Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Ciber de Enfermedades Respiratorias (Ciberes), Barcelona, Spain.
Department of Infectious Diseases, Hospital Clinic of Barcelona, Barcelona, Spain.
Semin Respir Crit Care Med. 2022 Feb;43(1):60-74. doi: 10.1055/s-0041-1740982. Epub 2022 Feb 16.
Severe viral infections may result in severe illnesses capable of causing acute respiratory failure that could progress rapidly to acute respiratory distress syndrome (ARDS), related to worse outcomes, especially in individuals with a higher risk of infection, including the elderly and those with comorbidities such as asthma, diabetes mellitus and chronic respiratory or cardiovascular disease. In addition, in cases of severe viral pneumonia, co-infection with bacteria such as and is related to worse outcomes. Respiratory viruses like influenza, rhinovirus, parainfluenza, adenovirus, metapneumovirus, respiratory syncytial virus, and coronavirus have increasingly been detected. This trend has become more prevalent, especially in critically ill patients, due to the availability and implementation of molecular assays in clinical practice. Respiratory viruses have been diagnosed as a frequent cause of severe pneumonia, including cases of community-acquired pneumonia, hospital-acquired pneumonia, and ventilator-associated pneumonia. In this review, we will discuss the epidemiology, diagnosis, clinical characteristics, management, and prognosis of patients with severe infections due to respiratory viruses, with a focus on influenza viruses, non-influenza viruses, and coronaviruses.
严重的病毒感染可能导致严重疾病,导致急性呼吸衰竭,进而迅速发展为急性呼吸窘迫综合征(ARDS),与更差的预后相关,特别是在感染风险较高的人群中,包括老年人和患有哮喘、糖尿病和慢性呼吸或心血管疾病等合并症的人群。此外,在严重病毒性肺炎的情况下,与细菌的合并感染,如 和 ,与更差的预后相关。越来越多的呼吸道病毒如流感病毒、鼻病毒、副流感病毒、腺病毒、副黏液病毒、呼吸道合胞病毒和冠状病毒被检测到。由于分子检测在临床实践中的可用性和实施,这种趋势在危重症患者中更为普遍。呼吸道病毒已被诊断为严重肺炎的常见病因,包括社区获得性肺炎、医院获得性肺炎和呼吸机相关性肺炎。在这篇综述中,我们将讨论由于呼吸道病毒引起的严重感染患者的流行病学、诊断、临床特征、管理和预后,重点讨论流感病毒、非流感病毒和冠状病毒。