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因呼吸道合胞病毒感染住院的成人患者的高病毒载量与呼吸衰竭

High Viral Load and Respiratory Failure in Adults Hospitalized for Respiratory Syncytial Virus Infections.

作者信息

Lee Nelson, Chan Martin C W, Lui Grace C Y, Li Ran, Wong Rity Y K, Yung Irene M H, Cheung Catherine S K, Chan Eugenia C Y, Hui David S C, Chan Paul K S

机构信息

Department of Medicine and Therapeutics Stanley Ho Centre for Emerging Infectious Diseases.

Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR PRC.

出版信息

J Infect Dis. 2015 Oct 15;212(8):1237-40. doi: 10.1093/infdis/jiv248. Epub 2015 Apr 22.

Abstract

A prospective study among adults hospitalized for polymerase chain reaction-confirmed respiratory syncytial virus infections (n = 123) showed frequent occurrence of lower respiratory-tract complications causing respiratory insufficiency (52.8%), requirement for assisted ventilation (16.3%), and intensive care unit admission/death (12.2%). High viral RNA concentration was detected at time of hospitalization, including in patients who presented later than 2 days of illness (day 1-2, 7.29 ± 1.47; day 3-4, 7.28 ± 1.41; day 5-8, 6.66 ± 1.87 log10 copies/mL). RNA concentration was independently associated with risk of complications and respiratory insufficiency (adjusted odds ratio 1.40 per log10 copies/mL increase, 95% confidence interval, 1.03-1.90; P = .034). Our data indicate the need and provide a basis for clinical research on antiviral therapy in this population.

摘要

一项针对因聚合酶链反应确诊为呼吸道合胞病毒感染而住院的成年人的前瞻性研究(n = 123)显示,下呼吸道并发症频繁发生,导致呼吸功能不全(52.8%)、需要辅助通气(16.3%)以及入住重症监护病房/死亡(12.2%)。住院时检测到高病毒RNA浓度,包括发病2天后就诊的患者(第1 - 2天,7.29 ± 1.47;第3 - 4天,7.28 ± 1.41;第5 - 8天,6.66 ± 1.87 log10拷贝/毫升)。RNA浓度与并发症和呼吸功能不全的风险独立相关(每增加1 log10拷贝/毫升,调整后的优势比为1.40,95%置信区间为1.03 - 1.90;P = 0.034)。我们的数据表明了在该人群中进行抗病毒治疗临床研究的必要性,并提供了依据。

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