Respiratory viral infections in adult patients hospitalized in an intensive care unit

Abstract

Background: Respiratory viral infection (RVI) for critically ill patients is an important factor in the aspects for treatment and infection control. Yet, recent data on their incidence and occurrence patterns is scarce. The aim of this study was to investigate the epidemiology of RVI in critically ill patients.

Methods: This retrospective observational study was conducted in a tertiary hospital in South Korea from November, 2014 to September, 2020. All adult patients (≥18 years old) admitted in intensive care unit (ICU) with positive multiplex polymerase chain reaction test (mPCR) for RVI were included. Clinical characteristics and outcomes were obtained by reviewing electronic medical records.

Results: Among 22 532 patients admitted in ICU during study period, 2222 (10.1%) patients underwent mPCR test for RVI detection. Finally, a total of 335 (15.1%) non-duplicative RVI positive cases were included for analysis. Incidence rate of RVI in ICU was 308.1 per 100,000 patient-day. Most frequently detected RVI was Influenza A (n = 93, 26.2%), followed by Rhinovirus (n = 85, 25.4%). Six (0.6%) patients were asymptomatic, and 301 (89.9%) cases had pneumonia: community-acquired (n = 193, 57.6%) and hospital-acquired pneumonia (n = 108, 32.2%). All-cause mortality was 27.9%, and 151 (42.5%) patients received mechanical ventilation care. Especially, 151 (45.1%) patients showed bacterial co-infection and presented with longer hospital stay, compared with patients infected only with RVI (P = 0.001). Incidence of RVI in ICU patients showed seasonality, with a high incidence in winter season.

Conclusion: The incidence of RVI in ICU patients was not uncommon. Further identification of subjects to be screened for RVI and its clinical implication should be investigated and used as foundation for infection control.