Incidence and risk factors of active human cytomegalovirus infection in patients with severe community-acquired pneumonia
10.3760/cma.j.cn112866-20210207-00029
- VernacularTitle:重症社区获得性肺炎患者人巨细胞病毒活动性感染状况以及危险因素分析
- Author:
Zhihui ZHANG
1
;
Zhan WU
;
Jierong ZHANG
;
Jiaqi LIANG
;
Minmin XU
;
Sibei CHEN
;
Xuesong LIU
;
Yonghao XU
;
Ling SANG
;
Weiqun HE
;
Yimin LI
;
Xiaoqing LIU
Author Information
1. 呼吸疾病国家重点实验室 广州呼吸健康研究院 广州医科大学附属第一医院呼吸与危重症医学科，广州 510120
- Keywords:
Human cytomegalovirus;
Active infection;
Severe community-acquired pneumonia;
Incidence;
Risk factors
- From:
Chinese Journal of Experimental and Clinical Virology
2021;35(4):389-394
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the incidence and risk factors of active human cytomegalovirus (HCMV) infection in patients with severe community-acquired pneumonia.Methods:Patients who required respiratory support and were diagnosed with severe community-acquired pneumonia in the respiratory intensive care unit (RICU) of the First Affiliated Hospital of Guangzhou Medical University from March 1, 2019 to June 1, 2020 were consecutively screened and divided into active HCMV infection group (20 cases) and non-active HCMV infection group (95 cases) based on whether a patient has active HCMV infection or not. Differences in demographic data, laboratory findings, and clinical outcomes were compared between the two groups. Moreover, logistic regression was applied to analyze risk factors for active HCMV infection.Results:The 20 of 115 patients with severe community-acquired pneumonia requiring respiratory support were confirmed to have active infection with HCMV, with a prevalence of active HCMV infection of 17.4%. The pneumonia severity index (PSI) and suppressor T lymphocytes (Ts) in active HCMV infection group were higher than that of the control group, and all the differences were statistically significant ( Z=2.432, P=0.015; Z=2.036, P=0.042); whereas lymphocytes, monocytes, blood lactate, and platelet levels were lower than those of the control group, and all the differences were statistically significant ( P < 0.05). Patients with active HCMV infection had a higher transfusion rate than the control group, and the differences were statistically significant (χ 2=3.941; P=0.047). Increasing levels of PSI and Ts percentage were independent risk factors for active HCMV infection ( OR=1.03, 95% CI: 1.01~1.05; OR=1.06, 95% CI: 1.00~1.11; P < 0.05). RICU length of stay, complication rates, and 90-day all-cause mortality were higher in the active HCMV infection group than the control group, and all the differences were statistically significant ( P < 0.05). Conclusions:Active HCMV infection is highly prevalent in patients with severe community-acquired pneumonia and associated with several adverse clinical outcomes, with PSI and Ts cell levels being independent risk factors.
