Respiratory virus detection in critically ill patients with severe pneumonia: epidemiology and clinical implications

Abstract

Introduction: Viral pneumonia is associated with high morbidity and mortality in critically ill patients. Considering various kinds of antiviral agents and vaccines, it is important to reveal prevalence of each virus, and furthermore announce clinical impact of such detection. Our study aimed to report viral pathogens in patients admitted to the intensive care unit (ICU) due to severe pneumonia, and further analyze their clinical implications. Methods: We evaluated patients with severe viral pneumonia admitted to a medical ICU between January 2008 and December 2015. Patients underwent reverse transcription polymerase chain reaction (RT-PCR) for 8 different respiratory viruses when viral pneumonia was suggested. Baseline clinical characteristics, laboratory results, results of microbiological detection, and the clinical outcomes including hospital stay and mortality were obtained. Results: Among the 2,347 patients admitted to the medical ICU over the 8 years, 519 patients were suspected of viral pathogen, and 69 of them had positive results from the RT-PCR. Detection rate was highest during the winter seasons

with respiratory syncytial virus was most common pathogen. Clinical characteristics and laboratory results did not differ among viral pathogens, however, such detection led to change of patient management in 33.3%. Bacterial coinfection was detected in 27 (39.1%) patients, but specific types of viral and bacterial pathogens did not show significant correlation with one another. Conclusions: Viral pathogens were detected in severe pneumonia not infrequently and such detection can lead to positive change of clinical managements in considerable cases.