Literature DB >> 30174887

Viral infection in community acquired pneumonia patients with fever: a prospective observational study.

Ru-Jia Tao1, Xiao-Li Luo1, Wen Xu1, Bei Mao1, Ruo-Xuan Dai1, Cheng-Wei Li1, Li Yu1, Fen Gu1, Shuo Liang1, Hai-Wen Lu1, Ke-Bin Chen1, Jiu-Wu Bai1, Xiao-Bin Ji1, Shu-Yi Gu1, Xiao-Li Sun1, Fa-Hui Dai2, Ping Jiang1, Wei-Jun Cao1, Jin-Fu Xu1.   

Abstract

BACKGROUND: Patients with community acquired pneumonia (CAP) caused by viruses can develop severe complications, which result in hospitalization and death. The purpose of this study was to analyse the aetiology, incidence, clinical characteristics, and outcomes of CAP patients with fever during non-pandemics, and then to provide theoretical basis for accurate diagnosis and treatment in CAP patients.
METHODS: An enrolment system was established for monitoring the CAP patients with fever. Multiplex polymerase chain reaction (mPCR) kits were used to detect 10 viruses [influenza A and B, adenovirus (ADV), respiratory syncytial virus (RSV) A and B, picornavirus, parainfluenza virus (PIV), coronavirus, human metapneumovirus (HMPV), and bocavirus]. Data on age, gender, underlying diseases, complications, laboratory indexes, and outcomes were collected by physicians.
RESULTS: This prospective study included 320 patients with fever. Among them, 23.4% were viral-positive by mPCR, with influenza virus most prominent followed by picornavirus. Strong variation in seasonal distribution was shown in viral infections, with peak months from December to February. Patients with influenza infection were likely to be taken to emergency rooms and have respiratory failure with higher creatinine kinase levels and lower white blood cell counts. Streptococcus pneumoniae followed by haemophilus influenzae were the most common bacteria in viral co-infections, which accounted for one third of virus-positive patients. Viral CAP and mixed CAP were not independent factors for death. In addition, lactate dehydrogenase (LDH) >246 IU/L [odds ratio (OR) =7.06, 95% confidence interval (CI): 2.15-23.2, P=0.001], and serum calcium <2.18 mmol/L (OR =6.67, 95% CI: 1.42-31.3, P=0.016) were associated with death.
CONCLUSIONS: Viruses play an important role in CAP patients with fever, a systematic clinical, radiological and biological analysis of these patients can contribute to effective therapy that may prevent the development of CAP and improve the outcomes. The present work showed an elaborate analysis evidence of viral infection among fever CAP inpatients.

Entities:  

Keywords:  Community acquired pneumonia (CAP); fever; multiplex polymerase chain reaction (mPCR); viruses

Year:  2018        PMID: 30174887      PMCID: PMC6105945          DOI: 10.21037/jtd.2018.06.33

Source DB:  PubMed          Journal:  J Thorac Dis        ISSN: 2072-1439            Impact factor:   2.895


  27 in total

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