Spectrum of respiratory viral infectionsin liver disease patients with cirrhosis admitted in critical care unit

Vijeta Bajpai; Ekta Gupta; Lalita Gauri Mitra; Hemant Kumar; Rakhi Maiwall; Kapil Dev Soni; Amit Gupta

doi:10.4103/JLP.JLP_6_19

Journal of Laboratory Physicians, Table of Contents

CC BY-NC-ND 4.0 · J Lab Physicians 2019; 11(04): 356-360
DOI: 10.4103/JLP.JLP_6_19

Original Article

Spectrum of respiratory viral infectionsin liver disease patients with cirrhosis admitted in critical care unit

Vijeta Bajpai

Departments of Clinical Virology, JPNATC, All India Institute of Medical Sciences, New Delhi, India

,

Ekta Gupta

Departments of Clinical Virology, JPNATC, All India Institute of Medical Sciences, New Delhi, India

,

Lalita Gauri Mitra

Critical Care and Anaesthesia, JPNATC, All India Institute of Medical Sciences, New Delhi, India

,

Hemant Kumar

Pulmonary Medicine, JPNATC, All India Institute of Medical Sciences, New Delhi, India

,

Rakhi Maiwall

Hepatology, Institute of Liver and Biliary Sciences, JPNATC, All India Institute of Medical Sciences, New Delhi, India

,

Kapil Dev Soni

Department of Trauma and Critical Intensive Care Unit, JPNATC, All India Institute of Medical Sciences, New Delhi, India

,

Amit Gupta

Department of Surgery, JPNATC, All India Institute of Medical Sciences, New Delhi, India

› Author Affiliations

Abstract

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Abstract

BACKGROUND: Clinical significance of respiratory viruses (RVs) as an etiology of pneumonia in liver disease patients with cirrhosis is usually underestimated. Therefore, the aim of this study was to evaluate the spectrum of RVs in cirrhotic patients with pneumonia admitted in critical care units (CCUs) and its impact on the clinical outcome of cirrhotic patients.

MATERIAL AND METHOD: A prospective study was conducted in a tertiary care CCU, and consecutive cirrhotic patients with pneumonia were included. Bronchoalveolar lavage or throat swab/nasal swab was collected in viral transport medium for analysis of RVs by multiplex real-time polymerase chain reaction. A total of 135 cirrhotic patients were included, viral and bacterial etiology of pneumonia was identified, and analysis was done with the clinical outcome.

RESULTS: Overall, RVs were detected in 30 (22.2%) cirrhotic patients and viral–bacterial coinfection in 16 (11.8%) cirrhotic patients. The most common virus detected was rhinovirus in 9 (30%) patients. Mortality in cirrhotic patients with RV infection was significantly higher in comparison to cirrhotic patients with no RV infection (25 [83.3%] and 11 [12.3%], respectively, P < 0.001).

CONCLUSION: Respiratory viruses in cirrhotic patients with pneumonia are associated with poor clinical outcome.

Key words

Care - chronic liver disease - critical - pneumonia - respiratory virus - unit - viral–bacterial coinfection

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References

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