An international perspective on hospitalized patients with viral community-acquired pneumonia

Radovanovic, D.; Sotgiu, G.; Jankovic, M.; Mahesh, P. A.; Marcos, P. J.; Abdalla, M. I.; Di Pasquale, M. F.; Gramegna, A.; Terraneo, S.; Blasi, F.; Santus, P.; Aliberti, S.; Reyes, L. F.; Restrepo, M. I.; Aruj, P. K.; Attorri, S.; Barimboim, E.; Caeiro, J. P.; Garzon, M. I.; Cambursano, V. H.; Ceccato, A.; Chertcoff, J.; Cordon Diaz, A.; de Vedia, L.; Ganaha, M. C.; Lambert, S.; Lopardo, G.; Luna, C. M.; Malberti, A. G.; Morcillo, N.; Tartara, S.; Pensotti, C.; Pereyra, B.; Scapellato, P. G.; Stagnaro, J. P.; Shah, S.; Lotsch, F.; Thalhammer, F.; Anseeuw, K.; Francois, C. A.; Van Braeckel, E.; Vincent, J. L.; Djimon, M. Z.; Aranha Nouer, S.; Chipev, P.; Encheva, M.; Miteva, D.; Petkova, D.; Balkissou, A. D.; Pefura Yone, E. W.; Mbatchou Ngahane, B. H.; Shen, N.; J. -F., Xu; Bustamante Rico, C. A.; Buitrago, R.; Pereira Paternina, F. J.; Kayembe Ntumba, J. -M.; Vladic-Carevic, V.; Jakopovic, M.; Matkovic, Z.; Mitrecic, I.; Bouchy Jacobsson, M. -L.; Bro Christensen, A.; Bodtger, U.; Meyer, C. N.; Vestergaard Jensen, A.; El-Said Abd El-Wahhab, I.; Elsayed Morsy, N.; Shafiek, H.; Sobh, E.; Abdulsemed, K. A.; Bertrand, F.; Brun-Buisson, C.; de Montmollin, E.; Fartoukh, M.; Messika, J.; Tattevin, P.; Khoury, A.; Ebruke, B.; Dreher, M.; Kolditz, M.; Meisinger, M.; Pletz, M. W.; Hagel, S.; Rupp, J.; Schaberg, T.; Spielmanns, M.; Creutz, P.; Suttorp, N.; Siaw-Lartey, B.; Dimakou, K.; Papapetrou, D.; Tsigou, E.; Ampazis, D.; Kaimakamis, E.; Bhatia, M.; Dhar, R.; D'Souza, G.; Garg, R.; Koul, P. A.; Jayaraj, B. S.; Narayan, K. V.; Udnur, H. B.; Krishnamurthy, S. B.; Kant, S.; Swarnakar, R.; Salvi, S.; Limaye, S.; Golshani, K.; Keatings, V. M.; Martin-Loeches, I.; Maor, Y.; Strahilevitz, J.; Battaglia, S.; Carrabba, M.; Ceriana, P.; Confalonieri, M.; d'Arminio Monforte, A.; Del Prato, B.; De Rosa, M.; Fantini, R.; Fiorentino, G.; Gammino, M. A.; Menzella, F.; Milani, G.; Nava, S.; Palmiero, G.; Petrino, R.; Gabrielli, B.; Rossi, P.; Sorino, C.; Steinhilber, G.; Zanforlin, A.; Franzetti, F.; Carone, M.; Patella, V.; Scarlata, S.; Comel, A.; Kurahashi, K.; Aoun Bacha, Z.; Barajas Ugalde, D.; Ceballos Zuniga, O.; Villegas, J. F.; Medenica, M.; van de Garde, E. M. W.; Raj Mihsra, D.; Shrestha, P.; Ridgeon, E.; Ishola Awokola, B.; Nwankwo, O. N. O.; Olufunlola, A. B.; Olumide, S.; Ukwaja, K. N.; Irfan, M.; Minarowski, L.; Szymon, S.; Froes, F.; Leuschner, P.; Meireles, M.; Ferrao, C.; Neves, J.; Ravara, S. B.; Brocovschii, V.; Ion, C.; Rusu, D.; Toma, C.; Chirita, D.; Dorobat, C. M.; Birkun, A.; Kaluzhenina, A.; Almotairi, A.; Bukhary, Z. A. A.; Edathodu, J.; Fathy, A.; Mushira Abdulaziz Enani, A.; Eltayeb Mohamed, N.; Ulhadi Memon, J.; Bella, A.; Bogdanovic, N.; Milenkovic, B.; Pesut, D.; Borderias, L.; Bordon Garcia, N. M.; Cabello Alarcon, H.; Cilloniz, C.; Torres, A.; Diaz-Brito, V.; Casas, X.; Encabo Gonzalez, A.; Fernandez-Almira, M. L.; Gallego, M.; Gaspar-GarcIa, I.; Gonzalez Del Castillo, J.; Javaloyes Victoria, P.; Laserna Martinez, E.; Malo de Molina, R.; Menendez, R.; Pando-Sandoval, A.; Prat Aymerich, C.; Lacoma de la Torre, A.; Garcia-Olive, I.; Rello, J.; Moyano, S.; Sanz, F.; Sibila, O.; Rodrigo-Troyano, A.; Sole-Violan, J.; Uranga, A.; van Boven, J. F. M.; Vendrell Torra, E.; Pujol, J. A.; Feldman, C.; Kee Yum, H.; Fiogbe, A. A.; Yangui, F.; Bilaceroglu, S.; Dalar, L.; Yilmaz, U.; Bogomolov, A.; Elahi, N.; Dhasmana, D. J.; Feneley, A.; Hancock, C.; Hill, A. T.; Rudran, B.; Ruiz-Buitrago, S.; Campbell, M.; Whitaker, P.; Youzguin, A.; Singanayagam, A.; Allen, K. S.; Brito, V.; Dietz, J.; Dysart, C. E.; Kellie, S. M.; Franco-Sadud, R. A.; Meier, G.; Gaga, M.; Holland, T. L.; Bergin, S. P.; Kheir, F.; Landmeier, M.; Lois, M.; Nair, G. B.; Patel, H.; Reyes, K.; Rodriguez-Cintron, W.; Saito, S.; Soni, N. J.; Noda, J.; Hinojosa, C. I.; Levine, S. M.; Angel, L. F.; Anzueto, A.; Scott Whitlow, K.; Hipskind, J.; Sukhija, K.; Totten, V.; Wunderink, R. G.; Shah, R. D.; Mateyo, K. J.; Carugati, M.; Morosi, M.; Monge, E.

