住院成年患者中流感病毒和呼吸道合胞病毒合并感染的严重程度。

Severity of influenza virus and respiratory syncytial virus coinfections in hospitalized adult patients.

机构信息

Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, Center for Respiratory Diseases, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China.

出版信息

J Clin Virol. 2020 Dec;133:104685. doi: 10.1016/j.jcv.2020.104685. Epub 2020 Nov 6.

DOI:10.1016/j.jcv.2020.104685

PMID:33220548

Abstract

BACKGROUND

With the introduction of molecular diagnostic techniques over the past decades, different kinds of viral pathogens in the same sample are detected simultaneously more frequently. Nevertheless, influenza virus (Flu) and respiratory syncytial virus (RSV) coinfection in adults was reported only occasionally. Moreover, the clinical implications of Flu/RSV coinfection in the respiratory tract of adults remain unclear.

METHODS

This retrospective study analyzed adult patients with acute respiratory infection from January 2017 to June 2019 in China-Japan Friendship Hospital.

RESULTS

A total of 574, 235 and 113 patients were positive for influenza A-only (FA-only), influenza B-only (FB-only) and RSV-only in influenza seasons (from Nov 2017 to Mar 2018 and from Nov 2018 to Mar 2019), respectively. Of these, 19 cases were coinfected by Flu and RSV and admitted to this hospital. Compared with 809 Flu-only infected patients and 113 RSV-only infected patients, both the rates of intensive care unit(ICU) admission and use of invasive mechanical ventilation in Flu/RSV coinfected patients were higher (ICU admission: 47.4% vs. 20.1%, P=0.004; 47.4% vs. 22.1%, P=0.020; invasive mechanical ventilation: 47.4% vs.13.2%, P<0.001; 47.4% vs. 17.7%, P=0.004). Furthermore, 60-day all-cause mortality attributed to Flu/RSV coinfections was significantly greater than that for Flu and RSV mono-infected patients (36.8% vs. 8.0%,P<0.001; 36.8% vs. 11.5%, P=0.004.

CONCLUSION

The findings of this study suggest that coinfection of Flu/RSV in adults is associated with a high adverse outcome. Thus, Flu/RSV coinfections should be increasingly appreciated and given appropriate management.

摘要

背景

在过去几十年中，随着分子诊断技术的引入，人们越来越频繁地同时检测同一样本中的多种病毒病原体。然而，成年人中流感病毒（Flu）和呼吸道合胞病毒（RSV）的合并感染仅偶尔有报道。此外，成年人呼吸道中 Flu/RSV 合并感染的临床意义尚不清楚。

方法

本回顾性研究分析了 2017 年 1 月至 2019 年 6 月期间在中国-日本友好医院就诊的急性呼吸道感染的成年患者。

结果

在流感季节（2017 年 11 月至 2018 年 3 月和 2018 年 11 月至 2019 年 3 月），分别有 574、235 和 113 例患者流感 A 型（FA-only）、流感 B 型（FB-only）和 RSV 型（RSV-only）呈阳性。其中，19 例 Flu 和 RSV 合并感染的患者入住我院。与 809 例 Flu 单感染患者和 113 例 RSV 单感染患者相比，Flu/RSV 合并感染患者 ICU 入住率和有创机械通气使用率均较高（ICU 入住率：47.4% vs. 20.1%，P=0.004；47.4% vs. 22.1%，P=0.020；有创机械通气：47.4% vs. 13.2%，P<0.001；47.4% vs. 17.7%，P=0.004）。此外，Flu/RSV 合并感染患者 60 天全因死亡率明显高于 Flu 和 RSV 单感染患者（36.8% vs. 8.0%，P<0.001；36.8% vs. 11.5%，P=0.004）。