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

One hundred sixty-seven patients with pulmonary ARDS were admitted to the medical ICU. Figure 1 shows flow of patients with ARDS during the period. One hundred and twenty-six patients with pulmonary ARDS (75.4%) underwent multiplex RT-PCR to evaluate the presence of respiratory viral infection, which was identified in 46% (58/126) subjects. Community-acquired respiratory viral infection was identified The mean age of patients was 67.6±13.3 years and the proportion of men was 70.7%. In all cases, the risk factor for pul- Table 2 compares laboratory results and radiologic scores of patients with influenza and those with other viruses. There was a trend toward higher hemoglobin and CRP levels in patients with influenza than in those with other respiratory viruses. No significant difference was observed in other parameters between the two groups. Transthoracic echocardiography was done in 75.9% (44/58) patients on admission of medical intensive care unit to evaluate acute heart failure. The mean ejection fraction was 59.2%±7.76%. Stress induced cardiomyopathy and right ventricular dysfunction were featured in three (6.7%) and five (11.1%) patients, respectively. Table 3 enlists the types of respiratory viruses and corespiratory pathogens in patients with pulmonary ARDS. Influenza A was the most common virus (21 cases) and other respiratory virus infection (10 coronavirus, 5 RSV, 4 parainfluenza virus, 4 rhinovirus, 3 adenovirus, 3 metapneumovirus, and 1 bocavirus) were isolated. Overall 43.1% co-respiratory Table 4 . Patients with influenza virus were treated with neuraminidase inhibitor such as oseltamivir or peramivir but those any antiviral agent was not administered in those with other respiratory viruses. Overall ICU mortality and hospital mortality rates were 51.7% and 55.2%, respectively. There were no significant differences in extubation success, duration of mechanical ventilation, mortality, and length of stay in the ICU and hospital.