Viral reactivation in the lungs of patients with severe pneumonia is associated with increased mortality, a multicenter, retrospective study
Viral reactivation is widespread in patients with severe pneumonia, yet the landscape of viral reactivation in the lungs is not well‐known. This study aims to assess the landscape and clinical features of viral reactivation in the early onset of severe pneumonia in ICU patients. The clinical data fr...
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| Veröffentlicht in: | Journal of medical virology 2023-01, Vol.95 (1), p.e28337-n/a |
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| creator | Huang, Lingtong Zhang, Xuan Pang, Lisha Sheng, Peng Wang, Yanqiu Yang, Fan Yu, Huili Huang, Xiaohan Zhu, Yue Zhang, Ning Cai, Hongliu Tang, Lingling Fang, Xueling |
| description | Viral reactivation is widespread in patients with severe pneumonia, yet the landscape of viral reactivation in the lungs is not well‐known. This study aims to assess the landscape and clinical features of viral reactivation in the early onset of severe pneumonia in ICU patients. The clinical data from 97 patients were collected retrospectively from the intensive care units of five teaching hospitals between June 2018 and July 2021. Metagenomic next‐generation sequencing (mNGS) of the bronchoalveolar lavage fluid (BALF) was performed at the onset of severe pneumonia. Cytomegalovirus (CMV), herpes simplex virus‐1 (HSV‐1), and Epstein‐Barr virus (EBV) were the most common reactivated viruses in the lower respiratory tract of patients with severe pneumonia. After adjusting for the risk of confounding and competition of age, sex, sequential organ failure assessment, acute physiology chronic health assessment II and immunosuppression status, viral reactivation resulted in an overall 2.052‐fold increase in 28‐day all‐cause mortality (95% CI: 1.004–4.194). This study showed that CMV, HSV‐1, and EBV were the most common reactivated viruses in the lungs of patients with severe pneumonia. The existence of viral reactivations was associated with an increased risk of mortality. The simultaneous reactivation of multiple viruses needs to be considered in the design of clinical trials. |
| doi_str_mv | 10.1002/jmv.28337 |
| format | Article |
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This study aims to assess the landscape and clinical features of viral reactivation in the early onset of severe pneumonia in ICU patients. The clinical data from 97 patients were collected retrospectively from the intensive care units of five teaching hospitals between June 2018 and July 2021. Metagenomic next‐generation sequencing (mNGS) of the bronchoalveolar lavage fluid (BALF) was performed at the onset of severe pneumonia. Cytomegalovirus (CMV), herpes simplex virus‐1 (HSV‐1), and Epstein‐Barr virus (EBV) were the most common reactivated viruses in the lower respiratory tract of patients with severe pneumonia. After adjusting for the risk of confounding and competition of age, sex, sequential organ failure assessment, acute physiology chronic health assessment II and immunosuppression status, viral reactivation resulted in an overall 2.052‐fold increase in 28‐day all‐cause mortality (95% CI: 1.004–4.194). This study showed that CMV, HSV‐1, and EBV were the most common reactivated viruses in the lungs of patients with severe pneumonia. The existence of viral reactivations was associated with an increased risk of mortality. The simultaneous reactivation of multiple viruses needs to be considered in the design of clinical trials.