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成人住院患者呼吸道合胞病毒感染的临床表现和结局。

Clinical manifestations and outcomes of respiratory syncytial virus infection in adult hospitalized patients.

机构信息

Division of Respiratory Disease and Tuberculosis, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Division of Respiratory Disease and Tuberculosis, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; Division of Respiratory Disease, Department of Medicine, Faculty of Medicine, Chonburi hospital, Chonburi, Thailand.

出版信息

J Clin Virol. 2019 Aug;117:103-108. doi: 10.1016/j.jcv.2019.07.001. Epub 2019 Jul 3.

Abstract

BACKGROUND

Respiratory syncytial virus (RSV) is an important virus found in adult hospitalized patients.

OBJECTIVES

To study the clinical outcomes of hospitalized patients aged ≥ 15 years and diagnosed with RSV infection.

STUDY DESIGN

Both retrospective and prospective cohort studies were conducted at a university hospital between May 2014 and December 2015.

RESULTS

RSV was detected in 86 of 1562(5.5%) adult hospitalized patients suspected of respiratory viral infection. Sixty-nine patients were included in the study. RSV was detected by RT-PCR (82.6%), IFA (10.1%), and both RT-PCR and IFA (7.3%). Most patients (87.0%) were aged ≥ 50 years. Cardiovascular diseases, pulmonary diseases, immunocompromised hosts, and diabetes were the major comorbidities. The common manifestations were cough (92.8%), dyspnea (91.3%), sputum production (87.0%), tachypnea (75.4%), wheezing (73.9%), and fever (71.0%). Fifty- five patients (79.7%) were diagnosed with pneumonia. Hypoxemia (SpO2 ≤ 92%) was found in 53.6% patients. Twenty-five of 69(36.2%) patients developed respiratory failure and required ventilatory support. Cardiovascular complications were found in 24.6% of patients. Congestive heart failure, acute myocardial infarction (MI), new atrial fibrillation, and supraventricular tachycardia were found in 9(13.0%), 7(10.1%), 4(5.8%), and 3(4.3%) of 69 patients, respectively. Overall mortality was 15.9%. Pneumonia (81.8%) and acute MI (18.2%) were the major causes of death.

CONCLUSIONS

Most adult hospitalized patients with RSV infection were of advanced age and had comorbidities. Cardiopulmonary complications were the major causes of death. Management and prevention of RSV infection in these vulnerable groups are necessary.

摘要

背景

呼吸道合胞病毒(RSV)是一种在成年住院患者中发现的重要病毒。

目的

研究诊断为 RSV 感染的≥15 岁住院患者的临床结局。

研究设计

2014 年 5 月至 2015 年 12 月,在一所大学医院进行了回顾性和前瞻性队列研究。

结果

在怀疑呼吸道病毒感染的 1562 例成年住院患者中,检测到 86 例 RSV。69 例患者纳入研究。RSV 通过 RT-PCR(82.6%)、IFA(10.1%)和 RT-PCR 和 IFA(7.3%)检测到。大多数患者(87.0%)年龄≥50 岁。心血管疾病、肺部疾病、免疫功能低下宿主和糖尿病是主要合并症。常见表现为咳嗽(92.8%)、呼吸困难(91.3%)、咳痰(87.0%)、呼吸急促(75.4%)、喘息(73.9%)和发热(71.0%)。55 例(79.7%)患者诊断为肺炎。53.6%的患者存在低氧血症(SpO2≤92%)。25 例(36.2%)患者发生呼吸衰竭,需要通气支持。24.6%的患者出现心血管并发症。9 例(13.0%)、7 例(10.1%)、4 例(5.8%)和 3 例(4.3%)患者分别出现充血性心力衰竭、急性心肌梗死(MI)、新发心房颤动和室上性心动过速。总死亡率为 15.9%。肺炎(81.8%)和急性 MI(18.2%)是主要死亡原因。

结论

大多数成年住院患者感染 RSV 年龄较大,合并症较多。心肺并发症是主要死亡原因。有必要对这些脆弱人群进行 RSV 感染的管理和预防。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60b3/7106545/6d5b6575a798/gr1_lrg.jpg

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