Department of Anaesthesiology and Critical Care, Complejo Asistencial Universitario de Salamanca, Gerencia Regional de Salud de Castilla y León (SACYL), Salamanca, Spain.
Department of Surgery, Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain.
Medicine (Baltimore). 2022 Aug 12;101(32):e29902. doi: 10.1097/MD.0000000000029902.
Respiratory viruses are part of the normal microbiota of the respiratory tract, which sometimes cause infection with/without respiratory insufficiency and the need for hospital or ICU admission. The aim of this study is to determine the prevalence of respiratory viruses in nontransplanted postoperative septic patients as well as lymphocyte count influence in their presence and its relationship to mortality. 223 nontransplanted postsurgical septic patients were recruited on the Intensive Care Unit (ICU) at Hospital Clínico Universitario de Valladolid prior to the SARS-COV-2 pandemic. Patients were split into 2 groups according to the presence/absence of respiratory viruses. Multivariate logistic regression analysis was used to identify independent factors related to positive respiratory virus PCR test. Respiratory viruses were isolated in 28.7% of patients. 28-day mortality was not significantly different between virus-positive and virus-negative groups. Logistic regression analysis revealed that lymphocyte count ≤ 928/µl is independently associated with a positive PCR result [OR 3.76, 95% CI (1.71-8.26), P = .001] adjusted by platelet count over 128,500/µL [OR 4.27, 95% CI (1.92-9.50) P < .001] and the presence of hypertension [OR 2.69, 95% CI (1.13-6.36) P = .025] as confounding variables. Respiratory viruses' detection by using PCR in respiratory samples of nontransplanted postoperative septic patients is frequent. These preliminary results revealed that the presence of lymphopenia on sepsis diagnosis is independently associated to a positive virus result, which is not related to a higher 28-day mortality.
呼吸道病毒是呼吸道正常微生物群的一部分，有时会导致感染，伴有或不伴有呼吸功能不全，需要住院或入住 ICU。本研究旨在确定非移植术后脓毒症患者呼吸道病毒的流行率，以及淋巴细胞计数对其存在的影响及其与死亡率的关系。在 SARS-COV-2 大流行之前，在巴利亚多利德大学临床医院的重症监护病房（ICU）招募了 223 名非移植术后脓毒症患者。根据是否存在呼吸道病毒，将患者分为两组。使用多变量逻辑回归分析确定与呼吸道病毒 PCR 检测阳性相关的独立因素。在 28.7%的患者中分离出呼吸道病毒。病毒阳性组和病毒阴性组的 28 天死亡率无显著差异。逻辑回归分析显示，淋巴细胞计数≤928/µl 与 PCR 结果阳性独立相关[OR 3.76，95%CI（1.71-8.26），P =.001]，校正血小板计数超过 128500/µL [OR 4.27，95%CI（1.92-9.50），P <.001]和高血压的存在[OR 2.69，95%CI（1.13-6.36），P =.025]作为混杂因素。在非移植术后脓毒症患者的呼吸道样本中使用 PCR 检测呼吸道病毒的检出率较高。这些初步结果表明，脓毒症诊断时出现淋巴细胞减少与病毒阳性结果独立相关，与 28 天死亡率升高无关。
