The impact of virus infections on pneumonia mortality is complex in adults: a prospective multicentre observational study

BMC Infectious Diseases

Research Article

Koya Ariyoshi¹  Konosuke Morimoto¹  Tomoko Ishifuji¹  Motoi Suzuki¹  Masahiko Abe²  Makito Yaegashi³  Naohisa Hamashige⁴  Norichika Asoh⁵  Masahiro Aoshima⁶  Naoko Katsurada⁷ 

[1] Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, 852-8523, Nagasaki, Japan;Department of General Internal Medicine, Ebetsu City Hospital, 6 Wakakusacho, Ebetsu, Hokkaido, Japan;Department of General Internal Medicine, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, Japan;Department of Internal Medicine, Chikamori Hospital, 1-1-16 Okawasuji, Kochi, Japan;Department of Internal Medicine, Juzenkai Hospital, 7-18 Kagomachi, Nagasaki, Japan;Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, Japan;Department of Pulmonology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba, Japan;Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Japan;

关键词: Pneumonia mortality;    Chronic respiratory disease;    Respiratory syncytial virus;    Respiratory virus;    Influenza;    Paramyxovirus;   

DOI  :  10.1186/s12879-017-2858-y

 received in 2017-08-15, accepted in 2017-11-26,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundVarious viruses are known to be associated with pneumonia. However, the impact of viral infections on adult pneumonia mortality remains unclear. This study aimed to clarify the effect of virus infection on pneumonia mortality among adults stratified by virus type and patient comorbidities.MethodsThis multicentre prospective study enrolled pneumonia patients aged ≥15 years from September 2011 to August 2014. Sputum samples were tested by in-house multiplex polymerase chain reaction assays to identify 13 respiratory viruses. Viral infection status and its effect on in-hospital mortality were examined by age group and comorbidity status.ResultsA total of 2617 patients were enrolled in the study and 77.8% was aged ≥65 years. 574 (21.9%) did not have comorbidities, 790 (30.2%) had chronic respiratory disease, and 1253 (47.9%) had other comorbidities. Viruses were detected in 605 (23.1%) patients. Human rhinovirus (9.8%) was the most frequently identified virus, followed by influenza A (3.9%) and respiratory syncytial virus (3.9%). Respiratory syncytial virus was more frequently identified in patients with chronic respiratory disease (4.7%) than those with other comorbidities (4.2%) and without comorbidities (2.1%) (p = 0.037). The frequencies of other viruses were almost identical between the three groups. Virus detection overall was not associated with increased mortality (adjusted risk ratio (ARR) 0.76, 95% CI 0.53–1.09). However, influenza virus A and B were associated with three-fold higher mortality in patients with chronic respiratory disease but not with other comorbidities (ARR 3.38, 95% CI 1.54–7.42). Intriguingly, paramyxoviruses were associated with dramatically lower mortality in patients with other comorbidities (ARR 0.10, 95% CI 0.01–0.70) but not with chronic respiratory disease. These effects were not affected by age group.ConclusionsThe impact of virus infections on pneumonia mortality varies by virus type and comorbidity status in adults.

【 授权许可】

CC BY   
© The Author(s). 2017