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Respiratory virus coinfection associated with more complications
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Patients hospitalized with respiratory virus coinfection, particularly with influenza A(H1N1), were more likely to have chest radiograph changes that were suggestive of viral pneumonia, according to data published in PLOS One.
“We thought that coinfection might be a risk factor for ICU admission or ICU length of stay, but that was not the case,” Leonard Mermel, DO, professor of medicine at Warren Alpert Medical School of Brown University, told Infectious Disease News. “These patients were more likely to be treated for a presumed secondary bacterial pneumonia. It is unclear how often the greater antibacterial treatment in coinfected patients reflected true bacterial superinfection or unnecessary antibacterial treatment for viral pneumonia.”
Leonard Mermel
Mermel and colleagues conducted a retrospective cohort study of all patients hospitalized with confirmed respiratory virus coinfection. These 49 patients were compared with 617 patients with a confirmed virus monoinfection. Among the coinfected patients, 49% had H1N1.
Those with coinfection were younger, with a mean age of 8.8 years compared with 21 years for those with monoinfection. The coinfected patients also were more likely to have fever/chills, tachypnea and chest radiograph features indicative of viral pneumonia. Although likelihood of death, the length of hospital stay and the need for ICU care were similar between the groups, coinfected patients were more likely to have complications, such as treatment for a secondary bacterial pneumonia.
“Objective measures to detect bacterial superinfection should be utilized in patients with respiratory viral coinfection, prior to the start of antibacterial treatment, if at all possible,” Mermel said. “Future studies should evaluate whether viral coinfection truly is associated with bacterial superinfection.”
Leonard Mermel, DO, can be reached at Division of Infectious Diseases, Rhode Island Hospital, 593 Eddy St., Providence, RI 02903; email: lmermel@lifespan.org.
Disclosure: Mermel reports no relevant financial disclosures.
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