Characteristics and Outcomes of Patients with Pulmonary Acute Respiratory Distress Syndrome Infected with Influenza versus Other Respiratory Viruses

Yoo, Jung-Wan; Ju, Sunmi; Lee, Seung Jun; Cho, Min-Chul; Cho, Yu Ji; Jeong, Yi Yeong; Lee, Jong Deog; Kim, Ho Choel

Patients diagnosed with pulmonary ARDS who were admitted to the medical ICU at a tertiary hospital and received invasive mechanical ventilation were searched from January 2014 to June 2018. ARDS was fulfilled for the Berlin diagnostic criteria 12 . Among them, those who underwent RT-PCR for respiratory viral infection were reviewed. Respiratory specimens such as bronchial and endotracheal aspirate, nasopharyngeal swab or sputum were obtained for RT-PCR analysis. AdvanSure RV real-time RT-PCR (LG Chemistry, Seoul, Korea) assay based on the multiplex polymerase chain reaction method was used to identify respiratory viruses (influenza virus, parainfluenza virus, respiratory syncytial virus, adenovirus, metapneumovirus, rhinovirus, bocavrius, and coronavirus). Baseline (age, sex, body mass index, and comorbidities) and clinical characteristics (Acute Physiology and Chronic Health Evaluation [APACHE] II score, Sequential Organ Failure Assessment [SOFA] score, clinical complications [shock, acute kidney injury], management, etc.) were assessed. Additionally, data from laboratory (neutrophil count, lymphocyte count, hemoglobin, platelet, C-reactive protein [CRP] level, total protein level, albumin level, etc.), microbiologic data (types of respiratory virus, co-respiratory bacterial or fungal pathogens) and clinical outcomes (length of stay in ICU and hospital, mortality) were analyzed. This study was approved by the Institutional Review Board of Gyeongsang National University Hospital (No. 2018-05-015). Informed consent was waived due to retrospective nature of the study. The study was in accordance with the ethical standards of institutional and/or national research committees and with the Helsinki declaration and its later amendments or comparable ethical standards.