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Host characteristics predict outcome among adult patients admitted by severe acute respiratory infection

tetano

Editor, Senior Moderator
Rev Med Chil. 2019 Jul;147(7):842-851. doi: 10.4067/S0034-98872019000700842. [h=1]Host characteristics predict outcome among adult patients admitted by severe acute respiratory infection.[/h]
Fica A[SUP]1[/SUP], Pinto F[SUP]1[/SUP], Sotomayor V[SUP]2[/SUP], Fasce R[SUP]3[/SUP], Andrade W[SUP]3[/SUP], Dabanch J[SUP]1[/SUP], Soto A[SUP]1[/SUP], Triantafilo V[SUP]4[/SUP].
[h=3]Author information[/h] 1 Servicio de Infectolog?a, Hospital Militar de Santiago, Santiago, Chile. 2 Departamento de Epidemiolog?a, Ministerio de Salud, Santiago, Chile. 3 Subdepartamento de Enfermedades Virales, Instituto de Salud P?blica de Chile, Santiago, Chile. 4 Laboratorio Central, Hospital Militar de Santiago, Santiago, Chile.

[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Except for influenza pandemics, different observational studies have failed to demonstrate differences in mortality between various etiologies in adult patients hospitalized for respiratory infections.
[h=4]AIM:[/h] To compare clinical and mortality differences between different viral pathogens associated with severe acute respiratory infections (SARI) in hospitalized adults.
[h=4]MATERIAL AND METHODS:[/h] One-year prospective study in a sentinel center. We included 132 patients with SARI hospitalized for any of the nine viruses under study by PCR. Clinical variables were compared, excluding cases of coinfection.
[h=4]RESULTS:[/h] A viral coinfection was identified in 12% and influenza infection in 56% of cases. Eighty percent of patients were aged ≥ 65 years, with a high frequency of comorbidities, 27% were bedridden. Twenty four percent were admitted to critical care units, 20% required ventilatory assistance and 16% died. Cases occurred throughout the year, with an expected seasonal peak between autumn and spring and a predominance of infections not associated with influenza during summer months. In the multivariate analysis, only being bedridden was significantly associated with mortality at discharge (Odds ratio 23.46; 95% confidence intervals 3.33-165.12, p < 0.01), without association with age, comorbidity, viral pathogen involved, laboratory parameters, clinical presentation or CURB65 score. No major clinical dissimilarities were found between different viral pathogens.
[h=4]CONCLUSIONS:[/h] In our series of patients, mostly elderly, only bedridden status was significantly associated with mortality at discharge in patients hospitalized for SARI. Viral pathogens were not relevant.


PMID: 31859982 DOI: 10.4067/S0034-98872019000700842
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