A Retrospective Study Investigating Risks of Acute Respiratory Distress Syndrome and Mortality Following Human Metapneumovirus Infection in Hospitalized Adults.
10.4266/kjccm.2017.00038
- Author:
Hyunjung HWANG
;
Yujin KIM
;
Jeong Woong PARK
;
Sung Hwan JEONG
;
Sun Young KYUNG
- Publication Type:Original Article
- Keywords:
metapneumovirus;
mortality;
nosocomial infection;
respiratory distress syndrome, adult
- MeSH:
Adult*;
Aged;
Blood Urea Nitrogen;
C-Reactive Protein;
Child;
Comorbidity;
Cross Infection;
Heart Failure;
Hospitalization;
Humans*;
Korea;
Metapneumovirus*;
Mortality*;
Pneumonia;
Real-Time Polymerase Chain Reaction;
Respiratory Distress Syndrome, Adult*;
Respiratory Syncytial Viruses;
Retrospective Studies*;
Risk Factors;
Tertiary Care Centers;
Thorax
- From:Korean Journal of Critical Care Medicine
2017;32(2):182-189
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Human metapneumovirus (hMPV) is a relatively recently identified respiratory virus that induces respiratory symptoms similar to those of respiratory syncytial virus infection in children. The characteristics of hMPV-infected adults are unclear because few cases have been reported. METHODS: We conducted a retrospective review of hospitalized adult patients with a positive multiplex real-time polymerase chain reaction assay result from 2012 to 2016 at a single tertiary referral hospital in South Korea. We analyzed clinical characteristics of the enrolled patients and divided patients into an acute respiratory distress syndrome (ARDS) group and a non-ARDS group. RESULTS: In total, 110 adults were reviewed in this study. Their mean age was 61.4 years, and the majority (n = 105, 95.5%) had comorbidities or were immunocompromised. Most of the patients had pneumonia on chest X-ray (n = 88, 93.6%), 22 (20.0%) had ARDS, and 12 (10.9%) expired during hospitalization. The mortality rate for patients with ARDS was higher than that of the other patients (36.4% vs. 5.7%, P = 0.001). The risk factor for hMPV-associated ARDS was heart failure (odds ratio, 5.24; P = 0.044) and laboratory values were increased blood urea nitrogen and increased C-reactive protein. The acquisition site of infection was divided into community vs. nosocomial; 43 patients (39.1%) had a nosocomial infection. The risk factors for nosocomial infection were an immunocompromised state, malignancy and immunosuppressive treatment. CONCLUSIONS: These data suggest that hMPV is one of the important respiratory pathogens important respiratory pathogen that causes pneumonia/ARDS in elderly, immunocompromised individuals and that it may be transmitted via the nosocomial route.
