Hangyong He1, Yajing Wang2, Meng Wu3, Bing Sun1. 1. Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Key Laboratory of Respiratory and Pulmonary Circulation, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 10020, China. 2. Department of No.1 Internal Medicine, the Shihua Hospital of Luoyang, Luoyang, Henan Province, 471012, China. 3. Department of Critical Care Medicine, Heilongjiang Province Hospital, Harbin, Heilongjiang Province, 150036, China.
Abstract
BACKGROUND: Epstein-Barr virus (EBV) infection may induce immune suppression in several ways, which may influence the proper host response to other pathogens and lead to a bad outcome of critically ill patients. METHODS: This was a single-center, retrospective, observational study. All patients admitted to an ICU because of respiratory failure were included. EBV detection from lower respiratory tract (LRT) and serum samples were routinely performed. RESULTS: Twenty-eight consecutive cases who were admitted to the ICU at high-risk for an infection or clinical signs of an infection were included in our study. Among the 28 patients, 15 were LRT-positive for EBV (53.6%), and 8 were seropositive for EBV (28.6%). Among the LRT EBV-positive patients, pneumonia was the main indication for ICU admission (93.3%), and in LRT EBV-negative patients, acute exacerbation of COPD (AECOPD) was another indication for ICU admission (46.2%). The CD3+ T cell count (especially the CD3+CD8+ T cell count) was lower than the normal range in LRT- and serum EBV-positive patients; these count were in the normal range in EBV-negative patients. The ICU mortality was 32.1% for all patients. The mortality rate was significantly higher in patients who were seropositive for EBV than seronegative patients (62.5% vs 20.0%). No differences were shown between any outcome parameters for LRT EBV-positive and -negative patients. CONCLUSIONS: This study showed that EBV DNA is detected in LRT and serum samples of a significant number of ICU patients with respiratory failure, and seropositivity for EBV was associated with mortality. This finding maybe correlated with a low CD3+CD8+ T cell count.
BACKGROUND:Epstein-Barr virus (EBV) infection may induce immune suppression in several ways, which may influence the proper host response to other pathogens and lead to a bad outcome of critically illpatients. METHODS: This was a single-center, retrospective, observational study. All patients admitted to an ICU because of respiratory failure were included. EBV detection from lower respiratory tract (LRT) and serum samples were routinely performed. RESULTS: Twenty-eight consecutive cases who were admitted to the ICU at high-risk for an infection or clinical signs of an infection were included in our study. Among the 28 patients, 15 were LRT-positive for EBV (53.6%), and 8 were seropositive for EBV (28.6%). Among the LRT EBV-positive patients, pneumonia was the main indication for ICU admission (93.3%), and in LRT EBV-negative patients, acute exacerbation of COPD (AECOPD) was another indication for ICU admission (46.2%). The CD3+ T cell count (especially the CD3+CD8+ T cell count) was lower than the normal range in LRT- and serum EBV-positive patients; these count were in the normal range in EBV-negative patients. The ICU mortality was 32.1% for all patients. The mortality rate was significantly higher in patients who were seropositive for EBV than seronegative patients (62.5% vs 20.0%). No differences were shown between any outcome parameters for LRT EBV-positive and -negative patients. CONCLUSIONS: This study showed that EBV DNA is detected in LRT and serum samples of a significant number of ICU patients with respiratory failure, and seropositivity for EBV was associated with mortality. This finding maybe correlated with a low CD3+CD8+ T cell count.
Authors: Jacek Roliński; Ewelina Grywalska; Aleksandra Pyzik; Michał Dzik; Violetta Opoka-Winiarska; Agata Surdacka; Maciej Maj; Franciszek Burdan; Michał Pirożyński; Piotr Grabarczyk; Elżbieta Starosławska Journal: BMC Infect Dis Date: 2018-04-20 Impact factor: 3.090