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Viral reactivation in the lungs of patients with severe pneumonia is associated with increased mortality, a multicenter, retrospective study.
Huang, Lingtong; Zhang, Xuan; Pang, Lisha; Sheng, Peng; Wang, Yanqiu; Yang, Fan; Yu, Huili; Huang, Xiaohan; Zhu, Yue; Zhang, Ning; Cai, Hongliu; Tang, Lingling; Fang, Xueling.
  • Huang L; Department of Critical Care Units, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Zhang X; Department of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Pang L; Department of Critical Care Units, Tongde Hospital of Zhejiang Province, Hangzhou, China.
  • Sheng P; Department of Critical Care Units, the First Hospital of Jiaxing, Jiaxing, China.
  • Wang Y; Department of Critical Care Units, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, China.
  • Yang F; Department of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Yu H; Department of Critical Care Units, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Huang X; Department of Nephrology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Zhu Y; Department of Critical Care Units, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Zhang N; Department of Emergency Medicine, Lishui City People's Hospital, Lishui, China.
  • Cai H; Department of Critical Care Units, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
  • Tang L; Department of Infectious Diseases, Shulan (Hangzhou) Hospital, Zhejiang Shuren University of Shulan International Medical College, Hangzhou, China.
  • Fang X; Department of Critical Care Units, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
J Med Virol ; 2022 Nov 23.
Article in English | MEDLINE | ID: covidwho-2173196
ABSTRACT

PURPOSE:

Viral reactivation is widespread in patients with severe pneumonia, yet the landscape of viral reactivation in the lungs is not well-known. This study aims to assess the landscape and clinical features of viral reactivation in the early onset of severe pneumonia in ICU patients.

METHODS:

The clinical data from 97 patients were collected retrospectively from the intensive care units of five teaching hospitals between June 2018 and July 2021. Metagenomic next-generation sequencing (mNGS) of the bronchoalveolar lavage fluid (BALF) was performed at the onset of severe pneumonia.

RESULTS:

Cytomegalovirus (CMV), herpes simplex virus-1 (HSV-1), and Epstein-Barr virus (EBV) were the most common reactivated viruses in the lower respiratory tract of patients with severe pneumonia. After adjusting for the risk of confounding and competition of age, sex, sequential organ failure assessment, acute physiology chronic health assessment II and immunosuppression status, viral reactivation resulted in an overall 2.052-fold increase in 28-day all-cause mortality (95% CI 1.004-4.194).

CONCLUSION:

This study showed that CMV, HSV-1, and EBV were the most common reactivated viruses in the lungs of patients with severe pneumonia. The existence of viral reactivations was associated with an increased risk of mortality. The simultaneous reactivation of multiple viruses needs to be considered in the design of clinical trials. This article is protected by copyright. All rights reserved.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Year: 2022 Document Type: Article Affiliation country: Jmv.28337

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Language: English Year: 2022 Document Type: Article Affiliation country: Jmv.28337