doi:10.1016/j.ejim.2018.10.020

Background: Who should be tested for viruses in patients with community acquired pneumonia (CAP), prevalence and risk factors for viral CAP are still debated. We evaluated the frequency of viral testing, virus prevalence, risk factors and treatment coverage with oseltamivir in patients admitted for CAP. Methods: Secondary analysis of GLIMP, an international, multicenter, point-prevalence study of hospitalized adults with CAP. Testing frequency, prevalence of viral CAP and treatment with oseltamivir were assessed among patients who underwent a viral swab. Univariate and multivariate analysis was used to evaluate risk factors. Results: 553 (14.9%) patients with CAP underwent nasal swab. Viral CAP was diagnosed in 157 (28.4%) patients. Influenza virus was isolated in 80.9% of cases. Testing frequency and viral CAP prevalence were inhomogeneous across the participating centers. Obesity (OR 1.59, 95%CI: 1.01–2.48; p = 0.043) and need for invasive mechanical ventilation (OR 1.62, 95%CI: 1.02–2.56; p = 0.040) were independently associated with viral CAP. Prevalence of empirical treatment with oseltamivir was 5.1%. Conclusion: In an international scenario, testing frequency for viruses in CAP is very low. The most common cause of viral CAP is Influenza virus. Obesity and need for invasive ventilation represent independent risk factors for viral CAP. Adherence to recommendations for treatment with oseltamivir is poor.