</description><identifier>ISSN: 0146-6615</identifier><identifier>EISSN: 1096-9071</identifier><identifier>DOI: 10.1002/jmv.28337</identifier><identifier>PMID: 36418241</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Bronchus ; Clinical trials ; Cytomegalovirus ; Cytomegalovirus - physiology ; Cytomegalovirus Infections ; Epstein-Barr virus ; Epstein-Barr Virus Infections ; Herpes simplex ; herpes simplex virus ; Herpesvirus 1, Human ; Herpesvirus 4, Human - physiology ; Hospitals ; Humans ; Immunosuppression ; Intensive care units ; Lavage ; Lung ; Lungs ; Metagenomics ; mNGS ; Mortality ; Patients ; Pneumonia ; Pneumonia, Viral ; reactivation ; Respiratory tract ; Retrospective Studies ; Short Communication ; Short Communications ; Virology ; Viruses</subject><ispartof>Journal of medical virology, 2023-01, Vol.95 (1), p.e28337-n/a</ispartof><rights>2022 The Authors. published by Wiley Periodicals LLC.</rights><rights>2022 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC.</rights><rights>2022. This article is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4447-b0083aa036bd1f1e74701dba01bf5c3ed7cdfb345a9f136b43816b5185e9b5d23</citedby><cites>FETCH-LOGICAL-c4447-b0083aa036bd1f1e74701dba01bf5c3ed7cdfb345a9f136b43816b5185e9b5d23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjmv.28337$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjmv.28337$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36418241$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huang, Lingtong</creatorcontrib><creatorcontrib>Zhang, Xuan</creatorcontrib><creatorcontrib>Pang, Lisha</creatorcontrib><creatorcontrib>Sheng, Peng</creatorcontrib><creatorcontrib>Wang, Yanqiu</creatorcontrib><creatorcontrib>Yang, Fan</creatorcontrib><creatorcontrib>Yu, Huili</creatorcontrib><creatorcontrib>Huang, Xiaohan</creatorcontrib><creatorcontrib>Zhu, Yue</creatorcontrib><creatorcontrib>Zhang, Ning</creatorcontrib><creatorcontrib>Cai, Hongliu</creatorcontrib><creatorcontrib>Tang, Lingling</creatorcontrib><creatorcontrib>Fang, Xueling</creatorcontrib><title>Viral reactivation in the lungs of patients with severe pneumonia is associated with increased mortality, a multicenter, retrospective study</title><title>Journal of medical virology</title><addtitle>J Med Virol</addtitle><description>Viral reactivation is widespread in patients with severe pneumonia, yet the landscape of viral reactivation in the lungs is not well‐known. This study aims to assess the landscape and clinical features of viral reactivation in the early onset of severe pneumonia in ICU patients. The clinical data from 97 patients were collected retrospectively from the intensive care units of five teaching hospitals between June 2018 and July 2021. Metagenomic next‐generation sequencing (mNGS) of the bronchoalveolar lavage fluid (BALF) was performed at the onset of severe pneumonia. Cytomegalovirus (CMV), herpes simplex virus‐1 (HSV‐1), and Epstein‐Barr virus (EBV) were the most common reactivated viruses in the lower respiratory tract of patients with severe pneumonia. After adjusting for the risk of confounding and competition of age, sex, sequential organ failure assessment, acute physiology chronic health assessment II and immunosuppression status, viral reactivation resulted in an overall 2.052‐fold increase in 28‐day all‐cause mortality (95% CI: 1.004–4.194). This study showed that CMV, HSV‐1, and EBV were the most common reactivated viruses in the lungs of patients with severe pneumonia. The existence of viral reactivations was associated with an increased risk of mortality. The simultaneous reactivation of multiple viruses needs to be considered in the design of clinical trials.</description><subject>Bronchus</subject><subject>Clinical trials</subject><subject>Cytomegalovirus</subject><subject>Cytomegalovirus - physiology</subject><subject>Cytomegalovirus Infections</subject><subject>Epstein-Barr virus</subject><subject>Epstein-Barr Virus Infections</subject><subject>Herpes simplex</subject><subject>herpes simplex virus</subject><subject>Herpesvirus 1, Human</subject><subject>Herpesvirus 4, Human - physiology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Immunosuppression</subject><subject>Intensive care