Impact of preceding respiratory viral infections on the clinical severity of patients with pneumococcal pneumonia

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Abstract

Background: This study aimed to investigate the impact of preceding respiratory viral infections (RVI) on the clinical severity of pneumococcal pneumonia patients. Methods: A retrospective observational study was conducted at a university hospital from January 2009 to March 2013. Study subjects included adults (aged ≥18 years) with pneumococcal pneumonia who had undergone laboratory tests for RVI. Multivariate logistic regression analysis was performed to identify risk factors associated with severe pneumococcal pneumonia, defined as severity with the Pneumonia Severity Index (PSI) score ≥91. Results: In total, 191 patients with pneumococcal pneumonia were included for analysis and stratified into 2 groups: the severe group with a PSI score ≥91 (n = 99) and the non-severe group with a PSI score <91 (n = 92). Preceding RVIs were detected in 48 patients, including influenza A virus (n = 20), influenza B virus (n = 4), parainfluenza viruses (n = 5), metapneumovirus (n = 4), rhinovirus (n = 4), respiratory syncytial viruses (n = 6), coronaviruses (n = 2), and mixed viral infections (n = 3). In the multivariate logistic regression analysis, preceding RVIs (odds ratio [OR], 2·49; 95% confidence interval [CI], 1·10-5·60), male sex (OR, 2·58; 95% CI, 1·24-5·38), old age (OR, 2·92; 95% CI, 1·37-6·24), hypoalbuminemia (OR, 3·26; 95% CI, 1·56-6·84)], and azotemia (OR, 2·24; 95% CI, 1·08-4·67) were significantly associated with severe pneumococcal pneumonia. Conclusion: This study suggests that preceding RVIs might be one of the risk factors affecting the clinical severity of pneumococcal pneumonia.

Original languageEnglish
Pages (from-to)549-556
Number of pages8
JournalInfluenza and other Respiratory Viruses
Volume8
Issue number5
DOIs
Publication statusPublished - 2014 Jan 1

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Pneumococcal Pneumonia
Virus Diseases
Respiratory Tract Infections
Odds Ratio
Confidence Intervals
Pneumonia
Parainfluenza Virus 5
Logistic Models
Regression Analysis
Metapneumovirus
Influenza B virus
Azotemia
Rhinovirus
Hypoalbuminemia
Coronavirus
Respiratory Syncytial Viruses
Influenza A virus
Sex Ratio
Coinfection
Observational Studies

Cite this

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title = "Impact of preceding respiratory viral infections on the clinical severity of patients with pneumococcal pneumonia",
abstract = "Background: This study aimed to investigate the impact of preceding respiratory viral infections (RVI) on the clinical severity of pneumococcal pneumonia patients. Methods: A retrospective observational study was conducted at a university hospital from January 2009 to March 2013. Study subjects included adults (aged ≥18 years) with pneumococcal pneumonia who had undergone laboratory tests for RVI. Multivariate logistic regression analysis was performed to identify risk factors associated with severe pneumococcal pneumonia, defined as severity with the Pneumonia Severity Index (PSI) score ≥91. Results: In total, 191 patients with pneumococcal pneumonia were included for analysis and stratified into 2 groups: the severe group with a PSI score ≥91 (n = 99) and the non-severe group with a PSI score <91 (n = 92). Preceding RVIs were detected in 48 patients, including influenza A virus (n = 20), influenza B virus (n = 4), parainfluenza viruses (n = 5), metapneumovirus (n = 4), rhinovirus (n = 4), respiratory syncytial viruses (n = 6), coronaviruses (n = 2), and mixed viral infections (n = 3). In the multivariate logistic regression analysis, preceding RVIs (odds ratio [OR], 2·49; 95{\%} confidence interval [CI], 1·10-5·60), male sex (OR, 2·58; 95{\%} CI, 1·24-5·38), old age (OR, 2·92; 95{\%} CI, 1·37-6·24), hypoalbuminemia (OR, 3·26; 95{\%} CI, 1·56-6·84)], and azotemia (OR, 2·24; 95{\%} CI, 1·08-4·67) were significantly associated with severe pneumococcal pneumonia. Conclusion: This study suggests that preceding RVIs might be one of the risk factors affecting the clinical severity of pneumococcal pneumonia.",
keywords = "Streptococcus pneumoniae, Clinical severity, Pneumonia, Respiratory viruses",
author = "Yoon, {Young Kyung} and Yang, {Kyung Sook} and Sohn, {Jang Wook} and Lee, {Chang Kyu} and Min, {Ja Kim}",
year = "2014",
month = "1",
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doi = "10.1111/irv.12265",
language = "English",
volume = "8",
pages = "549--556",
journal = "Influenza and other Respiratory Viruses",
issn = "1750-2640",
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TY - JOUR

