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Respiratory virus of severe pneumonia in South Korea: Prevalence and clinical implications

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  • Respiratory virus of severe pneumonia in South Korea: Prevalence and clinical implications

    PLoS One. 2018 Jun 18;13(6):e0198902. doi: 10.1371/journal.pone.0198902. eCollection 2018.
    Respiratory virus of severe pneumonia in South Korea: Prevalence and clinical implications.

    Kim HJ1, Choi SM1, Lee J1, Park YS1, Lee CH1, Yim JJ1, Yoo CG1, Kim YW1, Han SK1, Lee SM1.
    Author information

    Abstract

    BACKGROUND:

    Severe viral pneumonia is associated with a high mortality rate. However, due to the vulnerability of critically ill patients, invasive diagnostic methods should be performed with caution in the intensive care unit (ICU). It would be helpful if the prevalence, risk factors, and clinical impact of virus detection are elucidated.
    METHODS:

    We evaluated patients with severe pneumonia between January 1st 2008 and December 31st 2015. Reverse transcription-polymerase chain reaction (RT-PCR) analysis was performed for 8 respiratory viruses when viral pathogen could not be excluded as the origin of severe pneumonia. The baseline characteristics, laboratory results, microbiological findings, and clinical outcomes of the patients were analyzed.
    RESULTS:

    Of the 2,347 patients admitted to the medical ICU, 515 underwent RT-PCR for respiratory viruses, 69 of whom had positive results. The detection rate was higher during the winter, with a community onset, in patients with history of recent chemotherapy, and low platelet count. Additional bronchoscopic sampling along with upper respiratory specimen increased the yield of viral detection. Respiratory syncytial virus was the most common pathogen detected, while influenza A was the most common virus with bacterial coinfection. Respiratory virus detection led to changes in clinical management in one-third of the patients.
    CONCLUSIONS:

    The detection of viral pathogens in patients with severe pneumonia is not rare, and can be more common in certain group of patients. Invasive sampling for RT-PCR can be helpful, and such detection can lead to positive changes in clinical management.


    PMID: 29912989 DOI: 10.1371/journal.pone.0198902
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