Detection of influenza, RSV, and human metapneumovirus was strongly associated with community-acquired pneumonia across all ages (attributable fractions near 1.0), whereas other viruses varied by age.
Case-Control (n=1,783)
Does the detection of specific respiratory viruses by RT-PCR indicate an etiologic role in community-acquired pneumonia across different age groups?
The etiologic significance of respiratory viruses detected by RT-PCR in CAP varies significantly by virus type and patient age, with influenza, RSV, and hMPV being strong indicators of disease.
BACKGROUND: The clinical significance of viruses detected in patients with community-acquired pneumonia (CAP) is often unclear. METHODS: We conducted a prospective study to identify the prevalence of 13 viruses in the upper respiratory tract of patients with CAP and concurrently enrolled asymptomatic controls with real-time reverse-transcriptase polymerase chain reaction. We compared age-stratified prevalence of each virus between patients with CAP and controls and used multivariable logistic regression to calculate attributable fractions (AFs). RESULTS: We enrolled 1024 patients with CAP and 759 controls. Detections of influenza, respiratory syncytial virus, and human metapneumovirus were substantially more common in patients with CAP of all ages than in controls (AFs near 1.0). Parainfluenza and coronaviruses were also more common among patients with CAP (AF, 0.5-0.75). Rhinovirus was associated with CAP among adults (AF, 0.93) but not children (AF, 0.02). Adenovirus was associated with CAP only among children <2 years old (AF, 0.77). CONCLUSIONS: The probability that a virus detected with real-time reverse-transcriptase polymerase chain reaction in patients with CAP contributed to symptomatic disease varied by age group and specific virus. Detections of influenza, respiratory syncytial virus, and human metapneumovirus among patients with CAP of all ages probably indicate an etiologic role, whereas detections of parainfluenza, coronaviruses, rhinovirus, and adenovirus, especially in children, require further scrutiny.
Self et al. (Tue,) conducted a case-control in Community-Acquired Pneumonia (CAP) (n=1,783). Viral detection of 13 viruses via RT-PCR vs. Asymptomatic controls was evaluated on Age-stratified prevalence of each virus and attributable fractions (AFs). Detection of influenza, RSV, and human metapneumovirus was strongly associated with community-acquired pneumonia across all ages (attributable fractions near 1.0), whereas other viruses varied by age.
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