371/journal.pone.0060845. Print 2013. PLoS One. 2013. PMID: 23585856 Free PMC article.
-
Bacterial and fungal coinfection among hospitalized patients with COVID-19: a retrospective cohort study in a UK secondary-care setting.Clin Microbiol Infect. 2020 Oct;26(10):1395-1399. doi: 10.1016/j.cmi.2020.06.025. Epub 2020 Jun 27. Clin Microbiol Infect. 2020. PMID: 32603803 Free PMC article.
-
Community-acquired bacterial co-infection predicts severity and mortality in influenza-associated pneumonia admitted patients.J Infect Chemother. 2019 Feb;25(2):129-136. doi: 10.1016/j.jiac.2018.10.014. Epub 2018 Nov 15. J Infect Chemother. 2019. PMID: 30448361
-
Pneumonia with bacterial and viral coinfection.Curr Opin Crit Care. 2017 Oct;23(5):385-390. doi: 10.1097/MCC.0000000000000435. Curr Opin Crit Care. 2017. PMID: 28777158 Review.
Cited by
-
RSV enhances Staphylococcus aureus bacterial growth in the lung.Infect Immun. 2024 Oct 15;92(10):e0030424. doi: 10.1128/iai.00304-24. Epub 2024 Aug 16. Infect Immun. 2024. PMID: 39150268
-
Beyond SARS-CoV-2: epidemiological surveillance of respiratory viruses in Jalisco, Mexico.Front Public Health. 2024 Jan 11;11:1292614. doi: 10.3389/fpubh.2023.1292614. eCollection 2023. Front Public Health. 2024. PMID: 38274524 Free PMC article.
-
Clinical application of metagenomic next-generation sequencing in non-immunocompromised patients with severe pneumonia supported by veno-venous extracorporeal membrane oxygenation.Front Cell Infect Microbiol. 2023 Oct 13;13:1269853. doi: 10.3389/fcimb.2023.1269853. eCollection 2023. Front Cell Infect Microbiol. 2023. PMID: 37900317 Free PMC article.
-
Characterization of the pathogenicity of extraintestinal pathogenic Escherichia coli isolates from pneumonia-infected lung samples of dogs and cats in South Korea.Sci Rep. 2023 Apr 5;13(1):5575. doi: 10.1038/s41598-023-32287-z. Sci Rep. 2023. PMID: 37019949 Free PMC article.
-
Cross-protective antibodies against common endemic respiratory viruses.Nat Commun. 2023 Feb 13;14(1):798. doi: 10.1038/s41467-023-36459-3. Nat Commun. 2023. PMID: 36781872 Free PMC article.
References
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources