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2015 ; 94
(50
): e2332
Nephropedia Template TP
gab.com Text
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Epidemiology, Co-Infections, and Outcomes of Viral Pneumonia in Adults: An
Observational Cohort Study
#MMPMID26683973
Crotty MP
; Meyers S
; Hampton N
; Bledsoe S
; Ritchie DJ
; Buller RS
; Storch GA
; Micek ST
; Kollef MH
Medicine (Baltimore)
2015[Dec]; 94
(50
): e2332
PMID26683973
show ga
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.