T1 - Impact of preceding respiratory viral infections on the clinical severity of patients with pneumococcal pneumonia

AU - Yoon, Young Kyung

AU - Yang, Kyung Sook

AU - Sohn, Jang Wook

AU - Lee, Chang Kyu

AU - Min, Ja Kim

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background: This study aimed to investigate the impact of preceding respiratory viral infections (RVI) on the clinical severity of pneumococcal pneumonia patients. Methods: A retrospective observational study was conducted at a university hospital from January 2009 to March 2013. Study subjects included adults (aged ≥18 years) with pneumococcal pneumonia who had undergone laboratory tests for RVI. Multivariate logistic regression analysis was performed to identify risk factors associated with severe pneumococcal pneumonia, defined as severity with the Pneumonia Severity Index (PSI) score ≥91. Results: In total, 191 patients with pneumococcal pneumonia were included for analysis and stratified into 2 groups: the severe group with a PSI score ≥91 (n = 99) and the non-severe group with a PSI score <91 (n = 92). Preceding RVIs were detected in 48 patients, including influenza A virus (n = 20), influenza B virus (n = 4), parainfluenza viruses (n = 5), metapneumovirus (n = 4), rhinovirus (n = 4), respiratory syncytial viruses (n = 6), coronaviruses (n = 2), and mixed viral infections (n = 3). In the multivariate logistic regression analysis, preceding RVIs (odds ratio [OR], 2·49; 95% confidence interval [CI], 1·10-5·60), male sex (OR, 2·58; 95% CI, 1·24-5·38), old age (OR, 2·92; 95% CI, 1·37-6·24), hypoalbuminemia (OR, 3·26; 95% CI, 1·56-6·84)], and azotemia (OR, 2·24; 95% CI, 1·08-4·67) were significantly associated with severe pneumococcal pneumonia. Conclusion: This study suggests that preceding RVIs might be one of the risk factors affecting the clinical severity of pneumococcal pneumonia.

AB - Background: This study aimed to investigate the impact of preceding respiratory viral infections (RVI) on the clinical severity of pneumococcal pneumonia patients. Methods: A retrospective observational study was conducted at a university hospital from January 2009 to March 2013. Study subjects included adults (aged ≥18 years) with pneumococcal pneumonia who had undergone laboratory tests for RVI. Multivariate logistic regression analysis was performed to identify risk factors associated with severe pneumococcal pneumonia, defined as severity with the Pneumonia Severity Index (PSI) score ≥91. Results: In total, 191 patients with pneumococcal pneumonia were included for analysis and stratified into 2 groups: the severe group with a PSI score ≥91 (n = 99) and the non-severe group with a PSI score <91 (n = 92). Preceding RVIs were detected in 48 patients, including influenza A virus (n = 20), influenza B virus (n = 4), parainfluenza viruses (n = 5), metapneumovirus (n = 4), rhinovirus (n = 4), respiratory syncytial viruses (n = 6), coronaviruses (n = 2), and mixed viral infections (n = 3). In the multivariate logistic regression analysis, preceding RVIs (odds ratio [OR], 2·49; 95% confidence interval [CI], 1·10-5·60), male sex (OR, 2·58; 95% CI, 1·24-5·38), old age (OR, 2·92; 95% CI, 1·37-6·24), hypoalbuminemia (OR, 3·26; 95% CI, 1·56-6·84)], and azotemia (OR, 2·24; 95% CI, 1·08-4·67) were significantly associated with severe pneumococcal pneumonia. Conclusion: This study suggests that preceding RVIs might be one of the risk factors affecting the clinical severity of pneumococcal pneumonia.

KW - Streptococcus pneumoniae

KW - Clinical severity

KW - Pneumonia

KW - Respiratory viruses

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U2 - 10.1111/irv.12265

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