Key result
Viral infection in nonresponding community-acquired pneumonia was specifically associated with ground-glass opacity combined with consolidation, with no differences in clinical or laboratory findings.
Why the study?
It was unclear whether viral infection plays an important role in nonresponding CAP etiology and whether clinical characteristics differ between viral and nonviral cases.
Does viral infection present with different clinical, laboratory, and radiographic characteristics compared to nonviral infection in patients with nonresponding community-acquired pneumonia?
Cohort
Does viral infection present with different clinical, laboratory, and radiographic characteristics compared to nonviral infection in patients with nonresponding community-acquired pneumonia?
Viral infections are frequent in nonresponding CAP and are specifically associated with ground-glass opacity combined with consolidation on imaging.
May suggest viral etiology via imaging in nonresponding CAP despite similar labs; leaves open prospective validation before guiding testing or therapy.
Background: Nonresponding pneumonia is responsible for the most mortality of community-acquired pneumonia (CAP). However, thus far, it is not clear whether viral infection plays an important role in the etiology of nonresponding CAP and whether there is a significant difference in the clinical characteristics between viral and nonviral nonresponding CAP. Methods: From 2016 to 2019, nonresponding CAP patients were retrospectively enrolled in our study. All patients received bronchoalveolar lavage (BAL) and virus detection in BAL fluid by multiplex real-time polymerase chain reaction (PCR), and clinical, laboratory, and radiographic data were collected. Results: = 7) were more frequently detected, and others included herpes simplex virus, human enterovirus, cytomegalovirus, human coronavirus 229E, rhinovirus, and parainfluenza virus. Compared with nonviral nonresponding CAP, only ground-glass opacity combined with consolidation was a more common imaging manifestation in viral nonresponding CAP. However, no obvious differences were found in clinical and laboratory findings between the presence and the absence of viral infections. Conclusions: Viral infections were particularly frequent in adults with nonresponding CAP. The ground-glass opacity combined with consolidation was a specific imaging manifestation for viral nonresponding CAP, while the clinical and laboratory data showed no obvious differences between viral and nonviral nonresponding CAP.
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Zhang et al. (2020) conducted a cohort in Nonresponding community-acquired pneumonia. Viral infection vs. Absence of viral infection (nonviral nonresponding CAP) was evaluated on Clinical, laboratory, and radiographic manifestations. Viral infection in nonresponding community-acquired pneumonia was specifically associated with ground-glass opacity combined with consolidation, with no differences in clinical or laboratory findings.
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