Respiratory virus infection among hospitalized adult patients with or without clinically apparent respiratory infection: a prospective cohort study
Respiratory virus infection among hospitalized adult patients with or without clinically apparent respiratory infection: a prospective cohort study
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DOI：
10.1016/j.cmi.2019.04.012
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发表时间：
2019-12-01
影响因子：
14.2
通讯作者：
Yuen, K. -Y.
中科院分区：
文献类型：
--
作者：
To, K. K. W.;Chan, K. -H.;Yuen, K. -Y.
目的：确定有和无临床明显呼吸道感染患者的病毒流行病学和临床特征。方法：这项前瞻性队列研究在2018年冬季流感季节进行。将有发热/呼吸道症状的成人患者（发热/RS组）与无发热/RS的患者（无发热/RS组）以1：1的比例进行年龄和性别匹配。结果：共214例急性住院患者纳入最终分析，包括107例发热/RS患者（发热/RS组）和107例年龄和性别匹配的无发热/RS患者（非发热/RS组）。34.1%（73/214）的患者检出呼吸道病毒，7.9%（17/214）的患者发生合并感染。发热/RS组的呼吸道病毒发生率高于非发热/RS组（44.9%（48/107）vs 23.4%（25/107），p 0.001）。流感B病毒、肠道病毒/鼻病毒和冠状病毒在发热/RS组中检出率更高，而副流感病毒4型B和腺病毒在非发热/RS组中检出率更高。在非发热/RS组中，呼吸道病毒检测阳性的患者比未检测到呼吸道病毒的患者更常见胸部不适（44%（11/25）vs 22%（18/82），p 0.04）。结论：在没有典型呼吸道感染特征的住院患者中，呼吸道病毒可以频繁检测到。这些患者可能是院内暴发的来源。(C)2019年欧洲临床微生物学和传染病学会。由爱思唯尔有限公司出版。保留所有权利。
Objectives: To determine the viral epidemiology and clinical characteristics of patients with and without clinically apparent respiratory tract infection.Methods: This prospective cohort study was conducted during the 2018 winter influenza season. Adult patients with fever/respiratory symptoms (fever/RS group) were age- and sex-matched with patients without fever/RS (non-fever/RS group) in a 1:1 ratio. Respiratory viruses were tested using NxTAGT Respiratory Pathogen Panel IVD, a commercially-available multiplex PCR panel.Results: A total of 214 acutely hospitalized patients were included in the final analysis, consisting of 107 with fever/RS (fever/RS group), and 107 age- and sex-matched patients without fever/RS (non-fever/RS group). Respiratory viruses were detected in 34.1% (73/214) of patients, and co-infection occurred in 7.9% (17/214) of patients. The incidence of respiratory virus was higher in the fever/RS group than in the nonfever/RS group (44.9% (48/107) versus 23.4% (25/107), p 0.001). Influenza B virus, enterovirus/rhinovirus and coronaviruses were detected more frequently in the fever/RS group, whereas parainfluenza virus 4B and adenovirus were detected more frequently in the non-fever/RS group. Among the non-fever/RS group, chest discomfort was more common among patients tested positive for respiratory viruses than those without respiratory virus detected (44% (11/25) versus 22% (18/82), p 0.04).Conclusions: Respiratory viruses can be frequently detected among hospitalized patients without typical features of respiratory tract infection. These patients may be a source of nosocomial outbreaks. (C) 2019 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.