units</subject><subject>Lavage</subject><subject>Lung</subject><subject>Lungs</subject><subject>Metagenomics</subject><subject>mNGS</subject><subject>Mortality</subject><subject>Patients</subject><subject>Pneumonia</subject><subject>Pneumonia, Viral</subject><subject>reactivation</subject><subject>Respiratory tract</subject><subject>Retrospective Studies</subject><subject>Short Communication</subject><subject>Short Communications</subject><subject>Virology</subject><subject>Viruses</subject><issn>0146-6615</issn><issn>1096-9071</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNp1kc1u1DAUhS1ERYeBBS-ALLEBqWl9bedvVaEKaFERG-jWcpKbjkeJHWxnqnkHHhoPaStAYmXZ_nTuuecQ8grYKTDGz7bj7pRXQpRPyApYXWQ1K-EpWTGQRVYUkB-T5yFsGWNVzfkzciwKCRWXsCI_b4zXA_Wo22h2OhpnqbE0bpAOs70N1PV0Ss9oY6B3Jm5owB16pJPFeXTWaGoC1SG41uiI3cIY2ybFkK6j81EPJu5PqKbjPETTJin0J2lk9C5MeJiLNMS5278gR70eAr68P9fk-8cP3y4us-uvn64u3l9nrZSyzJq0h9CaiaLpoAcsZcmgazSDps9bgV3Zdn0jZK7rHhIkRQVFk0OVY93kHRdrcr7oTnMzYndwlEJQkzej9nvltFF__1izUbdup1LadV2lqNfk7b2Cdz9mDFGNJrQ4DNqim4PipahLKbnME_rmH3TrZm_TfokqAGrggiXq3UK1KZTgsX90A-wwlqtUsvpdcmJf_2n_kXxoNQFnC3BnBtz_X0l9_nKzSP4C4-q1Ig</recordid><startdate>202301</startdate><enddate>202301</enddate><creator>Huang, Lingtong</creator><creator>Zhang, Xuan</creator><creator>Pang, Lisha</creator><creator>Sheng, Peng</creator><creator>Wang, Yanqiu</creator><creator>Yang, Fan</creator><creator>Yu, Huili</creator><creator>Huang, Xiaohan</creator><creator>Zhu, Yue</creator><creator>Zhang, Ning</creator><creator>Cai, Hongliu</creator><creator>Tang, Lingling</creator><creator>Fang, Xueling</creator><general>Wiley Subscription Services, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7TK</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>202301</creationdate><title>Viral reactivation in the lungs of patients with severe pneumonia is associated with increased mortality, a multicenter, retrospective study</title><author>Huang, Lingtong ; 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This study aims to assess the landscape and clinical features of viral reactivation in the early onset of severe pneumonia in ICU patients. The clinical data from 97 patients were collected retrospectively from the intensive care units of five teaching hospitals between June 2018 and July 2021. Metagenomic next‐generation sequencing (mNGS) of the bronchoalveolar lavage fluid (BALF) was performed at the onset of severe pneumonia. Cytomegalovirus (CMV), herpes simplex virus‐1 (HSV‐1), and Epstein‐Barr virus (EBV) were the most common reactivated viruses in the lower respiratory tract of patients with severe pneumonia. After adjusting for the risk of confounding and competition of age, sex, sequential organ failure assessment, acute physiology chronic health assessment II and immunosuppression status, viral reactivation resulted in an overall 2.052‐fold increase in 28‐day all‐cause mortality (95% CI: 1.004–4.194). This study showed that CMV, HSV‐1, and EBV were the most common reactivated viruses in the lungs of patients with severe pneumonia. The existence of viral reactivations was associated with an increased risk of mortality. The simultaneous reactivation of multiple viruses needs to be considered in the design of clinical trials.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>36418241</pmid><doi>10.1002/jmv.28337</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Bronchus Clinical trials Cytomegalovirus Cytomegalovirus - physiology Cytomegalovirus Infections Epstein-Barr virus Epstein-Barr Virus Infections Herpes simplex herpes simplex virus Herpesvirus 1, Human Herpesvirus 4, Human - physiology Hospitals Humans Immunosuppression Intensive care units Lavage Lung Lungs Metagenomics mNGS Mortality Patients Pneumonia Pneumonia, Viral reactivation Respiratory tract Retrospective Studies Short Communication Short Communications Virology Viruses |
| title | Viral reactivation in the lungs of patients with severe pneumonia is associated with increased mortality, a multicenter, retrospective study |
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