Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei City 10507, Taiwan.
College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan.
Viruses. 2022 Jan 21;14(2):205. doi: 10.3390/v14020205.
Critically ill patients, such as those in intensive care units (ICUs), can develop herpes simplex virus (HSV) pneumonitis. Given the high prevalence of acute respiratory distress syndrome (ARDS) and multiple pre-existing conditions among ICU patients with HSV pneumonitis, factors predicting mortality in this patient population require further investigation. In this retrospective study, the bronchoalveolar lavage or sputum samples of ICU patients were cultured or subjected to a polymerase chain reaction for HSV detection. Univariable and multivariable Cox regressions were conducted for mortality outcomes. The length of hospital stay was plotted against mortality on Kaplan-Meier curves. Among the 119 patients with HSV pneumonitis (age: 65.8 ± 14.9 years), the mortality rate was 61.34% (73 deaths). The mortality rate was significantly lower among patients with diabetes mellitus (odds ratio [OR] 0.12, 95% confidence interval [CI]: 0.02-0.49, = 0.0009) and significantly higher among patients with ARDS (OR: 4.18, 95% CI: 1.05-17.97, < 0.0001) or high (≥30) Acute Physiology and Chronic Health Evaluation II scores (OR: 1.08, 95% CI: 1.00-1.18, = 0.02). Not having diabetes mellitus (DM), developing ARDS, and having a high Acute Physiology and Chronic Health Evaluation II (APACHE II) score were independent predictors of mortality among ICU patients with HSV pneumonitis.
危重症患者,如重症监护病房(ICU)中的患者,可能会发展为单纯疱疹病毒(HSV)肺炎。鉴于 ICU 中患有 HSV 肺炎的患者中急性呼吸窘迫综合征(ARDS)和多种预先存在的疾病的高发率,需要进一步研究预测该患者人群死亡率的因素。在这项回顾性研究中,对 ICU 患者的支气管肺泡灌洗液或痰液样本进行培养或进行聚合酶链反应以检测 HSV。进行单变量和多变量 Cox 回归分析以评估死亡率结果。根据 Kaplan-Meier 曲线绘制住院时间与死亡率的关系。在 119 例 HSV 肺炎患者(年龄:65.8±14.9 岁)中,死亡率为 61.34%(73 例死亡)。患有糖尿病的患者死亡率明显较低(比值比 [OR] 0.12,95%置信区间 [CI]:0.02-0.49, = 0.0009),患有 ARDS 的患者死亡率明显较高(OR:4.18,95% CI:1.05-17.97, <0.0001)或急性生理学和慢性健康评估 II 评分较高(≥30)(OR:1.08,95% CI:1.00-1.18, = 0.02)。没有糖尿病(DM)、发生 ARDS 和具有高急性生理学和慢性健康评估 II(APACHE II)评分是 ICU 中患有 HSV 肺炎的患者死亡率的独立预测因素。