Ciotti Marco, Maurici Massimo, Santoro Viviana, Coppola Luigi, Sarmati Loredana, De Carolis Gerardo, De Filippis Patrizia, Pica Francesca
Unit of Virology Fondazione Policlinico Tor Vergata, 00133 Rome, Italy.
Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy.
Microorganisms. 2020 Apr 1;8(4):501. doi: 10.3390/microorganisms8040501.
Respiratory tract infections account for high morbidity and mortality around the world. Fragile patients are at high risk of developing complications such as pneumonia and may die from it. Limited information is available on the extent of the circulation of respiratory viruses in the hospital setting. Most knowledge relates to influenza viruses (FLU) but several other viruses produce flu-like illness. The study was conducted at the University Hospital Policlinico Tor Vergata, Rome, Italy. Clinical and laboratory data from hospitalized patients with respiratory tract infections during the period October 2016-March 2019 were analysed. The retrospective analysis included 17 viral agents detected by FilmArray test and clinical data from medical records and hospital discharge sheets. Models were adjusted for relevant confounders such as clinical severity and risk of death, socio-demographic characteristics and surgical procedures. From a total of 539 specimens analysed, 180 (33.39%) were positive for one or more respiratory viruses. Among them, 83 (46.1 %) were positive for influenza viruses (FLU), 36 (20%) rhino/enteroviruses (RHV/EV), 17 (9.44%) human coronaviruses (HCOV-229E, -HKU1, -NL63, and -OC43), 17 (9.44%) respiratory syncytial virus, 15 (8.33%) human metapneumovirus (HMPV), 8 (4.44%) parainfluenza viruses (PIV) and 4 (2.22%) adenoviruses (ADV). The distribution of viral agents varied across age groups and month of detection. The positive specimens were from 168 patients [102 M, 66 F; median age (range): 64 years (19-93)]. Overall, 40% of them had a high-grade clinical severity and a 27% risk of death; 27 patients died and 22 of them (81.5%) had received a clinical diagnosis of pneumonia. Respiratory viral infections may have a severe course and a poor prognosis in hospitalized patients, due to underlying comorbidities. Monitoring the circulation of respiratory viruses in hospital settings is important to improve diagnosis, prevention and treatment.
呼吸道感染在全球范围内导致了较高的发病率和死亡率。脆弱患者发生肺炎等并发症的风险很高，甚至可能因此死亡。关于呼吸道病毒在医院环境中的传播程度，目前可获得的信息有限。大多数了解的情况都与流感病毒（FLU）有关，但其他几种病毒也会引发类似流感的疾病。该研究在意大利罗马的托尔韦尔加塔大学医院进行。分析了2016年10月至2019年3月期间住院的呼吸道感染患者的临床和实验室数据。回顾性分析包括通过FilmArray检测法检测到的17种病毒病原体以及病历和医院出院小结中的临床数据。针对相关混杂因素进行了模型调整，如临床严重程度和死亡风险、社会人口统计学特征以及外科手术。在总共分析的539份样本中，180份（33.39%）一种或多种呼吸道病毒检测呈阳性。其中，83份（46.1%）流感病毒（FLU）检测呈阳性，36份（20%）鼻病毒/肠道病毒（RHV/EV）检测呈阳性，17份（9.44%）人冠状病毒（HCOV - 229E、-HKU1、-NL63和-OC43）检测呈阳性，17份（9.44%）呼吸道合胞病毒检测呈阳性，15份（8.33%）人偏肺病毒（HMPV）检测呈阳性，8份（4.44%）副流感病毒（PIV）检测呈阳性，4份（2.22%）腺病毒（ADV）检测呈阳性。病毒病原体的分布因年龄组和检测月份而异。阳性样本来自168名患者[102名男性，66名女性；中位年龄（范围）：64岁（19 - 93岁）]。总体而言，其中40%的患者临床严重程度较高，死亡风险为27%；27名患者死亡，其中22名（81.5%）临床诊断为肺炎。由于存在基础合并症，呼吸道病毒感染在住院患者中可能病程严重且预后较差。监测医院环境中呼吸道病毒的传播对于改善诊断、预防和治疗非常重要。
