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Observational Study
. 2015 Dec;94(50):e2332.
doi: 10.1097/MD.0000000000002332.

Epidemiology, Co-Infections, and Outcomes of Viral Pneumonia in Adults: An Observational Cohort Study

Matthew P Crotty  1 , Shelby Meyers, Nicholas Hampton, Stephanie Bledsoe, David J Ritchie, Richard S Buller, Gregory A Storch, Scott T Micek, Marin H Kollef
Affiliations
Observational Study

Epidemiology, Co-Infections, and Outcomes of Viral Pneumonia in Adults: An Observational Cohort Study

Matthew P Crotty et al. Medicine (Baltimore). 2015 Dec.

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.

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Conflict of interest statement

All authors have declared no competing interests.

Figures

FIGURE 1
FIGURE 1
Identification of study population.
FIGURE 2
FIGURE 2
Description of patients with multiple respiratory viruses identified.
FIGURE 3
FIGURE 3
Respiratory co-infection rates according to virus identified.
See this image and copyright information in PMC

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