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Viral infection in community acquired pneumonia patients with fever: a prospective observational study

	author = {Ru-Jia Tao and Xiao-Li Luo and Wen Xu and Bei Mao and Ruo-Xuan Dai and Cheng-Wei Li and Li Yu and Fen Gu and Shuo Liang and Hai-Wen Lu and Ke-Bin Chen and Jiu-Wu Bai and Xiao-Bin Ji and Shu-Yi Gu and Xiao-Li Sun and Fa-Hui Dai and Ping Jiang and Wei-Jun Cao and Jin-Fu Xu},
	title = {Viral infection in community acquired pneumonia patients with fever: a prospective observational study},
	journal = {Journal of Thoracic Disease},
	volume = {10},
	number = {7},
	year = {2018},
	keywords = {},
	abstract = {Background: Patients with community acquired pneumonia (CAP) caused by viruses can develop severe complications, which result in hospitalization and death. The purpose of this study was to analyse the aetiology, incidence, clinical characteristics, and outcomes of CAP patients with fever during non-pandemics, and then to provide theoretical basis for accurate diagnosis and treatment in CAP patients.
Methods: An enrolment system was established for monitoring the CAP patients with fever. Multiplex polymerase chain reaction (mPCR) kits were used to detect 10 viruses [influenza A and B, adenovirus (ADV), respiratory syncytial virus (RSV) A and B, picornavirus, parainfluenza virus (PIV), coronavirus, human metapneumovirus (HMPV), and bocavirus]. Data on age, gender, underlying diseases, complications, laboratory indexes, and outcomes were collected by physicians.
Results: This prospective study included 320 patients with fever. Among them, 23.4% were viral-positive by mPCR, with influenza virus most prominent followed by picornavirus. Strong variation in seasonal distribution was shown in viral infections, with peak months from December to February. Patients with influenza infection were likely to be taken to emergency rooms and have respiratory failure with higher creatinine kinase levels and lower white blood cell counts. Streptococcus pneumoniae followed by haemophilus influenzae were the most common bacteria in viral co-infections, which accounted for one third of virus-positive patients. Viral CAP and mixed CAP were not independent factors for death. In addition, lactate dehydrogenase (LDH) >246 IU/L [odds ratio (OR) =7.06, 95% confidence interval (CI): 2.15–23.2, P=0.001], and serum calcium },
	issn = {2077-6624},	url = {}