Viral infection in community-acquired pneumonia: A systematic review and meta-analysis

Michael Burk, Karim El-Kersh, Mohamed Saad, Timothy Wiemken, Julio Ramirez, Rodrigo Cavallazzi

Research output: Contribution to journalReview articlepeer-review

67 Scopus citations

Abstract

The advent of PCR has improved the identification of viruses in patients with communityacquired pneumonia (CAP). Several studies have used PCR to establish the importance of viruses in the aetiology of CAP. We performed a systematic review and meta-analysis of the studies that reported the proportion of viral infection detected via PCR in patients with CAP. We excluded studies with paediatric populations. The primary outcome was the proportion of patients with viral infection. The secondary outcome was short-term mortality. Our review included 31 studies. Most obtained PCR via nasopharyngeal or oropharyngeal swab. The pooled proportion of patients with viral infection was 24.5% (95% CI 21.5–27.5%). In studies that obtained lower respiratory samples in >50% of patients, the proportion was 44.2% (95% CI 35.1–53.3%). The odds of death were higher in patients with dual bacterial and viral infection (OR 2.1, 95% CI 1.32–3.31). Viral infection is present in a high proportion of patients with CAP. The true proportion of viral infection is probably underestimated because of negative test results from nasopharyngeal or oropharyngeal swab PCR. There is increased mortality in patients with dual bacterial and viral infection.

Original languageEnglish (US)
Pages (from-to)178-188
Number of pages11
JournalEuropean Respiratory Review
Volume25
Issue number140
DOIs
StatePublished - Jun 1 2016
Externally publishedYes

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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