The frequency and seasonal distribution of viral infection in patients with community-acquired pneumonia and its impact on the prognosis
Background Studies on the effects of viral coinfection on bacterial pneumonia are still scarce in South Korea. This study investigates the frequency and seasonal distribution of virus infection and its impact on the prognosis in patients with community-acquired pneumonia (CAP). Methods The medical r...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Critical Care Medicine
2022-11-01
|
| Series: | Acute and Critical Care |
| Subjects: | |
| Online Access: | http://www.accjournal.org/upload/pdf/acc-2022-00682.pdf |
| _version_ | 1797980569181618176 |
|---|---|
| author | Kyung Jun Kim Doh Hyung Kim |
| author_facet | Kyung Jun Kim Doh Hyung Kim |
| author_sort | Kyung Jun Kim |
| collection | DOAJ |
| description | Background Studies on the effects of viral coinfection on bacterial pneumonia are still scarce in South Korea. This study investigates the frequency and seasonal distribution of virus infection and its impact on the prognosis in patients with community-acquired pneumonia (CAP). Methods The medical records of CAP patients with definite etiology, such as viruses and bacteria, were retrospectively reviewed. Their epidemiologic and clinical characteristics, microbiologic test results, the severity of illness, and 30-day mortality were analyzed. Results Among 150 study subjects, 68 patients (45.3%) had viral infection alone, 47 (31.3%) had bacterial infection alone, and 35 (23.3%) had viral-bacterial coinfection, respectively. Among 103 patients with viral infections, Influenza A virus (44%) was the most common virus, followed by rhinovirus (19%), influenza B (13%), and adenovirus (6%). The confusion-urea-respiratory rate-blood pressure-age of 65 (CURB-65) score of the viral-bacterial coinfection was higher than that of the viral infection (median [interquartile range]: 2.0 [1.0–4.0] vs. 2.0 [0.3–3.0], P=0.029). The 30-day mortality of the viral infection alone group (2.9%) was significantly lower than that of bacterial infection alone (19.1%) and viral-bacterial coinfection (25.7%) groups (Bonferroni-corrected P<0.05). Viral-bacterial coinfection was the stronger predictor of 30-day mortality in CAP (odds ratio [OR], 18.9; 95% confidence interval [CI], 3.0–118.3; P=0.002) than bacterial infection alone (OR, 6.3; 95% CI, 1.1–36.4; P=0.041), compared to viral infection alone on the multivariate analysis. Conclusions The etiology of viral infection in CAP is different according to regional characteristics. Viral-bacterial coinfection showed a worse prognosis than bacterial infection alone in patients with CAP. |
| first_indexed | 2024-04-11T05:56:07Z |
| format | Article |
| id | doaj.art-2d0e842b238f4206bc5aeb33e7c980e6 |
| institution | Directory Open Access Journal |
| issn | 2586-6052 2586-6060 |
| language | English |
| last_indexed | 2024-04-11T05:56:07Z |
| publishDate | 2022-11-01 |
| publisher | Korean Society of Critical Care Medicine |
| record_format | Article |
| series | Acute and Critical Care |
| spelling | doaj.art-2d0e842b238f4206bc5aeb33e7c980e62022-12-22T04:41:52ZengKorean Society of Critical Care MedicineAcute and Critical Care2586-60522586-60602022-11-0137455056010.4266/acc.2022.006821412The frequency and seasonal distribution of viral infection in patients with community-acquired pneumonia and its impact on the prognosisKyung Jun Kim0Doh Hyung Kim1 Army Training Center, Republic of Korea Army, Nonsan, Korea Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, KoreaBackground Studies on the effects of viral coinfection on bacterial pneumonia are still scarce in South Korea. This study investigates the frequency and seasonal distribution of virus infection and its impact on the prognosis in patients with community-acquired pneumonia (CAP). Methods The medical records of CAP patients with definite etiology, such as viruses and bacteria, were retrospectively reviewed. Their epidemiologic and clinical characteristics, microbiologic test results, the severity of illness, and 30-day mortality were analyzed. Results Among 150 study subjects, 68 patients (45.3%) had viral infection alone, 47 (31.3%) had bacterial infection alone, and 35 (23.3%) had viral-bacterial coinfection, respectively. Among 103 patients with viral infections, Influenza A virus (44%) was the most common virus, followed by rhinovirus (19%), influenza B (13%), and adenovirus (6%). The confusion-urea-respiratory rate-blood pressure-age of 65 (CURB-65) score of the viral-bacterial coinfection was higher than that of the viral infection (median [interquartile range]: 2.0 [1.0–4.0] vs. 2.0 [0.3–3.0], P=0.029). The 30-day mortality of the viral infection alone group (2.9%) was significantly lower than that of bacterial infection alone (19.1%) and viral-bacterial coinfection (25.7%) groups (Bonferroni-corrected P<0.05). Viral-bacterial coinfection was the stronger predictor of 30-day mortality in CAP (odds ratio [OR], 18.9; 95% confidence interval [CI], 3.0–118.3; P=0.002) than bacterial infection alone (OR, 6.3; 95% CI, 1.1–36.4; P=0.041), compared to viral infection alone on the multivariate analysis. Conclusions The etiology of viral infection in CAP is different according to regional characteristics. Viral-bacterial coinfection showed a worse prognosis than bacterial infection alone in patients with CAP.http://www.accjournal.org/upload/pdf/acc-2022-00682.pdfcommunity-acquired pneumoniaprognosisviral pneumoniavirus |
| spellingShingle | Kyung Jun Kim Doh Hyung Kim The frequency and seasonal distribution of viral infection in patients with community-acquired pneumonia and its impact on the prognosis Acute and Critical Care community-acquired pneumonia prognosis viral pneumonia virus |
| title | The frequency and seasonal distribution of viral infection in patients with community-acquired pneumonia and its impact on the prognosis |
| title_full | The frequency and seasonal distribution of viral infection in patients with community-acquired pneumonia and its impact on the prognosis |
| title_fullStr | The frequency and seasonal distribution of viral infection in patients with community-acquired pneumonia and its impact on the prognosis |
| title_full_unstemmed | The frequency and seasonal distribution of viral infection in patients with community-acquired pneumonia and its impact on the prognosis |
| title_short | The frequency and seasonal distribution of viral infection in patients with community-acquired pneumonia and its impact on the prognosis |
| title_sort | frequency and seasonal distribution of viral infection in patients with community acquired pneumonia and its impact on the prognosis |
| topic | community-acquired pneumonia prognosis viral pneumonia virus |
| url | http://www.accjournal.org/upload/pdf/acc-2022-00682.pdf |
| work_keys_str_mv | AT kyungjunkim thefrequencyandseasonaldistributionofviralinfectioninpatientswithcommunityacquiredpneumoniaanditsimpactontheprognosis AT dohhyungkim thefrequencyandseasonaldistributionofviralinfectioninpatientswithcommunityacquiredpneumoniaanditsimpactontheprognosis AT kyungjunkim frequencyandseasonaldistributionofviralinfectioninpatientswithcommunityacquiredpneumoniaanditsimpactontheprognosis AT dohhyungkim frequencyandseasonaldistributionofviralinfectioninpatientswithcommunityacquiredpneumoniaanditsimpactontheprognosis |