Sustained Viremia and High Viral Load in Respiratory Tract Secretions Are Predictors for Death in Immunocompetent Adults with Adenovirus Pneumonia.
Sustained Viremia and High Viral Load in Respiratory Tract Secretions Are Predictors for Death in Immunocompetent Adults with Adenovirus Pneumonia.
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呼吸道分泌物中持续的病毒血症和高病毒载量是免疫功能正常的腺病毒肺炎成人死亡的预测因素
DOI：
10.1371/journal.pone.0160777
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Cao B
中科院分区：
文献类型：
--
作者：
Gu L;Qu J;Sun B;Yu X;Li H;Cao B
在免疫功能正常的成年人中，致死性腺病毒肺炎的预测因子尚不清楚。2013年3月至6月在北京朝阳医院前瞻性入组经确诊的住院AdV肺炎成人患者。收集这些患者的临床数据和系列全血和呼吸道分泌物。进行定量实时聚合酶链反应以定量病毒载量。共连续入组了14例AdV肺炎病例，其中4例为致死性病例。10例由AdV-55引起，3例由AdV-7引起，1例由AdV-3引起。死亡病例和存活病例的患者在年龄、性别或基础疾病方面无差异。在入院时（发病后第5-7天），致死性病例中的患者在呼吸道分泌物中表现出较高的初始病毒载量（8.578 ± 2.115 vs 6.263 ± 1.225 Log 10拷贝/ml，p = 0.023）。致死性病例中的所有患者均在第12-14天出现病毒血症（100% vs 66.7%，p = 0.017）。呼吸道中较高的初始病毒载量和持续的病毒血症（超过2周）可能是致死性临床结局的预测因子。
The predictors for fatal adenovirus (AdV) pneumonia among immunocompetent adults are unclear. Laboratory-confirmed, hospitalized AdV pneumonia adults were prospectively enrolled in Beijing Chao-Yang hospital from March to June 2013. Clinical data and serial whole blood and respiratory tract secretions from such patients were collected. Quantitative real-time polymerase chain reaction was performed to quantify the viral load. A total of 14 AdV pneumonia cases were consecutively enrolled, and four of them were fatal. Ten cases were caused by AdV-55, three by AdV-7 and one by AdV-3. There were no differences in age, gender or underlying diseases between the patients in the fatal cases and surviving cases. At admission (on day 5–7 after illness onset), the patients in fatal cases presented higher initial viral loads in respiratory tract secretions (8.578 ± 2.115 vs 6.263 ± 1.225 Log10 copies/ml, p = 0.023). All patients in fatal cases presented with viremia on day 12–14 (100% vs 66.7%, p = 0.017). A higher initial viral load in the respiratory tract and sustained viremia (more than 2 weeks) may be predictors for fatal clinical outcomes.