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Viral community acquired pneumonia at the emergency department: Report from the pre COVID‐19 age
The role of viruses in community acquired pneumonia (CAP) has been largely underestimated in the pre‐coronavirus disease 2019 age. However, during flu seasonal early identification of viral infection in CAP is crucial to guide treatment and in‐hospital management. Though recommended, the routine use...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8250557/ https://www.ncbi.nlm.nih.gov/pubmed/33783850 http://dx.doi.org/10.1002/jmv.26980 |
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author | Spagnolello, Ornella Pierangeli, Alessandra Cedrone, Maria Civita Di Biagio, Valentina Gentile, Massimo Leonardi, Annalisa Valeriano, Camilla Innocenti, Giuseppe Pietro Santinelli, Letizia Borrazzo, Cristian Russo, Alessandro Oliveto, Giuseppe Viscido, Agnese Ciccozzi, Massimo Bertazzoni, Giuliano d'Ettorre, Gabriella Ceccarelli, Giancarlo |
author_facet | Spagnolello, Ornella Pierangeli, Alessandra Cedrone, Maria Civita Di Biagio, Valentina Gentile, Massimo Leonardi, Annalisa Valeriano, Camilla Innocenti, Giuseppe Pietro Santinelli, Letizia Borrazzo, Cristian Russo, Alessandro Oliveto, Giuseppe Viscido, Agnese Ciccozzi, Massimo Bertazzoni, Giuliano d'Ettorre, Gabriella Ceccarelli, Giancarlo |
author_sort | Spagnolello, Ornella |
collection | PubMed |
description | The role of viruses in community acquired pneumonia (CAP) has been largely underestimated in the pre‐coronavirus disease 2019 age. However, during flu seasonal early identification of viral infection in CAP is crucial to guide treatment and in‐hospital management. Though recommended, the routine use of nasopharyngeal swab (NPS) to detect viral infection has been poorly scaled‐up, especially in the emergency department (ED). This study sought to assess the prevalence and associated clinical outcomes of viral infections in patients with CAP during peak flu season. In this retrospective, observational study adults presenting at the ED of our hospital (Rome, Italy) with CAP from January 15th to February 22th, 2019 were enrolled. Each patient was tested on admission with Influenza rapid test and real time multiplex assay. Seventy five consecutive patients were enrolled. 30.7% (n = 23) tested positive for viral infection. Of these, 52.1% (n = 12) were H1N1/FluA. 10 patients had multiple virus co‐infections. CAP with viral infection did not differ for any demographic, clinic and laboratory features by the exception of CCI and CURB‐65. All intra‐ED deaths and mechanical ventilations were recorded among CAP with viral infection. Testing only patients with CURB‐65 score ≥2, 10 out of 12 cases of H1N1/FluA would have been detected saving up to 40% tests. Viral infection occurred in one‐third of CAP during flu seasonal peak 2019. Since not otherwise distinguishable, NPS is so far the only reliable mean to identify CAP with viral infection. Testing only patients with moderate/severe CAP significantly minimize the number of tests. |
format | Online Article Text |
id | pubmed-8250557 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-82505572021-07-02 Viral community acquired pneumonia at the emergency department: Report from the pre COVID‐19 age Spagnolello, Ornella Pierangeli, Alessandra Cedrone, Maria Civita Di Biagio, Valentina Gentile, Massimo Leonardi, Annalisa Valeriano, Camilla Innocenti, Giuseppe Pietro Santinelli, Letizia Borrazzo, Cristian Russo, Alessandro Oliveto, Giuseppe Viscido, Agnese Ciccozzi, Massimo Bertazzoni, Giuliano d'Ettorre, Gabriella Ceccarelli, Giancarlo J Med Virol Research Articles The role of viruses in community acquired pneumonia (CAP) has been largely underestimated in the pre‐coronavirus disease 2019 age. However, during flu seasonal early identification of viral infection in CAP is crucial to guide treatment and in‐hospital management. Though recommended, the routine use of nasopharyngeal swab (NPS) to detect viral infection has been poorly scaled‐up, especially in the emergency department (ED). This study sought to assess the prevalence and associated clinical outcomes of viral infections in patients with CAP during peak flu season. In this retrospective, observational study adults presenting at the ED of our hospital (Rome, Italy) with CAP from January 15th to February 22th, 2019 were enrolled. Each patient was tested on admission with Influenza rapid test and real time multiplex assay. Seventy five consecutive patients were enrolled. 30.7% (n = 23) tested positive for viral infection. Of these, 52.1% (n = 12) were H1N1/FluA. 10 patients had multiple virus co‐infections. CAP with viral infection did not differ for any demographic, clinic and laboratory features by the exception of CCI and CURB‐65. All intra‐ED deaths and mechanical ventilations were recorded among CAP with viral infection. Testing only patients with CURB‐65 score ≥2, 10 out of 12 cases of H1N1/FluA would have been detected saving up to 40% tests. Viral infection occurred in one‐third of CAP during flu seasonal peak 2019. Since not otherwise distinguishable, NPS is so far the only reliable mean to identify CAP with viral infection. Testing only patients with moderate/severe CAP significantly minimize the number of tests. John Wiley and Sons Inc. 2021-04-06 2021-07 /pmc/articles/PMC8250557/ /pubmed/33783850 http://dx.doi.org/10.1002/jmv.26980 Text en © 2021 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Articles Spagnolello, Ornella Pierangeli, Alessandra Cedrone, Maria Civita Di Biagio, Valentina Gentile, Massimo Leonardi, Annalisa Valeriano, Camilla Innocenti, Giuseppe Pietro Santinelli, Letizia Borrazzo, Cristian Russo, Alessandro Oliveto, Giuseppe Viscido, Agnese Ciccozzi, Massimo Bertazzoni, Giuliano d'Ettorre, Gabriella Ceccarelli, Giancarlo Viral community acquired pneumonia at the emergency department: Report from the pre COVID‐19 age |
title | Viral community acquired pneumonia at the emergency department: Report from the pre COVID‐19 age |
title_full | Viral community acquired pneumonia at the emergency department: Report from the pre COVID‐19 age |
title_fullStr | Viral community acquired pneumonia at the emergency department: Report from the pre COVID‐19 age |
title_full_unstemmed | Viral community acquired pneumonia at the emergency department: Report from the pre COVID‐19 age |
title_short | Viral community acquired pneumonia at the emergency department: Report from the pre COVID‐19 age |
title_sort | viral community acquired pneumonia at the emergency department: report from the pre covid‐19 age |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8250557/ https://www.ncbi.nlm.nih.gov/pubmed/33783850 http://dx.doi.org/10.1002/jmv.26980 |
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