Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
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
_version_ 1783717057917878272
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
work_keys_str_mv AT spagnolelloornella viralcommunityacquiredpneumoniaattheemergencydepartmentreportfromtheprecovid19age
AT pierangelialessandra viralcommunityacquiredpneumoniaattheemergencydepartmentreportfromtheprecovid19age
AT cedronemariacivita viralcommunityacquiredpneumoniaattheemergencydepartmentreportfromtheprecovid19age
AT dibiagiovalentina viralcommunityacquiredpneumoniaattheemergencydepartmentreportfromtheprecovid19age
AT gentilemassimo viralcommunityacquiredpneumoniaattheemergencydepartmentreportfromtheprecovid19age
AT leonardiannalisa viralcommunityacquiredpneumoniaattheemergencydepartmentreportfromtheprecovid19age
AT valerianocamilla viralcommunityacquiredpneumoniaattheemergencydepartmentreportfromtheprecovid19age
AT innocentigiuseppepietro viralcommunityacquiredpneumoniaattheemergencydepartmentreportfromtheprecovid19age
AT santinelliletizia viralcommunityacquiredpneumoniaattheemergencydepartmentreportfromtheprecovid19age
AT borrazzocristian viralcommunityacquiredpneumoniaattheemergencydepartmentreportfromtheprecovid19age
AT russoalessandro viralcommunityacquiredpneumoniaattheemergencydepartmentreportfromtheprecovid19age
AT olivetogiuseppe viralcommunityacquiredpneumoniaattheemergencydepartmentreportfromtheprecovid19age
AT viscidoagnese viralcommunityacquiredpneumoniaattheemergencydepartmentreportfromtheprecovid19age
AT ciccozzimassimo viralcommunityacquiredpneumoniaattheemergencydepartmentreportfromtheprecovid19age
AT bertazzonigiuliano viralcommunityacquiredpneumoniaattheemergencydepartmentreportfromtheprecovid19age
AT dettorregabriella viralcommunityacquiredpneumoniaattheemergencydepartmentreportfromtheprecovid19age
AT ceccarelligiancarlo viralcommunityacquiredpneumoniaattheemergencydepartmentreportfromtheprecovid19age