Predictors of viral pneumonia in patients with community-acquired pneumonia
Viruses are increasingly detected as major causes of community-acquired pneumonia (CAP), and early antiviral therapy affects the outcome. However, few studies were performed about the clinical predictors of viral pneumonia. In this study, we investigated the clinical predictor of viral pneumonia in patients with CAP, which are helpful for considering diagnostic tests for respiratory viruses and early empirical antiviral therapy.
We retrospectively identified all adult patients (≥ 18 years old) with CAP who were tested by polymerase chain reaction (PCR) test for respiratory virus at two teaching hospitals between October 2010 and May 2013. Demographic and clinical data were collected by reviewing the Electronic Medical Records of the patients.
During the study period, 333 patients with CAP who were tested by respiratory virus PCR were identified. Viral pneumonia (n=53) was associated with rhinorrhea, higher lymphocyte fraction in white blood cells, lower serum creatinine and ground-glass opacity (GGO) in radiography, compared to non-viral pneumonia (n=256) (p<0.05 each). In multivariate analysis, rhinorrhea (HR 2.78; 95% CI, 1.23-6.29) and GGO (HR 3.83; 95% CI, 1.97-7.43) were revealed as independent risk factors for viral pneumonia in patients with CAP. The sensitivity, specificity, positive and negative predictive value (PPV and NPV) of rhinorrhea were 21%, 91%, 32% and 85%: The sensitivity, specificity, PPV and NPV of GGO were and 41%, 84%, 35% and 87%, respectively.
Clinical predictors have low sensitivity to viral pneumonia. However, high specificity and PPV of rhinorrhea and GGO suggest that these can be useful indicators for empirical antiviral therapy.
J. E. Kim,
J. H. Ahn, None
S. K. CHO, None
S. J. Kang, None
K. H. Park, None
S. I. Jung, None
H. C. Jang, None