Community-acquired viral pneumonias: etiological peculiarities

Abstract

Introduction. Molecular diagnostic tests have greatly increased our understanding of the role of viruses in pneumonia, and findings indicate that the incidence of viral pneumonia has been underestimated. Depending on the virulence of the organism, as well as the age and comorbidities of the patient, viral pneumonia can vary from a mild, self-limited illness to a lifethreatening disease. Aim of the study. The aim of study is to highlight the etiological pecularities of communityaquired viral pneumonias. Materials and methods. In the study were included the patients admitted to Sfanta Treime Municipal Hospital during the year 2019 with community-acquired pneumonia (CAP) and tested for viral infections. The patients were chosen based on the clinical criteria: the presence of fever, acute onset, asthenia, myalgia, headache, cough, expectoration and dyspnea. The testing methods included detection of respiratory viruses in nasopharyngeal swabs by PCR and microbiological testing by blood and sputum cultures. Results. Of 52 patients with CAP tested, the viral etiology was found in 42.3% (22/50). The most common was influenza A (H1N1) virus – 77.3% (17/22). Other detected viruses were rhinovirus 13.6% (3/22), metapneumovirus - 4.5% (1/22) and influenza A (H3N2) virus – 4.5% (1/22). In the majority of cases CAP had mixed viral and bacterial etiology. The most frequent association was with streptococci (Streptococcus viridans and Streptococcus betahaemolyticus). The CAP caused by influenza A (H1N1) virus was frequently associated with severe evolution - 54.5% (12/22) and in 9.1% cases (2/22) it even lead to lethal outcome. Conclusions. Viral etiology of community-acquired pneumonia is frequently detected, especially in patients with severe pneumonia. In many cases there is a mixed viral and bacterial infection.