Influenza or other respiratory viruses: does it matter as the cause of acute respiratory failure in the critically-ill patients?

Introduction: Respiratory virus infections may cause serious respiratory failure requiring intensive care unit (ICU) admission. The objective of this study was to evaluate the clinical features and the outcome in patients with acute respi-ratory failure (ARF) due to viral infections comparing etiological agents.Materials and Methods: ARF patients with positive viral serology were retros-pectively recruited. Cohort was evaluated with regard to subgroups as influ-enza and other respiratory viruses (ORV), as well as survivors and non-survivors.Results: Out of 938 admitted patients, 319 were followed as ARF and only 149 patients had viral respiratory panel results. In 49 patients with ARF, 52 positive viral results were detected and 47 patients with single positive viral isolates of either influenza or ORV were included. Among them, 62% had ORV with quite similar characteristics with influenza group apart from diabe-tes mellitus which was encountered more in influenza group (p= 0.02). Overall ICU mortality was 32% and there was no difference between the two groups (p= 0.42). Acute Physiology and Chronic Health Evaluation (APACHE) II score was independently associated with ICU mortality (OR: 1.25; 95% CI: 1.04-1.51; p= 0.02). Conclusion: This study emphasizes to consider the possibility of other respiratory viruses for the cause of ARF with similar characte-ristics and mortality as influenza species.

İnfluenza veya diğer solunum yolu virüsleri: kritik hastalarda akut solunum yetmezliğinin sebebi olarak önemli midir?

Giriş: Solunum yolu virüsleri yoğun bakım ünitesi yatışı gerektiren ciddi solunum yetmezliğine neden olabilir. Bu çalışmanın amacı, viral enfeksiyonlara bağlı akut solunum yetmezliği (ASY) olan hastalarda etiyolojik ajanları karşılaştırmak, klinik özellikleri ve sonuç-ları değerlendirmektir.Materyal ve Metod: Viral serolojisi pozitif olan ASY hastaları geriye dönük olarak değerlendirildi. Kohort, influenza ve diğer solunum virüsleri (DSV), sağ kalanlar ve kaybedilenler olarak alt gruplara ayrılarak incelendi.Bulgular: Kabul edilen 938 hastanın 319’u ASY olarak takip edildi ve sadece 149 hastanın viral solunum paneli sonuçları mevcuttu. ASY’li 49 hastanın 52 pozitif viral sonucu tespit edildi ve influenza veya DSV’den tek pozitif viral izolatı olan 47 hasta çalışmaya dahil edildi. Bu hastaların %62’sini influenza grubu ile benzer özelliklere sahip DSV oluşturmaktaydı. Sadece diyabet mellitus influenza grubunda DSV grubuna göre daha fazla görüldü (p= 0.02). Toplam YBÜ mortalitesi %32 idi ve iki grup arasında mortalite açısından fark yoktu (p= 0.42). Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi (APACHE) II skoru bağımsız olarak YBÜ mortalitesi ile ilişkili bulundu (OR: 1.25; %95 GA: 1.04-1.51; p= 0.02).Sonuç: Bu çalışma, ASY nedeni için influenza ile benzer özelliklere ve mortaliteye sahip diğer solunum virüsleri olasılığının düşünül-mesi gerektiğini vurgulamaktadır.

Kaynakça

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